On Wednesday afternoon, The Trudeau Liberal government, in alliance with the Conservatives and Bloc Québécois, voted down an NDP bill that would have started the process towards a truly universal pharmacare program, bringing Canada one step closer to Tommy Douglas’s dream of comprehensive healthcare for all Canadians.

NDP MP Peter Julian introduced Bill C-213, the Canada Pharmacare Act, but it failed by a vote of 295 to 32. While the Greens joined with the NDP to support this legislation, the vast majority of Liberals, Tories, and Bloc MPs were against it. There were some exceptions, such as Tory MP Ben Lobb, and Liberals Nathaniel Erskine-Smith and Wayne Long.

Crucially, the entire Trudeau cabinet opposed an effort which would have kept a landmark promise made by the prime minister in the past election: “And that’s why we’re going to implement universal pharmacare, so all Canadians can get the prescription drugs they need.” As NDP MP Matthew Green said on Twitter, this promise “Aged like milk.” Likewise, the Canadian Federation of Nurses Unions slammed the broken promise. CFNU President Linda Silas said:

I am not only disappointed with the outcome of today’s vote, but I am left wondering how so many Liberal MPs can justify rejecting this bill. The bill closely mirrors a recommendation from the government’s own expert advisory council on pharmacare, which calls for federal legislation laying out the principles of a national universal pharmacare program.

Indeed, the Trudeau Liberals tried to do a delicate dance in their opposition to C-213, suggesting that while they remain fully supportive of universal pharmacare, they feel the NDP’s approach was superficial, unconstitutional, and would undo their existing progress towards pharmacare. This is frankly absurd. The Liberals will tout new rules and agencies to lower drug prices as proof they are on the path towards pharmacare, but neither during their majority nor minority governments—the latter relying on NDP support—have they done anything to meaningfully kickstart such a program, nor push provinces to do so.

The Liberals will tell voters they don’t support C-213 because it infringes on provincial rights, but the NDP’s proposal does not override provincial jurisdiction, and it is largely faithful to the 2019 report Trudeau commissioned from former Ontario Liberal Health Minister Eric Hoskins. This report had a slower timeline than the NDP’s proposal, but it nonetheless shared a commitment for a national pharmacare act which could be used to dovetail into substantive negotiations with the provinces to create a real pharmacare system.

Liberal MP Petitpas Taylor admits the NDP bill adheres to the Hoskins report, but baselessly claims her party in the process of implementing it: they are not. The Trudeau Liberals can simultaneously promise universal pharmacare in 2019 while declaring it unconstitutional in 2021, but that doesn’t pass the smell test. They had an opportunity to cooperate with the NDP to implement something very similar to their own recommendations, and they failed to do so.

This is inexcusable, because even before this COVID pandemic, millions of Canadians suffered without the medications they needed, and many were forced to choose between medicine and other basic needs. Indeed, since the Liberals first began promising pharmacare in the 1990s, the shifting nature of the labour market—with increasing amounts of precarious, contract, and gig workers—means that many people can no longer rely on workplace pharmaceutical (and dental) plans as previous generations did. It was already becoming evident that connecting essential healthcare to a particular form of employment was untenable, and then COVID hit, leaving many without jobs, and potentially losing forms of healthcare that are only feasible if they remain employed. For anyone on the fence, this pandemic should show not only the essentiality—but the urgency—to get the ball rolling on pharmacare. C-213 was that opportunity, now lost.

Ultimately, this is yet another instance of the Liberals and Conservatives blocking a policy which has extremely high levels of support from Canadians across parties, regions, and ideological affiliations. As I noted in Jacobin recently, supermajorities of Liberals and Conservatives supported a wealth tax proposed by the NDP in 2020, but both parties united in lockstep against it. Likewise, polling from right after the 2019 election—just after the Liberals promised universal pharmacare and before COVID exposed an even greater need for it—showed that nearly 80 percent of Canadians (including 85 percent of Liberals and 66 percent of Conservatives) supported pharmacare.

Liberal MPs will tell you that they truly support pharmacare, but that they just don’t like the way the NDP is going about it. But I think the reality is far clearer. Like with the wealth tax, the Liberals see a popular policy that their own base supports, but it is one which clashes with their core neoliberal ideology. In the end, allegiance to the latter is what matters. After all, when it comes to Canadians suffering and dying without medicine, we recall the remarks of a Toronto Liberal MP: “Who gives a fuck?”

Christo Aivalis is political writer and commentator with a PhD in History. His work has appeared in the Washington Post, Globe and Mail, Maclean’s, and Passage. He can be found daily on YouTube.