A Complicated, Messy Dental Plan

Government introduces the Canadian Dental Care Plan (CDCP), a $13 billion initiative with complex eligibility rules and phased implementation. Questions arise over administrative hurdles, income-linked co-payments, and its potential impact on healthcare costs. Photo Credit: Pexels

The federal government just released the details around their much-heralded dental plan, and is it ever a complicated mess. Whomever designed the criteria for receiving government funds appears to have at least been aware of the potential for costs much higher than estimated, hence the complexity and the staged introduction of the plan for different age groups. The federal government is promoting the Canadian Dental Care Plan (CDCP) as a program that will cost $13 billion over the next 5 years that as many as 9 million Canadians may be eligible to join. 

The plan will be phased in over the next couple of years, with older seniors being the first able to apply, followed by ever younger age groups each month into 2024. Disabled Canadians and children can apply in mid-2024, and low- and middle-income Canadians between 18 and 65 can start applying in 2025.  Income level also matters, as families with income lower than $70,000 will not have to make a co-pay to a dentist, whereas those with incomes between $70,000 and $80,000 will face a co-pay of 40 per cent and a co-pay of 60 per cent will be required of those with a family income between $80,000 and $90,000. Anyone with a family income over $90,000 is not eligible for the program.  

The program is not intended to replace existing programs offered by employers, private insurers or provincial governments. About two-thirds of Canadians currently have dental insurance in one form or another. Businesses are already being required to fill out paperwork for government indicating whether or not they currently offer a dental program for their employees, as the government does not want employers to abandon their existing arrangements and direct their employees to the government plan. One can only imagine the ridiculous red tape and auditing that will have to occur to ensure this does not take place, and the complex rules of the dental plan suggest that a whole new expensive government bureaucracy will be required to administer it. 

Dentists are required to enrol in the program, which will be run by Sun Life. It is still uncertain as to how many dental professionals will buy in, as many questions remain about the program, what reimbursement amounts will be and how the administration will work. Naturally the fee levels set by the government will be a key determinant of how attractive it is to dentists, denturists and dental hygienists. 

Another important issue is how much can anyone expect to receive from the plan. Dental care is costly, and the roughly $600-700 maximum that one can receive may be enough to cover a couple of fillings, but certainly not costly procedures like root canals. Dental care is important as it can have a major impact on overall health, so one would hope that there will be some savings in total health care costs if dental hygiene is improved. Of course, to determine that the government should put in place some measurement methods so that any gains can be quantified and future programs modified accordingly if necessary. Unfortunately, governments of all stripes rarely bother to see if their programs have any measurable positive outcomes, so the likelihood we’ll be able to gauge the success of the CDCP for the monies spent is slim to none. 

As for the politics of the plan, NDP leader Jagmeet Singh is boasting that his coalition deal with the Liberals is why the CDCP came about, and he is likely correct to claim credit. Whether he will get any bump in the polls as a result is uncertain, especially considering that current political polling data indicate that the losses the Liberals have experienced in electoral support are not going to the NDP, but rather the Conservatives. The timing of the plan was definitely constructed with politics in mind, however, since the CDCP will roll out over the next couple of years during which an election is guaranteed. 

History shows that once an entitlement is created, it is virtually impossible to take away by a future government, so any new programs such as the CDCP will now have to be financed long into the future. As well, government programs always seem to turn out to be more costly than initial estimates would suggest, so the eventual cost of the CDCP will almost certainly be higher than predicted. Even at the current estimates, the CDCP is expected to be the government’s largest social program once it is fully rolled out in 2025. Providing proper dental care for Canadians is a laudable goal and may produce savings in other areas of health care, but the jury is still out on whether this costly, complicated program will fit the bill. 

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