That, in the opinion of the House, the government should establish a federal dental care plan as soon as possible for Canadian families earning less than $90,000 per year who are not covered by a dental care plan, as an interim measure toward the inclusion of full dental care in Canada’s healthcare system.
Madam Speaker, I am very pleased to rise today in this virtual House to begin debate on this extremely important motion, which would establish a federal dental care plan for all Canadian families that earn less than $90,000 a year in family income and do not currently have a dental care plan. This would be an interim measure toward the inclusion of full dental care in Canada's health care system.
I think it is well known that Canadians are very proud of their health care system. Our national universal publicly funded medicare system is a point of national pride. It is a defining element of our society. When we ask people in public opinion polls, they treat it as a national treasure. Indeed, it is a national treasure. It provides equal care. Regardless of social status, income or where in the country people live, they are entitled to care by our health care system without using their credit card to use their health care card.
We have a significant gap in that system because oral health is one of the most unequal aspects of health care in Canada, as most dental care is not covered by any public insurance plan. In fact, those with the highest levels of oral health problems are also those who have the greatest difficulty accessing oral health care due to cost.
About 35% of Canadians have no dental care plan at all, and more than 20% of Canadians avoid going to the dentist because of the cost. It puts them in a situation where other aspects of their health becomes affected. Left untreated, poor dental hygiene is linked to many other serious conditions, such as cardiovascular disease, dementia, respiratory infections, diabetes complications, renal disease, premature births and low birth weights. There are a whole series of diseases that are affected by a lack of proper dental care.
The evidence is very clear that dental care and oral health care are part of health care. They ought to be considered not as an add-on to a system but as a part of that system. The situation in the last year and a half due to the pandemic has become even more urgent. We have seen millions of Canadians lose jobs over the last year, and with them they have lost their health care benefits, including dental care. There are, of course, many people who never had any health care or dental care to begin with.
Of our young people, 30% have no access to dental care. These are young adults who are no longer covered by their family plan or who never had a plan in the first place. We are seeing emergency rooms across the country feel the full weight of COVID-19, yet every nine minutes, someone visits an emergency room in Ontario for dental care when who that person really needs to see is a dentist.
Also, a recent study at McGill University showed that those with poor oral hygiene are far more likely to experience more severe systems of COVID-19. Shockingly, patients with gum disease are more than three and a half times more likely to be admitted to intensive care, four and a half times more likely to require a ventilator and, sadly, almost nine times more likely to die from COVID-19 compared to those without oral health and gum disease issues.
The plan we wish to put in place is extremely important because a large number of Canadians would benefit from it. The estimates are that almost seven million people in Canada, who are currently not covered by a dental plan and cannot afford to pay the cost, would be covered. That would include more than half of Canadians who have low incomes, more than half of seniors who are age 60 years and older and 30% of young adults. More than a quarter of the women in our country would benefit from this plan because of the income test.
Children with poor oral health are almost three times more likely to miss school due to dental pain than those with good oral health. Some of the stories I heard, the feedback I received from people when we first started talking about this as New Democrats in our election campaign in 2019, are heartbreaking. The feedback I received is astonishing.
Robin from St. John's East said, “I needed a root canal, which would have cost $1,500. Since I didn't have dental coverage, I was unable to have this procedure done, which resulted in having the tooth extracted. This has had dire consequences on my mental health. As someone who works with vulnerable populations, I see the pain both physically and mentally they endure because they cannot afford dental care. The government often talks about the importance of mental health, and access to oral health is a major part of this.”
Charmaine says, “This is so late in coming, but better late than never. We absolutely do need dental coverage here in Canada. So many people are suffering with pain, humiliation, low self-esteem, depression and poverty. There aren't too many employment options for a person with 'dental illness'.”
Jen is a chronically underemployed disabled single mother who says, “I've been forced to choose my child's dental care over my own on many occasions. I've been forced to borrow money and to pay for costly emergency extractions and X-rays. Basic dental procedures should be covered by the government, especially for children. No one should have to suffer dental pain due to poverty in this country. ”
There were many comments like these heard since the beginning of the discussions about this particular program, a program that is absolutely essential to people's health.
There is an economic cost too for the lack of dental care. According to the Canadian Dental Association, poor dental health and oral diseases not only cause pain and long-term health concerns for individuals but account for over $1 billion in lost productivity in Canada per year. Almost 40% of Canadians have been taken away from normal activities because of dental complaints. There are 2.3 million school days and 4.2 million work days lost annually due to dental visits or sick days for dental problems. There are also expenses for emergency room visits for people coming in with dental pain when they really need a dentist.
When we talk about dental care being part of health care, many people ask why it is not already covered under the dental care system. There is an astonishing answer to that a lot of people perhaps are not aware of. In 1964, the Royal Commission on Health Services formed the original framework for Canada's public health care system.
In its final report, the commission called for the inclusion of dental services as part of a health care plan, but it noted the shortage of dentists was so acute at the time that it would be impossible to implement a universal system. However, it did suggest at the time it was imperative to establish a public dental care system for children, expectant mothers and public assistance recipients, which could be scaled up as resources expanded. At the time, this was called one of the highest priorities among all its proposals, in addition to regular health care, but unfortunately it was never established.
Today the situation is quite different. We have plenty of dentists, we have orthodontists and other providers in the dental and oral care system, but we still do not have universal dental care. In Canada, 94% of spending on dental care is private and only 6% comes from government programs. This is the second-lowest level of government spending on dental care among OECD countries, ranking even worse than the United States.
We are proposing a program that would provide dental care without premiums for families with family income of $70,000 or less. For those with incomes from $70,000 to $90,000 per year, there would be a sliding co-pay system.
This proposal would be administered by the federal government or by the provinces and territories upon agreement, and the minimum basket of services would comprise annual diagnostic services, including examinations and radiographs; preventive services, which are very important, including scaling, polishing and fluorides; restorations, including fillings and crowns; endodontic services, including root canal treatments; and various other services that would be required, including oral services and extractions; orthodontic services, including non-cosmetic braces; and the various other associated services that are part of this program.
It has been fully costed by the Parliamentary Budget Officer, and this has been available publicly since October 2020. It would cost about a billion and a half dollars per year. This is a lot of money, but when we look at what the government has spent on special programs in the country in the last year, it is certainly affordable. There may be some upfront costs of about $3 billion because of pent-up demand and untreated diseases that already exist that would have to be looked after, but this is a doable plan.
This is something that can be put in place now. It can be done through the support of Parliament; legislation can make it possible. It is part of what has to be done to deal with a significant lack of equality in this country regarding access to an important part of health care. It is a problem that we can fix and we must fix.
I implore all members of Parliament, each of whom has access to excellent health care and dental care benefits through the House of Commons, to vote in favour of this motion. As I said, it is a problem that we can and must fix.
I want to pay tribute to my colleague, the member for Vancouver Kingsway, who will be speaking to this motion later on today. He has put forth a similar motion in the House, but mine came first in the draw. I am glad to say that it will be a votable motion if we get to debate it at another time. I want to thank my hon. colleague for his work on this issue and for seconding my motion today.