Bridging the Financial Gap in Dental Care

Appendix C - What We Heard Report (Executive Summary)

In early 2022, the Canadian federal government announced that they were going to be investing over $5 billion into access to dental care for Canadians. Dentists were excited and wanted to know what this would mean for them and their offices.

In a series of online roundtable discussions, CDA reached out to dentists across Canada to get their thoughts on the new federal funding. Below is a high-level summary of their feedback.

• Ensure appropriate reimbursement of dental services and compensation of dentists in line with provincial/territorial fee guides.

We have heard that this is one of the most significant factors impacting dentists’ participation in a publicly funded dental program, and hence improving access for Canadians to oral health care. Appropriate remuneration levels in relation to provincial fee guide levels will help ensure patients who need treatment continue to be seen, while also ensuring that dentists can afford to keep their practices going, based on regionality.

• Provincial/territorial public plans already exist and there is infrastructure in place.

Some dentists feel that keeping already established provincial programs in place will avoid conflict over jurisdiction and in many provinces would allow for efficient implementation of the under 12 children’s program by the end of 2022. Keeping existing and well-known programs in place will ensure ease of administration and ensure that programs that are currently working well for patients will continue to provide the same or even enhanced services. Provincial/territorial programs can be amended and enhanced to include more eligibility and a better basket of services for the program. In provinces without adequately funded provincial programs, notably in Ontario and Québec, this sentiment may not be fully endorsed.

• Income eligibility criteria need to be administered efficiently by governments, either federal and/or provincial/territorial.

Dentists hope that determining income eligibility will be an easy process so that they can avoid making mistakes as well as avoid additional administrative burden. They also hope this process also includes the critical step of ensuring that in the case of private dental insurance availability, the government plan is the payer of last resort to ensure effective and efficient service provision in dental offices and help prevent employers from dropping existing coverage.

• Provincial/territorial fee guides and claims processing systems currently exist and should continue to exist.

Dentists know that the provincial fee guides are reviewed yearly by experts and incorporate the procedure, time required, materials used, manpower requirements, cost of living and other factors. Keeping the existing system would ensure that the fee guides remain up to date and would make administration easier on dental staff who have been using the fee guide and coding system for years.

• Ensure that the private employer-based insurance system, which has worked well for decades, remains intact.

Mechanisms should be in place prior to the roll out of the federal public dental program to avoid major decreases in private dental insurance coverage, which will result in significant impacts on the viability of dental practices. Private insurance must be the primary payer, and government plans should only be used as a last resort. Dentists feel that the ability to balance-bill should be an element of the plans. Dentists feel the private insurance model has been working well up until now and hope that public programs are used to fill in the gaps for patients who do not currently have access to private insurance.