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December 11, 2009 | dentalproductsreport.com Dare to compare A snapshot of how Canada handles dental care and coverage.  Photo: Richard Ward/ Getty Images Our friendly neighbor to the North has received increased attention since the debate over health care reform began in the U.S. earlier this year. With politicians toying with the idea of a public option and many in the country up in arms over “socialized” medicine, people in the dental community have wondered how that type of reform might impact dentistry. Even once a bill is passed in Congress, it’s highly unlikely that there will be any major shifts in dental care and coverage, especially in the immediate future. However, it is worth looking at how countries with differing health care models to see what, if any, impact those differences have on the dental profession. The system In the early 1960s Canada and the U.S. had fairly similar health care systems, while today they offer very different models. Canada has a universal, single-payer health care system that covers about 70% of expenditures, and is now famous for the Canada Health Act and its system of socialized medicine. According to the Canada Health Act, all insured persons must be fully insured for all medically necessary hospital and physician care. In the end, about 91% of hospital expenditures and 99% of total physician services are financed by the public sector. Dentistry remains a separate entity. There is no government-funded dental system, with exceptions made for certain special populations such as those on Indian reservations. In general, dental care is paid for by individual patients or through private and/or employer-sponsored insurance plans, much like the U.S. According to Economy Watch, a basic Canada dental insurance policy covers dental examinations, dental x-rays, periodontal treatment, extractions, fillings, dentures and crowns. More comprehensive plans could also include cosmetic dental straightening, whitening or orthodontic surgery; these types of plans would require the patient to pay high premiums. A study published in the American Journal of Public Health in 2006 indicated that in both the U.S. and Canada, approximately 64% of participants had contacted a dentist for treatment within the past year. What the association says The Canadian Dental Association (CDA) declined to be interviewed and, instead, directed us to a position statement that affirms the idea that all Canadians should have timely access to affordable health care. The organization applauds the Canadian tax system for providing an additional financial incentive for employer-sponsored plans. According to the CDA, “the resulting widespread adoption of these plans has had an extremely positive effect on Canada’s standard of oral health, which is one of the best in the world. Preventive dental care—cleaning, check-ups and early diagnosis—on a regular basis has been a core feature of traditional employer-sponsored dental plans.” The association also pointed out that as a profession, dentists have done their part in helping keep the quality of care high while keeping prices reasonable. Prices for preventive dental care coverage, for example, have increased less than the overall increases in Canada’s Consumer Price Index for the past dozen years. What patients say We talked to a group of patients in Canada, about not just the quality of care they receive, but about public opinions of oral health and treatment costs. When asked if the current disparity in medical coverage versus dental coverage lead to the perception that oral health is less important than overall health, the group was split—half thought no, half yes. Brienne Wright, 29, a client services assistant, described the perception of dental care as “two-faced.” “The fact that dental coverage is the responsibility of the patient and not the health care system implies that it is less important,” she said. “However, health-wise, because of the regular six-month for oral health versus the ‘on a needed basis’ for overall health makes oral health seem as important.” Joe Tolomeo, 27, a teacher, thinks that in the end, the question is a moot point. “People have an opinion about health versus oral health and it has nothing to do with the coverage they have,” he said. The majority of respondents admitted that both they and peers had put off needed treatment due to cost, an issue they rarely face with medical treatment decisions. Wright put off seeing a dentist for three years after graduating university because in her position before her current job, there way no dental insurance provided. She finally went and paid out of pocket on two separate occasions because she couldn’t stand not knowing what was wrong. “Every time I felt the slightest bit of discomfort I worried about cavities,” she admitted. All of the respondents were pleased with their overall quality of care.
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