Suppose you wake up one morning with a splitting headache. In most cases, you can trust that the doctor will treat your condition regardless of your ability to pay. After all, Canada’s universal health care system (called Medicare) provides equal access to medical services for all Canadians.
That is, unless, the pain stems from a toothache.
People outside Canada are often surprised to learn that our universal health care system stops where the teeth meet the gums.
Dental care in Canada is almost entirely privately-funded, with 51% coming from employment-based dental insurance and 44% paid out-of-pocket. The remaining 5% consists of the few Canadians who receive support from the federal or provincial government, like low-income children, members of the armed forces, and some aboriginal groups.
Unfortunately, this system leaves millions of Canadians without the care they need, including the ones who need it most. Almost half of all Canadians without dental insurance (over six million people) skip going to the dentist due to the cost.
Immigrants, the elderly, children, and adults working low income jobs are most likely to avoid the dentist for this reason. They are also the groups most likely to have problems with tooth and gum disease due to limited access to healthy foods, which increases the risk of other health problems like diabetes.
That means those who are most in need of dental treatment are least likely to be able to get it.
Why Canada Doesn’t Pay for Dental Care
When Canada created Medicare back in 1966, legislators did consider including dental care as part of the system. However, social and economic forces kept dental care in the private realm.
Dentists lobbied for a private system, arguing a lack of human resources and a desire to keep the government out of the patient-practitioner relationship. The government anticipated the cost of universal dental care in Canada would be too high, as the U.K. saw 16% of the population seek dental treatment when it was brought into the National Health Service. There were also alternatives, like water fluoridation, that could help promote good oral health for less cost.
For these reasons, the government left dental treatment out of the universal health care system.
Today, there is some public assistance available. All provinces and territories pay for in-hospital dental surgery, and some have prevention programs for children. Still, Canada spends just $700 million on publicly funded dental care each year, one of the lowest rates in the world.
Universal dental care would be a massive undertaking in Canada. In the meantime, the government should do more to ensure everyone has reasonable access to dental care. For example, putting more public dental clinics in hospitals and community health centers could help fill the gaps in access to treatment. More financing for vulnerable groups, like low-income children, could treat and prevent dental issues before they become serious and costly issues.