As the debate over pharmacare heats up, a new report released by the C.D. Howe Institute is suggesting expanded public coverage for dental services.
“Many Canadians today, including most of the working poor and the retired, are covered neither by government programs nor by private insurance,” said Ake Blomqvist, an adjunct research professor at Carleton University and one of the authors of the report.
“Lack of coverage is likely to worsen in the next decade as the baby boom generation retires and loses insurance coverage and as more Canadians work in the gig economy, where insurance benefits are rare.”
The report refers to data showing solid levels of employer-sponsored dental coverage for working Canadians. In Ontario, for example, about 64 per cent of people aged 12 and above had employer-sponsored coverage in 2013/14. But as the report noted, those without a workplace plan are more likely to be in low-wage jobs. “These individuals — who include the group often referred to as the ‘working poor’ — account for the fact that as many as 30 per cent of those in households that rely principally on employment income still do not have dental insurance,” the authors, Blomqvist and Carleton economics Prof. Frances Woolley, wrote in the report.
While the report touted the idea of expanding existing public dental programs to ensure everyone has coverage, it noted that beyond the need to ensure access to care, doing so would improve efficiency and could help to reduce costs.
“A well-managed government plan might be able to offer good dental care to population groups that currently are covered by private plans, at a cost that is lower than what they pay today,” the authors wrote.
“If it were offered as an alternative to private insurance, it could make the dental sector more competitive. There are several reasons why fees for dental services in Canada today are higher than they would be in more competitive markets and with better-informed consumers. Those who are insured may often be treated in ways that end up costing them more than they would be willing to pay if, first, they knew more about the nature of their dental problems and the effectiveness of the services they are receiving, and, second, were more aware of the true cost of their dental care in terms of foregone salary increases.”
While the report considered the option of a universal single-payer dental program, it also noted the option of public dental insurance with public-private competition. Provincial coverage would be the default option, but people could opt out if they had a coverage under a government-approved private plan.
“The large number of Canadians who currently are covered by private plans that they are satisfied with could continue as they are,” the authors wrote, suggesting such an approach could help boost efficiency in dental services.
“Competition with private plans would give the public insurer an incentive to operate efficiently and innovate and to contain the influence of the provider groups that would supply its services,” they added.