Montreal – The federal government’s new Canadian Dental Care Plan is a significant step forward in reforming dental care and one of the biggest expansions of medicare in 50 years. However, the authors of a study published by the Institute for Research on Public Policy argue the “payer-of last-resort model” the government has chosen to implement the plan falls short of providing equitable access to primary and preventive dental care.

The government pledged $13 billion over five years in the 2023 budget to provide dental care to Canadian families without private dental insurance whose income is less than $90,000 a year. The plan is being rolled out in phases: coverage was extended first to children under 12 years old at the end of 2022; children under 18 years old, seniors and those with disabilities will receive coverage by the of 2023; and then all families that meet the income threshold by the end of 2025.

Colleen M. Flood, the report’s lead author and the incoming dean of the Faculty of Law at Queen’s University, and her co-authors identify four broad policy goals that should guide future dental care reform: universality, fairness, accessibility and accountability. And they weigh the pros and cons of six possible options for achieving these goals – including cash payments, refundable tax credits and transfers to the provinces and territories.

They argue that federal, provincial and territorial governments should work together to create an arm’s-length agency that would be federally funded and empowered  to regulate issues such as user charges and extra-billing. The agency would also be tasked with collecting data on oral health to monitor accessibility, use and quality of care.

This would avoid intergovernmental squabbles over the constitutional division of powers and would be the most effective and efficient way to achieve broad coverage, the report concludes.

“Canada has an opportunity to revolutionize its dental care system and provide equitable access to quality care to everyone in Canada,” said Flood. “With a strong evidence base, Canada will be able to build a better dental care program that not only provides universal coverage, but also ensures that care is received by those who need it most.”

Toward a Universal Dental Care Plan: Policy Options for Canada can be downloaded from the IRPP’s website (irpp.org).