Finance Committee on April 18th, 2024

[Dr. Amrinderbir Singh]

From the information I have been hearing, there has been some consideration given to increasing the fee guide from 82% to about 88%. That's what I am aware of right now.

[Don Davies, NDP, Vancouver Kingsway, BC]

If the CDCP pays dentists 88% of the fees that they and the provinces set, would that be sufficient, do you think, to attract dentists to the plan?

[Dr. Amrinderbir Singh]

I am not able to speak on behalf of dentist providers, but I think if more work is required, especially if there's more administrative work, and there's less compensation, that may not be attractive for the providers.

[Don Davies, NDP, Vancouver Kingsway, BC]

Well, there's good news on that front too. Those concerns have been raised for the last two years, but I understand that the CDCP will have a reimbursement goal of money being repaid within 24 hours, and the administration should be no more complicated than that of any other dental plan that offices work with. The other advantage I would mention is that the federal government, of course, is a guaranteed payer, so there's no chasing bad debts.

If the plan is streamlined, is easy to use and has guaranteed quick payment, and if, as you said, you understand that the fee guide is about 88%, do you see any reason dentists may be reluctant to join the plan other than the reduction in money?

[Dr. Amrinderbir Singh]

Another factor would be if existing practices are already full and the providers are at their capacity. Then we would have to look at how we can increase that capacity by bringing in new providers or creating opportunities for internationally trained providers to become licensed in Canada.

[Don Davies, NDP, Vancouver Kingsway, BC]

You clearly care a lot about marginalized communities that don't have access. Do you think the CDCP should prohibit balanced billing in order to minimize out-of-pocket costs for patients, especially, obviously, low-income and poorer patients who haven't been to a dentist in many years?

[Dr. Amrinderbir Singh]

In my opinion, we should look into opportunities to not have balanced billing or to harmonize the fee guides so that we will not be creating tough situations for anybody—providers or patients.

[Don Davies, NDP, Vancouver Kingsway, BC]

I agree. Thank you for that.

[The Chair, Liberal, Peter Fonseca]

Thank you, MP Davies.

Again, members, we have very limited time. We have about two minutes per party for a question or two.

MP Lawrence, go ahead.

[Philip Lawrence, Conservative, Northumberland—Peterborough South, ON]

Thank you.

My question is for Mr. Laberge.

Monsieur Laberge, I want a clarification. Interpretation does their best, but sometimes they're not a hundred per cent.

I almost couldn't believe it when I heard what is stopping your expansion. I understand that millions, or maybe more, are on the line waiting for what is simply a government change with respect to the letters patent. Is that correct?

[Carl Laberge]

I'll speak about the current situation.

We're doing construction work, and we have to make payments to an entrepreneur to get it to advance. We have loans on the side that we cannot access because we are not allowed to by our letters patent. Our letters patent limit our ability to borrow money. We have to have permission from the government to change our letters patent to get access to that money.

Analyses have been done at Transport Canada, but they have to have—I cannot say the blessing—the permission from Finance as well to give us that permission.

[Philip Lawrence, Conservative, Northumberland—Peterborough South, ON]

I'm sorry, but my time is short.

What type of economic outcome would there be from getting these letters patent fixed? How many jobs, how many millions in flows and how much in construction would there be if we were able to get this done?

[Carl Laberge]

Actually, it's just to get that work under way. Our work is under way. If we don't have it, we're going to block everything. We have $110 million on the way, and we might stop that work if we don't have those letters patent.

[The Chair, Liberal, Peter Fonseca]

Thank you, MP Lawrence.

Now we'll go to MP Thompson for a couple of minutes.

[Joanne Thompson, Liberal, St. John's East, NL]

Thank you to both witnesses.

Dr. Singh, clearly this is a historic investment.

I know there's a very short period of time for an answer, but can you explain how investment in the Canadian dental care plan and access to oral health care is going to impact the health care of the many Canadians who haven't been able to access full or even partial oral care?

[Dr. Amrinderbir Singh]

Absolutely.

You said it very well. It is historic. It is a milestone for all of us. Oral health care is on the table, and like many others, I am pleased to see that.

We are aware that the mouth is literally the gateway to the body. It impacts how we function day to day and what we eat. If someone has experienced any type of dental pain in their life, they would know that it is quite discomforting in the way that it inhibits anybody's ability to eat, to smile and to function.

I think this investment has a lot of potential to improve not only oral health, but overall health. There are many demonstrated systemic oral linkages, so this has the potential to also decrease the burden on acute care settings and emergency settings, where people end up in an emergency for oral health care issues.

[The Chair, Liberal, Peter Fonseca]

Thank you, MP Thompson.

Now we will move to MP Ste-Marie.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Thank you, Mr. Chair.

Mr. Laberge, rest assured that we'll follow up on the letters patents.

I can see on screen the Parliamentary Secretary to the Minister of Tourism and Minister responsible for the Economic Development Agency of Canada for the Regions of Quebec, Ms. Koutrakis, who also always proactively follows up on files. With her help and the help of all our colleagues, we can follow up and get things moving again.

You spoke about the budget. You would have liked more support for the port authorities. Can you elaborate, or share any other thoughts on the matter?

[Carl Laberge]

The national trade corridors fund, or NTCF, has been a popular and valued program.

As you know, we hear a great deal about supply chains. The national supply chain office, which the government set up, is starting its work. Investments will be needed in this area.

Ports are highly strategic public assets for the country. They need upgrades and maintenance. To that end, they need the appropriate funding. This program has been quite popular. As far as we know, funds for this program have dried up, creating issues across the country. We think that this is important.

There are many priorities. However, this is certainly one of them.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

As you rightly said, this is a key priority. Your support makes it possible to boost the economy as a whole. This is vital, and I want to thank you for it. My colleagues and I will keep in touch to ensure that your applications move along and that the national trade corridors fund gets a further boost.

[Carl Laberge]

Thank you, Mr. Ste‑Marie. I appreciate it.

[The Chair, Liberal, Peter Fonseca]

Thank you, Mr. Ste‑Marie.

We will now move over to MP Davies.

These will be the last questions for our witnesses.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Dr. Singh.

The CAPHD has said it would like “clarification on how health care providers can coordinate benefits for individuals eligible under more than one public insurance plan”. That means a federal, provincial or territorial plan. It said that's “essential to streamline the process for health care providers and ease the financial burden for eligible individuals, which aligns with the CAPHD's preference for minimizing out-of-pocket expenses for patients.”

It's my understanding, Dr. Singh, that the federal government is in active negotiations with the provinces. That likely will make the federal government the first payer, and then, if a person is on a social services program, the province or territory will be the second payer. In your view, would that be an acceptable coordination of benefits?

[Dr. Amrinderbir Singh]

I would think so, yes. If there is better alignment and better understanding along with the communication and clarity, that would help.

[Don Davies, NDP, Vancouver Kingsway, BC]

Finally, the CAPHD has also said that it's important that this plan “remain responsive to the evolving needs of Canadians.” Can you give us an idea of the kind of data we should be collecting or what we should be looking for to make sure that this plan remains responsive and maybe becomes even better?