It is time to implement a universal dental plan
Canada’s private dental care system leaves about six million Canadians without access each year due to financial constraints. As a result, many people experience chronic dental pain, often related to caries, a treatable infection that results in cavities. Anyone who has experienced dental pain is surely aware that it can significantly reduce one’s quality of life. The burden relating to limited dental care access do not end at those affecting personal well-being but also significantly extends into the economic realm. For example, according to a 2017 study in Ontario, doctor’s offices were visited every three minutes and emergency departments every nine minutes by patients seeking treatment for dental pain. Using minimum estimates per visit, the study found the cost to taxpayers is $38 million per year in Ontario alone. Many may have concerns relating to the cost of a universal dental plan to taxpayers, but those taxpayers are footing the bill for our current system’s inefficiencies.
Most dentists agree that more public spending is needed. Currently 93.8 per cent of dental spending is private, which is paying private health insurance companies or the dentist directly, whereas 6.2 per cent comes from targeted public programs. Now, the discussion is whether public spending should be used to implement a universal dental plan or expand targeted programs. A targeted approach focuses resources for care to vulnerable populations (children, working poor, Indigenous peoples). Under a universal dental plan, in contrast, certain procedures are considered medically necessary (i.e., check-ups, Xrays, cleanings, fluoride, fillings, ex- tractions, trauma and oral pathology treatment) and the government will pay a set fee for each time that procedure is performed. A universal dental plan would require more government spending, but it would eliminate the out-of-pocket spending and monthly payments to the private health insurance companies for basic dental care.
Targeted programs are more susceptible to cuts in funding since there are less likely to be repercussions in the form of public outrage as the cuts would only affect a relatively small, marginalized group. Groups relying on targeted programs become less of a priority to dentists, as underfunded programs pay a fraction of what is indicated on the fee guide. In a universal system, by contrast, dentists are paid the same amount for specific procedures regardless of the patient’s income. This encourages dentists to set up clinics in com- munities where there is a need for basic dental care as opposed to being deterred by the socioeconomic status of the individuals within the community. As such, a universal program will help ameliorate the strong disparities of dentist per capita ratio in poor versus affluent communities.
The idea of a universal dental plan is not radical. Andrea Horwath, the head of the Ontario NDP had universal dental and pharmacare as key pillars of her 2018 campaign. Instead voters chose Doug Ford, who is actively cutting hospital beds and health-care spending while claiming the opposite. Draft bills for Medicare included dental care, but it was decided that dental care would be publicly financed at a later stage.
Now is the time to follow through with that promise.