Dental plan not yet filling needs

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This article was published 16/02/2024 (777 days ago), so information in it may no longer be current.

Brandon denturist Kyle Ryan says the federal government “jumped the gun” with its multibillion-dollar federal dental-care plan — he has people waiting for services, but there’s been no official word from the feds about a pay structure for patients or providers.

“I was really excited about the plan, and I still think it’s going to be great,” Ryan said. “I have at least 20 people who are approved — they’re good to go — but I can’t work on them yet because we don’t have a deal.”

Some dentists share the same concern about the new plan and have raised other issues as well.

Ottawa released its new $13-billion Canadian Dental Care Plan (CDCP) in mid-December, promising routine dental coverage for people who have a household income below $90,000 with no access to benefits through private insurance.

Coverage will include preventive, diagnostic, restorative and surgical services including X-rays, fillings, root canal treatments and dentures.

The first phase of the plan included seniors over the age of 87, who can now apply for coverage and are expected to be able to start claiming dental services in May.

As the plan expands it will include all qualifying seniors, children under the age of 18 and people with disabilities.

Ryan said he has concerns that some denturists may opt out of the program because the fees in the new plan will be lower than what some currently receive through private insurance companies.

“I’ve been doing this for 21 years this year, and it doesn’t matter to me where you come from or what insurance you have, we always give you the best product we can,” Ryan said.

“My concern is a lot of guys have higher overheads than myself. So, I think that they have more staff and it would be harder for them to take a reduced fee for working. So are guys going to cut corners for people because they’re going to be getting a smaller wage for doing these jobs?”

Under the federal plan, those with an income lower than $70,000 will receive 100 per cent coverage. People with an income between $70,000 and $79,999 will receive 60 per cent coverage, which means paying 40 per cent of the CDCP fees. And people with an income between $80,000 and $89,999 will receive 40 per cent coverage, meaning they pay 60 per cent of CDCP fees.

Additional charges that people could face include when an oral health provider charges more than the CDCP fees, or if someone receives care that is not covered by the plan.

There are some Manitoba dentists who are also concerned about the new dental care plan, says Dauphin dentist Dr. Daron Baxter. She has been practising for 10 years and is the president of the Manitoba Dental Association.

Fee schedules for dentists have not been fully released, Baxter said. “We were given a 2023 suggested fee grid with the promise that an updated one will happen once the program officially starts in May. So, denturists may be in the same position as we are.”

Dentists also have other concerns about the fee schedule, she said.

“It can be confusing, and this is a piece we feel the government has not been clear with Canadians on. They’ve advertised a program that is free dentistry and that’s not the case, because they’ve chosen not to meet the existing cost of care. The government has underfunded that cost. It is less than what that cost is.”

A dentist or denturist can opt out of the federal plan, which is another concern, added Baxter.

In the current system, patients are free to choose their oral health provider, and many enjoy long-term relationships that are important for ongoing health for them and their families.

Under the new program, Canadians will register through Health Canada, and from there, Sun Life Financial Inc. will operate it.

There is the potential, Baxter said, that having a third-party insurance company will lead to the creation of a separate list of available dentists, taking away patients’ freedom to choose.

“So, it’s not full patient choice of provider. And it’s especially an issue for rural and remote access to care. Because if a private plan follows suit, what if your plan doesn’t include the dentist in your community? That can greatly limit access to care. And we see systems like that in other jurisdictions, but not currently in Canada,” Baxter said.

There are certain aspects of the plan that could permanently and irreparably change the scope of health care in Canada, Baxter said, including how private insurance plans will be affected by the launch of the CDCP.

“We worry about a system where employers might drop or cancel their private plans that they offer to employees in search of different benefits or incentives that they deem useful in their employment systems. And the problem is, if de-insurance or reduction in private insurance becomes a reality, that will increase the costs of this program, of dental care to all Canadians,” Baxter said.

“If private insurance groups — and the populations within them — diminish, that increases the cost for those individuals. And if the increase of people on the CDCP occurs, then that increases the cost of taxpayers,” she said.

“That’s where we feel there’s still work to be done.”

Baxter, representing the Manitoba Dental Association, along with representatives from other provincial and territorial dental associations and the Canadian Dental Association, had the opportunity to meet with federal Health Minister Mark Holland and deputy health minister Stephen Lucas.

“We offered our expertise, and at this point, we feel certain aspects have not been incorporated. So, we hope to have opportunity to speak with the minister and his team again,” Baxter said.

“But now we want to speak with our membership, so they fully understand the ins and outs of what we’re seeing.”

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