From “High costs keep 6 million Canadians from the dentist each year: report“, a September 13, 2014 CTV News article by Andrea Janus, in relation to the 2014 report by the Canadian Academy of Health Sciences, Improving Access To Oral Health Care For Vulnerable People Living In Canada:
…Because dental care is not included in the Canada Health Act, the vast majority of dental services in this country are paid for by private insurance or out-of-pocket.
Taxpayers cover some 70 per cent of health care costs to the tune of about $148 billion. Only about 6 per cent of dental care costs, about $800 million, are paid for with public funds.
According to 2011 data from the Canadian Institute for Health Information:
59 per cent of private dental care expenditures, about $6.6 billion, were paid for by insurance.
The remaining 41 per cent, some $4.6 billion, was paid by patients out-of-pocket.
And according to the new 2014 report report, nearly 50 per cent of Canadians in the lowest-income bracket do not have dental insurance, compared to just under 20 per cent in the highest bracket.
Andrea Janus also wrote a second article, published the same day, on the Canadian Academy of Health Sciences Report: “Dental dilemma: No ‘magical financial solution’ to fixing oral health care“
…The first order of business, then, will be to get dental- and health-care stakeholders together to develop an agreed-upon national standard for preventative and restorative oral health care, “irrespective of (patients’) physical or geographical ability to access services, or their capacity to pay,” the report says.
While different regions of the country will have different priorities based on their demographics, there would be a number of large- and small-scale projects to choose from based on need.
Some of the ways that access and overall oral health can be improved:
Mobile dental units;
Clinics at community health centres or long-term care homes;
Or programs that provide preventative care for children under a certain age.
After those standards are established, a process that could take about a year, stakeholders have to identify the systems and the personnel needed to deliver that care.
While dental care is not included in the Canada Health Act and so does not fall under the national system of health insurance, it could be added either wholly or in part. A select number of basic services, such as regular cleanings, could be offered to all Canadians, with extra services available to Canadians deemed to be at greater need, the report says.
The exact cost of publicly financing basic dental care for all Canadians has yet to be determined, Allison [Dr. Paul Allison, Chair of the expert panel that issued the report] said. However, the report notes that because workplace dental benefits are not treated as employee income, they are not taxed as such. This leaves “a significant level of foregone revue that could, at least in theory, be used to finance care for underserviced groups,” the report notes.
Estimates suggest that the federal government loses about $1.6 billion due to employee and employer tax breaks, and “the total loss in revenue may be much higher once foregone revenues from provincial and payroll taxes are considered,” the report says.
Indeed, the Commission on the Future of Health Care in Canada [the "Romanow Commission", 2002] estimated that the loss in revenue from all benefits, including dental insurance, for all levels of government is about $4 billion.
…In the end, Allison said, a lack of oral health care “goes against what we would say are the values of the Canadian health care system. And I think we should acknowledge that and try to do something about that.”
Where the ones most affected are the working poor, since those on social assistance receive basic dental care, while those working in many minimum or near minimum-wage contexts have few employment-related benefits, let alone a dental plan…
When one considers the relationship between heart and dental, plus general health and dental, a mystery is why dental care has not been included as a basic component of a national health care program.