99 Metcalfe Street, Suite Ottawa, ON K1P 6L7 Ottawa, September 13th, 2024 Letter sent by email to all members of the Standing Senate Committee on Social Affairs, Science and Technology Subject: Small Businesses’ Perspective: Bill C-64,

An Act Respecting Pharmacare Dear Senators, We are writing on behalf of the 97,000 small - and medium-sized enterprises (SMEs) who are members of the Canadian Federation of Independent Business (CFIB). Bill C -64,

An Act Respecting Pharmacare, has passed the House of Commons and is now being studied by the Standing Senate Committee on Social Affairs, Science and Technology. We wanted to take this opportunity to share some survey results with you and recommendations on further deployment of Pharmacare. While the goal behind a single-payer pharmacare system may be commendable, it raises significant concerns among SMEs, particularly regarding the financial responsibilities associated with such a plan.

In fact, a report from the Parliamentary Budget Officer (PBO) estimated that total drug expenditures under a comprehensive, single -payer plan would be $33.2 billion for 2024-25, rising to $38.9 billion by 2027-28.1 As such, there is a significant concern among SMEs about the financial implications of funding a national pharmacare system. SMEs believe that Pharmacare should be funded primarily by cutting existing spending and by making individuals responsible for covering their own premium cost (figure 1).

The financial strain of covering the cost of Pharmacare could be detrimental to the sustainability and growth of many small businesses, which are already operating with limited resources, facing massive cost increases and a difficult business environment. As such, CFIB recommends that the cost of Pharmacare be funded through reallocation o f existing funds rather than through additional or increased payroll taxes.

We also recommend that consultations with SMEs should be conducted prior to any further expansion of the Pharmacare program. 1 Parliamentary Budget Officer (PBO), Cost Estimate of a Single-payer Universal Drug Plan, October 12th, 2023. https://www.pbo-dpb.ca/en/publications/RP-2324-016-S-- cost-estimate-single-payer-universal-drug-plan--estimation-couts-un-regime-assurance-medicaments-universel-payeur-unique Figure To what extent do you agree or disagree with the following options to fund Pharmacare if it were to be implemented? (% response) Source: CFIB, Your Voice – February survey, February 8-21, 2024, final results, n = 3,763.

Should you have any questions or concerns, you can reach us via e-mail at Michelle.Auger@cfib.ca.

Sincerely, Jasmin Guénette Vice-President, National Affairs Michelle Auger Senior Policy Analyst, National Affairs 38 38 6 4 3 2 2 31 27 18 12 7 5 3 10 13 15 17 10 16 10 12 16 53 62 77 70 80 8 7 7 4 3 Reallocate funds by cutting other existing spending and programs Make individuals solely responsible for paying monthly/annual premiums directly to the government Implement a new payroll tax with cost-sharing between employees and their employer Increase personal income taxes Increase the GST from 5% to 7% Increase spending and run larger deficits Implement a new payroll tax that is fully paid by employers Strongly agree Somewhat agree Somewhat disagree Strongly disagree Don’t know/Unsure