11
Volume2 Issue4
|
CDA
at
W
ork
For35years,
Dr.PhilPoonhas
beenadvocating for
improvementstothe
Non-insuredHealth
Benefits(NIHB)
program, the federal
initiativethatprovides
FirstNationsand
Inuitwithhealthcare
coveragenotavailable
throughotherplans
orprograms.
CDA Spotlight
DR.PHILPOONANDTHECDA-NIHB
TECHNICALWORKINGGROUP
At hisdowntownWinnipegpractice,
roughly25%ofDr. Poon'spatients are
FirstNations, “but they requireabout
60%of thework that I do.”Hehas agood
understandingof the severityof oral health
problems they face, their tremendous
treatment needs, and thenecessityof
havingaprogram that improves access to
care for thispatient group.
Healso recognizeshow things could
be improved. Throughhisworkon the
CDAAdvocacyCommitteeandhis current
roleasdentistry’s leadvoiceon the
CDA-NIHBTechnicalWorkingGroup (a
group that includes representatives from
HealthCanada, theAssemblyof First
Nations, Inuit Tapiriit Kanatami, andCDA)
Dr. Poonhasbeenan important part of
discussions aboutmaking theprogram
moreeffective. “I felt thisparticular patient
groupwasn’t getting thecare they
deserved,”Dr. Poon says.
“When thisprogramfirst cameout, there
were somanycomplaints about the
administrativeburden—therewas somuch
paperwork,” he recalls. Administrative
burden is aproblem, saysDr. Poon, not
onlybecause it is an irritant todentists, but
because it canmake somedentists less
willing toworkwithFirstNations and
Inuit peopleandcandiscourage
patients fromusing theprogram.
Today, submittingaclaim is less
taxing thanks toa small
butmeaningful policychangenegotiated
byCDA in2005: dentists canuse the
standarddental claim formor submit
electronicallyas analternative tousing
theNIHB form (DENT-29),which “isn’t
user-friendly for a lot of offices,” according
toDr. Poon.
After 2yearsof negotiationswithHealth
Canada, additional improvements came
in2005,whenboth the$600 limit and
thepredetermination requirementwere
eliminated for basic restorativeprocedures.
“TheoverwhelmingmajorityofNIHB
patientsneedmore than$600of restorative
work,” saysDr. Poon. ”Peoplewouldcome
inwith rampant decay, needingevery tooth
filled. I coulddoabout 4or 5fillingsbut
then I had to stopbecauseof the limit.”
For somepatients, even if theadditional
treatmentwas eventuallyapproved, the
difficultyof arranging for transportation to
hisofficewouldprevent them fromgetting
theworkdone.
Avisit fromoneyoungpatient inparticular
motivatedDr. Poon topush for achange
thatmade it easier for patients to receive
anterior endodontic treatment. Aboyhad
flown from theFirstNations community
of St. TheresaPoint tohisWinnipegoffice
becausehehad fracturedhis front tooth
whileplayinghockey. Dr. Poon recountshis
frustrationwith the situation. “I couldn’t fix
his tooth so I had to send this childback
withnothing,” he says. At the time, the
predetermination requirementmeant it
could takemonthsbefore theapprovals
Myworkwith theTechnicalWorkingGroup is
something I need todo tohelpmy patients.Wewant
to support the dentistswho treat FirstNations and
Inuit patients.
Dr. Poonathis
Winnipegdental
office.
