The following letter was sent by the Ontario Federation of Labour to The Standing Committee on Health May 22, 2024:


Standing Committee on Health

Sixth Floor, 131 Queen Street

House of Commons

Ottawa ON K1A 0A6


Dear Members of the House of Commons Standing Committee on Health,

The Ontario Federation of Labour (OFL) represents 54 unions and empowers more than a million workers from all regions of the province in their struggle for better working and living conditions. We are pleased to make a submission on Bill C-64, An Act Respecting Pharmacare.

We are dedicated to making the lives of all workers and their families safe, secure, and healthy. We believe that every worker is entitled, without discrimination, to a job with decent wages, benefits, and working conditions. We commit ourselves to the goals of worker democracy, social and economic justice, equality, and peace – and that includes fighting for universal pharmacare for all Ontarians and Canadians.

Prescription drugs are unaffordable for millions of Ontarians today. Too many families worry about how they will pay for their medications. More and more people are being forced to choose between paying for their electricity, housing, medications, and food. And the problem is getting worse – not better – as the cost-of-living skyrockets. People should not be forced to forgo their medicines as prescribed because of cost. Not filling prescriptions, not renewing prescriptions, skipping doses, or splitting pills to make a prescription last longer is a systemic failure. In fact, Canada is the only high-income country with universal health care that does not have universal coverage for prescription drugs.

Ontario’s existing patchwork of private employer-provided benefits plans, and public drug benefit programs leave at least 2.2 million Ontarians with no drug coverage. Across Canada, this figure balloons to 7.5 million people. The reality is that these gaps in coverage suggest everyone in Ontario and in Canada do not currently have the same opportunity for good health. And that’s unacceptable.

The latest 2024 poll from Ledger found that 82 per cent agreed that the federal government has a responsibility to ensure there is prescription drug coverage for all people living in Canada.

Bill C-64, An Act Respecting Pharmacare, represents the most significant enhancement to our health care system since the creation of public health care in Canada. When a full universal single-payer pharmacare is implemented, it will profoundly impact the lives of Canadians by making health care more accessible and affordable. Bill C-64 is an important first step towards a full universal single-payer drug program.


The OFL endorses the recommendations made by the Canadian Labour Congress.

  1. The OFL calls for the speedy passage of Bill C-64 An Act Respecting Pharmacare before the House of Commons and the Senate adjourns for the summer, so that millions of Canadians can access contraception and diabetes drug and device coverage, giving them some relief from the high cost of living.
  2. The OFL urges the federal government to prioritize the signing of bilateral agreements with provinces and territories concurrently with the progression of Bill C-64 through the different legislative stages.
  3. The OFL recommends that the federal government commit to the expansion of Bill C-64, after the Act receives royal assent, to a full national single-payer pharmacare program with first-dollar coverage for a comprehensive list of prescription drugs:
    – that are based on both how well they work, and whether they offer good value for money;
    – starting with an initial list of essential medicines that represents 50 per cent of all prescriptions in Canada; and
    – with the authority of the federal government as the single buyer of prescription drugs for Canada, negotiating the lowest prices for prescription drugs, replacing the current patchwork multiple private and public buyers.
  4. The OFL calls on the government to exercise due diligence in the selection of members for the Committee of Experts, ensuring that there is no conflict of interest that can influence or shape their work in making recommendations of public benefit and respecting options for the operation and financing of national universal single-payer pharmacare. The Committee of Experts’ work is too important, and the common practice of signing disclosure of conflicts forms is not a sufficient safeguard.

The truth is that the current patchwork prescription drug system is very lucrative for big pharmaceutical and insurance companies’ profit margins. Under the current patchwork arrangement, both these industries can manipulate the supply and pricing of prescription drugs to make excessive profits.

Their proposals for changes to the prescription drug system are various fill-in-the-gaps options aimed at extracting more profits from people suffering and managing their illness. These profit-making proposals include solely covering people who do not have either public or private insurance; having the government assume all the financial risks of covering very expensive prescription drugs while private insurance assume good risks of cheaper prescriptions; or transferring federal funding to bridge prescription drug delivery gaps unique to the province without creating a universal approach that is fair across the country.

This highlights the importance of a comprehensive universal single-payer pharmacare as the only solution to the current health care crisis, and the future of economic and social prosperity for Canada. This publicly funded, publicly delivered program will:

  • provide fairness and equity of access to affordable prescription drugs to people across Canada solely based on need;
  • modernize and establish an effective and efficient prescription drug program that makes medicines more affordable, accessible, and safer for people;
  • align and make universal health care (Medicare) in Canada more complete as needed medication will be available not only in hospitals but also outside of hospitals;
  • have a full comprehensive prescription drug list (formulary) comprised of drugs that offer effective therapeutic effects and value for money;
  • provide a more streamlined administrative process through the Canada Drug Agency, offering more public transparency and accountability; and
  • consolidate the buying power for prescription drugs to the federal government, giving it the single authority to negotiate prescription drug prices for the whole of Canada.

More importantly, full comprehensive universal single-payer pharmacare puts people first – not profits. The OFL strongly encourages the committee to quickly pass Bill C-64, An Act Respecting Pharmacare, before the House of Commons and the Senate adjourns for the summer.




Ontario Federation of Labour