Health Committee on Oct. 24th, 2022

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

I heard that part, sir. Do they get the money or not?

[Jean-Yves Duclos, Liberal, Québec, QC]

You cannot have access to private dental insurance; therefore, you are typically struggling in life. You have to look after your children. You don't have a very large income, and you have to chose between paying your rent, your groceries or paying dental care for your children. That's a very hard choice to make for many families.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

That wasn't my question at all.

[The Chair, Liberal, Sean Casey]

Thank you, but that is your time.

We have Dr. Hanley, please, for five minutes.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you very much.

I'd like to add my thanks to the ministers and officials for being here.

Minister Duclos, you have certainly spoken well to the importance of oral health. I salute this first foray into dental coverage for Canadians, coverage that we expect to see eventually expand into full dental care for Canadians. I can't emphasize enough how important an initiative this is, and thank you for your work on this.

To follow on Dr. Ellis's point, I think we may not be in an acute dental crisis, but I think we all agree that we are in the midst of an affordability crisis. I know in addition that access to dental care, including to preventative care, is not equal around the country.

In fact, I was at a national meeting of Canadian dental hygienists in Whitehorse just a few weeks ago. Yes, we do have national meetings in Whitehorse. We certainly heard loud and clear how important preventative care dental therapy for children is to help set them up for lifelong health, good psychological health, good mental health, better attention and learning ability in class, less risk for chronic disease and healthier teeth.

Do you think that children who currently fall between the cracks of access to dental care through provincial and territorial programs may, during an affordability crisis, forgo access to dental care? Is this a means to address not only affordability but to enable access to dental care that may, for some children, not exist?

[Jean-Yves Duclos, Liberal, Québec, QC]

Yes. I think the phrase you pointed to at the end, MP Hanley, is one of the most important ones. Some of our children don't.... Our children are not equal, and those living in families with lower incomes particularly struggle when they need to access dental care.

Just to give you a quick figure, if we cut the population into three pieces and look at the third-lowest income, the population with children, they have two-thirds of the cavities and emergency dental care needs of the population. You see how unequally distributed dental care conditions and, therefore, the dental care needs are across our children.

Let's start by acknowledging that—the impacts on those who live in families with lower incomes and those whose parents don't have access to private dental insurance. We need to acknowledge that. As we acknowledge that together, we can focus on how we can help those families look after their children. That's their objective. That's our objective, I believe, as policy-makers as well.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you.

To change tracks a little bit, Minister Duclos, and take advantage of your being an economist, maybe you can talk to the general principle of targeted versus broad measures to address affordability and to enable a break, as it were, for those who are most in need at a time when we have a cost of living crisis and rising inflation.

[Jean-Yves Duclos, Liberal, Québec, QC]

Let me speak to what economists call “utility”.

Jean-Denis and others wouldn't want to dig too deeply into this.

Welfare or utility well-being, to be properly defined, is a function of many variables. One of them is how much income you have. Another one is your health.

In French, we say that money can't buy health, and that is true. You cannot put a price on health.

I think we have to acknowledge that. As we're reducing poverty, which we have done very successfully through the Canada child benefit, we need to acknowledge that there are other conditions of our children that matter for their well-being. Health is one and oral health is absolutely one of them.

When we invest in those, then we increase the utility function of the family. More importantly, we increase the well-being of the whole family including the children because parents care about their children. They struggle in asking themselves where to invest their rare dollars. Do they invest them in buying clothing for school or buying nutritious food, which is very expensive, or do they bring them to see a dentist?

Unfortunately, too many of our lower-income families don't go to see a dentist because they believe they don't have the means to do so. That's very unfortunate in our collective and individual well-being functions.

[The Chair, Liberal, Sean Casey]

Thank you, Minister.

Next we go back to Dr. Ellis for five minutes, please.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you, Mr. Chair.

I think we've established very clearly that there's no dental crisis here. We know there's a mental health crisis.

The minister has a long list of government witnesses, private sector witnesses and other provincial government witnesses. In this process, how many of those do you think we should be able to speak to here at the committee?

[Jean-Yves Duclos, Liberal, Québec, QC]

That's a great question, MP Ellis.

I think you should ask yourselves that question. It's your wonderful committee members who have the ability and the power to make those decisions among yourselves.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Do you think it should be more than government witnesses?

[Jean-Yves Duclos, Liberal, Québec, QC]

I think it's the question you need to ask yourselves. You have a lot of work, obviously, because health is a very busy committee and you have all sorts of priorities.

