Madam Speaker, it is a pleasure to speak to this motion. I also acknowledge the contributions of my colleague from Vancouver Kingsway on this issue. I serve admirably with him on the health committee.
As I have said before in debate on similar issues, income and ability to pay should not stop people from having access to needed treatments and care. This is a principle that every Canadian supports. It is something that sets our country apart from others as well, that whole principle of Canadians having reasonable access to the health care they need and deserve. The question becomes how do we deliver that?
We can all agree on the principle and the question then becomes how. This motion suggests one way, and I do have a few questions for my colleagues who are proposing it. I would need a bit more information before I would go to nationalizing dental care as the best way to achieve this outcome. My understanding is that the motion proposes to establish a nationalized dental care plan for individuals who are uninsured and with a household income of less than $90,000 per year.
While this is laudable, I am not sure the motion recognizes there are already a number of government-funded dental care programs that are specifically catered to help vulnerable groups, such as these persons, gain access to dental care. With regard to what is being proposed, I am wondering what gaps are being discussed and why this is necessary if programs like this already exist.
On the flip side of that, the motion and how it reads to me does not clarify how Canadians who already have a dental care plan through their employment, union, insurance or provincial government would be affected. I have raised this concern in a similar motion around a nationalized pharmacare system. For the purposes of this evening, let us talk about dental care coverage.
In my research, in 2018, according to Statistics Canada, approximately 65% of Canadians had access to dental insurance to cover all or part of their expenses. Then existing provincial programs filled in the gaps. The motion does not say how adequate that coverage is and where the gaps are with respect to what is needed to cover those gaps as well as what the additional cost would be to the provinces.
For example, Ontario has a government-funded dental care program that provides free routine dental services to low-income seniors who are age 65 and older, and for children and youth age 17 and under. In Alberta, Albertans can apply at an Alberta Health Services dental clinic for reduced fee dental care for families in financial need. In British Columbia, individuals who receive income or disability assistance are eligible to have basic dental cost coverage. Nova Scotia has the Nova Scotia children's oral health program that covers basic dental care services for children from birth until they are 15, and so on across the country.
At this point, it is incumbent upon me to bring up the element of jurisdiction as is always discussed in the issue of health care and health care programming. As I have just outlined, existing provincially funded dental care programs do exist across the country. I am wondering if a better course of action would be to get the federal government to enter into negotiations with provinces to mandate means-tested dental coverage for seniors and low-income residents who cannot access private dental care plans via their employer or through other means. Is that a better step one? I will try and provide some rationale for that.
To support this argument, the Canadian Dental Association has stated that while it advocates for improving access to oral health care, it believes the best way to achieve this is by improving the funding of existing public programs. I am wondering if creating another bureaucracy or nationalized program would be the best way to target Canadians who are most in need. Perhaps, the best way to understand those gaps and then address them is to enter into negotiations with the provinces in the manner I suggested above.
Health care delivery does have a large jurisdictional responsibility within the provinces, and while I believe federal and provincial governments should work together to address issues like this, we also need to ensure that the potential solution respects jurisdictions and unique regional challenges, which are a part of our confederation.
The other thing I am a little concerned about with the motion is on the cost. Now, I understand that the PBO has done some preliminary analysis, but when I read the 2019 cost estimate of election campaign proposals by the PBO, I saw there is a moderate level of uncertainty with cost estimates. This is due to assumptions about population growth, disease prevalence, utilization rate, inflation and the possibility that the new nationalized plan might cause existing public and private insurers to reduce or even cancel their coverage.
This is something that I think we have a responsibility to discuss, and it is the same principle as pharmacare. What would be the cost or potential risk of using a nationalized program? Would it displace coverage that Canadians already have through private means? I am not clear, from what is in the motion, if safeguards would be built in to prevent that from happening, or if the member is suggesting a full nationalization of the system and this is the first step towards that.
I raised this issue in the context of pharmacare with an example that I think many Canadians who live in Ontario would know. When Ontario tried to nationalize health care with OHIP+ under the Ontario Liberals, OHIP+ created coverage for 1.2 million Ontarians who did not have it before, but transferred 2.1 million Ontarians who already had private plans to a public plan that did not have the same level of coverage. I am concerned that, without having some prescriptive boundaries around ensuring that displacement of coverage does not happen, jumping to a nationalized model is perhaps not step number one, especially when that is coupled with the issue of jurisdiction.
There are a couple other things that I want to raise as well. Throughout the course of my parliamentary career, I have had many constituents who come in, new Canadians, who were concerned about the issue of credentialling, and one area of credentialling that I hear about over and over particularly is for the dental profession in Canada.
As I am sure everyone who is listening tonight is aware, it is very difficult to have dental credentials recognized in Canada. Of course, we respect professional associations, but I am wondering if we actually have an adequate number of dentists in Canada. Perhaps that is a reason why costs are being driven up. Is it supply and demand issue, and if we had more supply, would this still be an issue?
Listening to the speech from my colleague from the Liberal Party, he talked a lot about access to care in Canada. I am wondering if perhaps there was a bit more information on where the gaps are here, so we might have a better solution moving forward.
I am a Conservative. I think it is my obligation to provide a viewpoint in the House that suggests that maybe we do not always need to leap to more bureaucracy and government in every instance, but I do agree that the goal of providing access to care for dental services for those who are lower income or who might not have coverage is a laudable one.
However, I think that perhaps the better first step, as opposed to just moving towards a new bureaucracy, would be to work collaboratively with the provinces, respecting jurisdiction and looking at a means-tested solution, such as the one I provided, while simultaneously ensuring that there are safeguards in place for those who do have adequate coverage.