Canada’s dentists say new national system should not sharply reduce fees for visits

The Canadian dental industry is urging the federal government to make sure its dental-care expansion doesn’t affect coverage under workplace plans or sharply reduce dentists’ fees for visits.

The Liberal government promised in its spring budget to fund a program that would ultimately see dental coverage guaranteed for children under 18, seniors and people with disabilities.

The promise is a key part of a power-sharing agreement between the Liberals, who hold a minority of seats in Parliament, and the NDP, who hold the balance of power.

The government is consulting industry stakeholders on the design of its plan, with an aim of tabling legislation this fall.

Industry groups say they are on board with increasing access to oral care, but that much depends on how the program is designed.

The Canadian Life and Health Insurance Association said it hopes no new government insurance will affect the majority of Canadians who have plans through their workplaces.

“Government programs need to be designed to ensure that no Canadian loses access to their current coverage or access to dental services,” said Susan Murray, vice-president of government relations and policy at the insurance lobby group.

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One of the main concerns for the Canadian Dental Association is how much the plans might pay in reimbursing dentists for procedures.

Aaron Burry, chief executive officer of the CDA and a practising dentist in Ottawa, said the cost to a dentist of an examination may be $200, but a provincial plan may only pay out $70. If more patients came under government coverage, he said, that could put pressure on a dentist’s bottom line.

“What we’re looking at is a pretty significant number of individuals being covered under these programs,” Dr. Burry said. “And these programs need to cover the costs of the provided care.”

A key design question for the federal scheme is whether it will be a new national program or an augmentation of existing provincial plans that cover low-income Canadians and other groups without coverage.

The CDA is lobbying the federal government to work through the provinces so as to not add another layer of programs for dentists to worry about.

The Canadian Dental Hygienists Association, however, is pressing Ottawa to create its own plan so it can ensure there are national standards to accessing oral care.

Donna Wells, manager of professional practice at the CDHA, said there are too many holes in provincial plans. She said in some provinces, regular cleanings are not covered, which can cause patients to develop serious problems, such as cavities, down the road.

“The program will cost money upfront, but, if we can get preventative care in there, it will save money in the long run,” Ms. Wells said. “It will prevent emergency room visits, which cost a lot of money.”

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Emelyana Titarenko, a spokesperson for federal Health Minister Jean-Yves Duclos, said the government is committed to making sure the federal plan complements existing provincial ones.

The federal government says its plan could ultimately see between seven and nine million more Canadians get dental insurance.

Sina Amiri, a dental-industry consultant and vice-president of revenue at Zentist, said he is concerned about whether the industry will be able to absorb the extra demand. Labour challenges and COVID-era guidelines that require breaks between appointments have made it challenging for dental offices to see even their existing patient base.

“The question is: Where are we going to find all the dental assistants and hygienists to serve them?” Mr. Amiri said.

The Liberals’ spring budget put $5.3-billion over five years toward the program, though a recent costing from the Parliamentary Budget Office estimated the price tag would be closer to $9-billion.

Guy Amini, president of Dentalcorp, told analysts on an earnings call on Friday that he didn’t think the plan would substantively affect his company, which is part of a growing corporate consolidation of dental practices.

But he said he thought the government should be directing its dollars to other urgent health care priorities instead because Canada has relatively high rates of access to oral care compared with other countries.

“There is a degree of confusion on the industry and profession’s part that billions of taxpayers’ dollars are being spent on addressing what isn’t – what the data suggests – isn’t an access to oral care problem in Canada,” he told analysts . “But, again, the government will prioritize what government wants to prioritize.”

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