Question Period Note: DENTAL CARE

• Some dental care stakeholders and the New Democratic Party have called for a universal dental care program.

KEY MESSAGES

• While most Canadians have dental coverage through their employment health plans, we know there are unmet dental care needs in Canada.

• Dental care is only one aspect of improving health care for Canadians. The Government is 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 and address the opioid epidemic.

• 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.

• 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.

• In the 2021 election, the NDP committed to “work together with provincial partners, health professionals and dentists to develop a roadmap to incorporate universal dental care into Canada’s public health care system, and immediately deliver dental care coverage for people who don’t have any private insurance.” According to the NDP, dental coverage would cost $11 billion in the first five years.

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.

KEY FACTS
• 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.