Dental care in Canada: it’s time

By NDP MP DON DAVIES       FEB. 4, 2019

When Tommy Douglas came to Ottawa as the Member of Parliament for Burnaby-Coquitlam, B.C., he understood that medicare was a project that would transcend his own lifetime.

Although he successfully secured universal coverage for hospital and physician services, he knew that the task of expanding and improving medicare would fall to future generations.

That’s why, at the NDP’s most recent policy convention, delegates from across our nation were challenged to dream boldly once again. They looked beyond pharmacare and toward including dental care as part of our universal health care system.

This is not just an aspiration. As with prescription medication, the omission of dental coverage from our universal health-care system is both a pressing public health concern and a social justice issue.

Many would be surprised to learn that the most common noncommunicable diseases are oral diseases. Studies have also linked poor dental health to serious health conditions, including cardiovascular disease, dementia, respiratory infections, diabetic complications, renal disease complications, premature birth and low birth weight. And numbers cannot quantify the pain, social impacts and economic losses suffered by those with untreated dental problems.

Yet 32 per cent of Canadians have no dental insurance at all, and six million Canadians avoid visiting the dentist every year due to cost.

Unsurprisingly, this hurts poor and marginalized Canadians the most. Canada’s most vulnerable people have the highest rates of dental decay and disease, but the worst access to this much needed service.

According to the Canadian Academy of Health Sciences, 50 per cent of lower-income Canadians have no dental coverage, along with a majority of seniors over the age of 60. Indigenous populations have nearly twice as much dental disease as non-Indigenous Canadians, and income-related inequalities in oral health are greater in women than men.

Given these stark disparities, what is the federal government doing to tackle this crisis of neglect?

Unfortunately, nothing at all.

When these issues were put to federal Health Minister Ginette Petitpas Taylor at a recent appearance before the House Health Committee, she confirmed that “with respect to investments in that area, no federal investments are being made.”

This was a deeply disappointing answer since Canada currently ranks second last in public financing for dental care among OECD countries.

It seems plainly deficient to have a public health system that provides care for every part of our bodies except the mouth, but this is the present state of Canadian medicare. In order to close this illogical gap, it’s worth examining why dental care was excluded from our public system to begin with.

The 1964 Royal Commission on Health Services formed the original framework for our public health care system. The commission’s final report called for the inclusion of dental services, while noting that the shortage of dentists was so acute at the time that it would be impossible to implement a universal system without training a substantial number of new dentists.

Nevertheless, the commission believed that it was imperative to immediately establish a public system for children, expectant mothers, and public assistance recipients that could be scaled up as resources expanded. They called this program “one of the highest priorities” among all of their proposals.

The commission envisioned that by 1980, all children up to the age of 18 would be entitled to public dental services in Canada. Moreover, if the dental resources of the nation were expanded as recommend, the Commission concluded that it would also be possible to implement universal coverage for adults thereafter.

In 1964, there was one dentist for every 3,108 Canadian patients. The commission projected that a ratio of 2,671 patients per dentist could be reached by 1981 in order to form the basis of a universal system.

We have achieved that and more. Today, there is one dentist for every 1,622 patients in Canada, according to the Canadian Dental Association (CDA).

By turning Canada’s dentist shortage into a surplus, we have resolved the original impediment to implementing universal dental care. The most significant barrier that we face today is a lack of political will.

Clearly, work will have to be done to determine how we can best finance this initiative. However, through our experience with Canadas’s public medicare system, Canadians know that delivery of health services through a public, single-payer model is the most effective and efficient way of doing so, rather than through a private, patchwork system.

Canadians have waited long enough. Access to medically necessary dental care should be a right in this country, not a privilege.

It’s time to roll up our sleeves and begin the work necessary to make this overdue health care service a reality for all Canadians.

NDP MP Don Davies, who represents Vancouver Kingsway, B.C., is his party’s health critic.

The Hill Times 

Read more posts about: ,