Canada’s nascent dental plan falls short of providing equitable access to primary and preventative care, according to a report from the Institute for Research on Public Policy, whose researchers propose a new federal agency for universal care.
The federal government has allocated $13 billion to launch the Canadian Dental Care Plan for children from households with a net income of less than $90,000 and no private dental insurance. The plan will include up to $650 per year for children under age 18, seniors and people with disabilities. A sliding scale of coverage exists for household incomes between $70,000 and $90,000.
Colleen M. Flood, the report’s lead author and the incoming dean of the Faculty of Law at Queen’s University, argues in the June 22 IRPP report the current cash-based “payer of last resort” will mix public payers and private insurers. This will possibly give rise to problems such as dentists avoiding public-pay patients and employers shifting away from private insurance and relying on the public plan. There is also no sufficient plan to ensure people — especially marginalized and remote communities — receive treatment through their new benefit, the group claims.
“In our view, for both equity and efficiency reasons, the federal government should aspire to a goal of universal coverage for dental care for a core set of necessary services,” wrote Flood.
Additionally, this universal plan should be regulated by a new arm's-length agency that will have provinces cede their authority, in order to avoid foreseen constitutional squabbles.
“A central agency could also set national and transparent standards of coverage for all of Canada and create an effective and fair process for determining the range of services covered,” the report states.
This agency would also regulate how the public plan functions with private insurance, such as barring extra billing and upselling, the report states.
The report commended the new Oral Health Access Fund to "invest in targeted programs that address oral health gaps and access issues among vulnerable populations, including those living in rural and remote communities," however, the $250 million investment is too small.
The dental plan is part of the federal NDP agreement with the Liberal minority government to govern with its confidence through 2025.
The report notes Canada ranks 27th among 31 OECD countries for the percentage of spending on dental care from government programs; Canada spends about five per cent whereas 20 countries are above 20 per cent.
