OTTAWA — NDP Leader Jagmeet Singh says he expects the federal government's new dental plan will reflect his party's original vision for oral health care in Canada.
The Liberals promised the NDP they would start to phase in a dental-care program this year as part of a confidence and supply agreement to keep the minority government in power until 2025.
Singh says the program would ultimately be a stand-alone federal dental plan that would offer coverage to all those who do not already have it.
"What we're proposing is a federal plan, like an employment insurance plan, which will cover those who do not have coverage and who need it the most," Singh said at a news conference in Ottawa on Thursday.
"That's what we're offering."
What the Liberals actually put in the budget, and ultimately implement, remains to be seen.
The NDP pitched federal dental care in the last election, but Prime Minister Justin Trudeau's Liberals did not.
The terms of the deal announced Tuesday state the Liberals will need to launch a new dental-care program for Canadian families with an annual income of less than $90,000, with no co-pays for anyone with an annual income under $70,000.
Trudeau and Singh agreed the program would start this year with children under the age of 12, then expand to those under 18 years old, seniors and people with disabilities next year. The program is supposed to be fully implemented by 2025.
That agreement could leave the Liberals room to manoeuvre toward a different kind of program, such as one that offers money to the provinces to bolster existing publicly funded dental coverage for children from low- or middle-income families.
That's the direction the Canadian Dental Association has advocated for in its preliminary meeting with the health minister's office this week.
"If the federal government wants to take a seat at the table, great. But let's actually look at investing in the existing programs, making them sustainable. They're significantly underfunded," said Michel Breau, head of advocacy and governance for the association.
The infrastructure already exists at the provincial level, he said, and it could be improved with more federal funding.
But Singh appears steadfast that the NDP plan will move ahead.
"This is our plan," he said Thursday. "And that's what we're going to do, and we're going to work to make sure this happens."
When asked whether the Liberals plan to execute the NDP plan as designed, the office of Health Minister Jean-Yves Duclos did not directly respond.
"Our government has always prioritized working collaboratively with provinces and territories, including on matters related to housing, child care, the response to COVID-19, and overall health care — we will continue to do just that," Duclos' office said in a statement.
"This agreement will ensure Parliament works constructively to deliver results for Canadians."
A 2020 report by the parliamentary budget officer offers some details on the NDP's vision.
The report is based on NDP health critic Don Davies' request to estimate the cost of a federal dental plan based on the current non-insured health benefits program, a federal benefits program for First Nations and Inuit in Canada.
The program includes more robust and preventive coverage than the federal dental program for refugees or federal inmates, which are aimed at emergency dental procedures.
Davies' request also stipulated that the program would not replace existing provincial and territorial programs, which form a patchwork across the country, and would be operated either by the federal or provincial government.
The PBO estimated the initial cost of a full-fledged dental program to be about $4.6 billion, with an ongoing annual cost of about $1.7 billion.
Davies says the cost to implement this phased-in plan under the Liberals would be only a fraction of that amount the first year. Singh said the program could be paid for by hiking taxes for financial institutions that have made strong profits during the pandemic — something the Liberals also agreed to as part of the deal with the NDP.
Indigenous Services Canada has noted some issues with the non-insured health benefits program that could inform the federal government's next steps, said Jennifer Robson, associate professor of political management at Carleton University.
"As I looked into it, it became pretty clear there seem to be some pretty big issues with administration in there," Robson said in an interview Thursday.
The number of people actually using the benefits is quite low, she said. The department aims to have 74 per cent of eligible First Nations and Inuit make at least one claim per year.
Only about 67 per cent of eligible people made a claim in 2020-21, according to the latest departmental plan from Indigenous Services Canada.
"Some people don't necessarily know what is covered and what isn't covered. There's the sort of the administrative burdens of having to go through, find the form, figure out if the thing that you need is covered. You have to pay it up front and then request reimbursement," she said.
She's also found documented government concerns about the quality of care, which is common in public plans in Europe and elsewhere as governments attempt to keep costs down, she said.
The fact that the program eligibility will depend on income will also likely mean that people will need to file taxes in order to take advantage, she said.
Still, academics and policy experts including Robson argue there is a strong case for an expanded government role in financing dental care in Canada.
The number of people needing dental care is likely to grow rapidly in the next decade as baby boomers retire and lose insurance coverage, argue Frances Woolley, a Carleton University economics professor, and Åke Blomqvist, a health policy scholar at the C.D. Howe Institute.
"There is no doubt that, in the current system, there are many population groups in which individuals have had difficulty accessing even urgently needed dental care," Blomqvist and Woolley wrote in a 2018 policy paper.
Singh says the variety of public programs in Canada offer plenty of examples to draw from in crafting the new federal program.
"That will give us evidence for us to make the best decision possible around a plan that covers people. That's exactly what we want to do," he said.
This report by The Canadian Press was first published March 24, 2022.
The Canadian Press