We just heard that you want to spend more time on mental health. There is a crisis in accessing family health teams. There are crises affecting our health care workers in long-term care, home care and palliative care. These are all important aspects of health care that you want to invest some of your time and resources in, I'm quite certain.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

All those things are very important. You used the word “crisis” many times.

I think the Canadian Medical Association established that there's a crisis—a catastrophe even. I think those are the words that have been used by the president of the Canadian Medical Association about our Canadian health care system, and here we are spending money on this. What's the urgency, sir? I don't understand.

I know you're going to tell me that oral care is health care. I get all that. Why do we need to rush this thing? Ten billion dollars is a lot of money, and of course, sir, as you know, your government has already added more to the debt in seven years than the previous 148 years of government of this great country.

What's the rush to spend $10 billion?

[Jean-Yves Duclos, Liberal, Québec, QC]

I'm going to try not to be partisan, but I have listened to your questions, Stephen, and others in the House, especially from the Conservative side. You've pointed quite often to the affordability crisis that we are living in. This is an important answer to that crisis.

I find it very difficult to reconcile what I hear in the House about the need to support Canadians—low-income and average-income Canadians—with what we are hearing from you now, which is that it's not a crisis and that we can wait a long time before we help those families.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

I think it's important that we understand there's a guillotine motion with respect to this bill in the House and we're not having a good debate respecting $10 billion.

It's clear, sir, that you don't understand the position that we have on this side of the House. Not to be disparaging towards you, but you're not articulating our position, nor would I expect you to. It's certainly your own partisan opinion and I can understand that because it's hard for you to unravel that, just as it would be for me to understand why you would want to spend $10 billion of Canadians' hard-earned money.

If you want to hand out cheques for $650, that's your prerogative. I don't have an issue with that, but the rush to get this bill through when, as I said, we've clearly established here that there's no dental care crisis.... We do know there's a mental health crisis out there. You're not addressing that at all, sir. Again, I'll go back to the $875 million that should have been spent or at least budgeted by now—which is clearly not—and the $4.5 billion in mental health transfers that have not happened.

We know that people are hurting out there and that money that you already said you were going to spend, you haven't. Now suddenly—big surprise—it's necessary that we spend another $10 billion. It is absolutely mind-boggling to me, when clearly you said yourself that in households, certain things need to be put on hold—

[Adam van Koeverden, Liberal, Milton, ON]

I have a point of order, Mr. Chair, on relevancy.

[The Chair, Liberal, Sean Casey]

There's a fairly broad latitude on relevancy.

Dr. Ellis, go right ahead, but come to your point.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

I think it's very important when we know there's a guillotine motion here to try to pass this legislation unbelievably quickly with respect to $10 billion, give or take, with very little oversight. It is mind-boggling to Canadians how you continue to want to spend their money. I guess that's it.

I do want to go back to the fact that again that Atlantic Canada, which already has a comprehensive program, is really getting no benefit from this program, as you clearly pointed out, because there's not even a copay in Nova Scotia they can apply to this program. Why do you want to penalize Atlantic Canadians?

[Jean-Yves Duclos, Liberal, Québec, QC]

Maybe I should come back to your very early statement, MP Ellis, about the link between this package and inflation. I think it would be very unfair and perhaps even offensive to claim that investing in low-income Canadians is fuelling inflation in Canada.

Inflation is not driven by our support to low- and average-income families. Inflation is driven by the outcomes of the pandemic, the supply chain disruptions, the war in the Ukraine and the energy crisis. No, investing in low- and middle-income families is not driving inflation in Canada.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

I have a point of order, Mr. Chair. The minister is going on about me talking about inflation. I never even said the word “inflation”, so I'm not sure what the relevance of that is.

[The Chair, Liberal, Sean Casey]

You took two and a half minutes to pose your question and he's going to take about another 30 seconds to answer it. Then we're going to move on.

Go ahead, Mr. Minister.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

He can knock himself out.

[Jean-Yves Duclos, Liberal, Québec, QC]

This $900-million investment to look after the dental care needs of our children, that's not driving inflation in Canada and that's not going to drive inflation in the rest of the world either. This is helping low- and middle-income Canadians.

Inflation is driven by other factors than investments in our most disadvantaged families. That, I think, we need to resist spreading opinions on. I think we need to keep doing what we all do well, regardless of party, which is to be mindful, as you do really well in the House, of the cost of living crisis, and repeat the need for the government to invest to make the lives of lower-income families more affordable. You do this really well in the House. We are reacting with this type of measure, and we hope everyone will support it.

[The Chair, Liberal, Sean Casey]

Thank you, Minister.

We have Mr. van Koeverden, please, for five minutes.