Question Period Note: Dental Care

• What is the Government of Canada doing to address the unmet dental care needs of Canadians?

KEY MESSAGES
• While most Canadians have dental coverage through their employment health plans, we know there are unmet dental care needs in Canada.
• My mandate letter highlights this Government’s desire to work with Parliament to study and analyze the possibility of national dental care.
• Dental care is only one aspect of our commitment to improving health care for Canadians. The 2019 Speech from the Throne committed to work with provinces and territories to address health needs arising from the pandemic, but also to improve access to primary care, set standards for long-term care, address the opioid epidemic and implement pharmacare for Canadians.

IF PRESSED ON MOTION M-62 FEDERAL DENTAL CARE PLAN
• The 2019 Speech from the Throne and Minister of Health Mandate Letter both committed to support Parliament in studying and analyzing the possibility of a national dental care program.
• The results of this work by Parliament would be helpful for determining the best approach for identifying gaps, improving access to dental care, and determining a federal role in this area. The Government looks forward to the outcomes of Parliamentary work on this issue.

BACKGROUND
• The 2019 Speech from the Throne and the mandate letter for the Minister of Health both committed the Government to work with Parliament to study and analyze the possibility of national dental care. The 2020 Speech from the Throne is silent on this issue.
• In February 2020, the House of Commons Standing Committee on Health (HESA) agreed to undertake a study on the development of a national dental care program, although the study never began during the last session. On October 26, 2020, New Democratic Party Member of Parliament Don Davies introduced a motion that HESA undertake a study on the development of a national dental care program as an insured service for Canadians. Health Canada remains ready to support a study by the Committee, should it decide again to undertake that work.

• On February 22, 2021, Motion M-62 – Federal Dental Care Plan was placed on the Order of Precedence was introduced by the New Democratic Party. The Motion proposes: “That, in the opinion of the House, the government should establish a federal dental care plan as soon as possible for Canadian families earning less than $90,000 per year who are not covered by a dental care plan, as an interim measure toward the inclusion of full dental care in Canada’s health care system.” The Motion’s first hour of debate occurred on May 4, 2021. The second hour of debate has not yet occurred.
• In October 2020, the Parliamentary Budget Officer published a cost estimate of a federal dental care program for uninsured Canadians with a total household income below $90,000. It is estimated that this program would cost close to $11 billion over five years (a one-time upfront cost of around $3 billion to clear accumulated care needs, plus ongoing program costs of around $1.5 billion annually through 2024-25). The program was estimated to benefit close to 6.5 million Canadians in the first year, and decrease to 6.3 million by 2025 due to changes in population and labour market conditions.
• During the 2019 election campaign, the New Democratic Party (NDP) identified inequality and wasted spending related to dental care as an issue, citing that care avoidance due to cost results in preventable oral health emergency room spending. The NDP planned to address this issue through a national, income-based “Denticare” plan that would have provided free care for households earning under $70,000 annually, and a sliding co-payment scale for those earning between $70,000 and $90,000.

Current Dental Care Programs in Canada
• According to the Canadian Institute for Health Information, $15.9 billion was spent on dental services in 2018: 55% was covered through private insurance; 39% was paid out-of-pocket; and 6% was publicly funded. About two-thirds of Canadians receive dental coverage through employment-based private health insurance plans.
• Provinces and territories (PTs) provide emergency, in-hospital medically necessary dental care for all residents. Additional PT programs vary in eligibility and coverage, and are limited to select services for groups such as those with low incomes, people with disabilities, children, and seniors.
• Federal support for dental care includes:
o The federal government provides recognized First Nations and Inuit with dental coverage for services not available under other FPT programs. The Government also provides dental services to Canadian Armed Forces personnel, inmates in federal penitentiaries, and some veterans and refugee claimants.
o Federal public servants are provided with dental coverage through the Government of Canada’s employee benefits program.
o The Canada Health Transfer is providing $41.9 billion to the provinces and territories in 2020-21, which is used to support health services (including PT dental programs if they choose).
o The federal government supports Canadians with private health insurance by not including the value of these insurance plans in the taxable income of employees. In addition, the income tax system provides assistance through the Medical Expenses Tax Credit, and through a refundable medical expenses supplement available for working individuals with low-incomes and high medical expenses.
• Comprehensive data does not exist on unmet dental care needs at a national level in Canada. A campaign led by the Canadian Association of Public Health Dentistry suggests that 1 in 5 people (6 million Canadians) are not receiving needed dental care due to cost, and that only Canadians with financial resources or insurance can experience good oral health.

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