Canada's dental associations, which say some of their members are reluctant to participate in the national dental care plan, are in fact just negotiating with Ottawa over the program, says federal Health Minister Mark Holland.
"They're doing their job. They are negotiating," Holland told reporters on Monday. "They want to get the best deal for their members; I want to get the best deal for taxpayers."
However, he said, the federal government can't accept the demand by "a lot" of dentists and other dental care providers that patients pay for services first and then get reimbursed by Ottawa, as is possible with private insurers.
"We can't do that," Holland said. "These are vulnerable people who can't pay out of their own pocket. So that's a red line."
The government, he added, is open to reducing as much as possible the administrative burden on dental providers, but he said Ottawa is also looking for some sort of control mechanism over the program.
"Otherwise, somebody could abuse it and we wouldn't want that, and we do have a responsibility for taxpayers."
The Liberal government launched the Canadian Dental Care Plan as a condition of a deal with the NDP to ensure the opposition party's support on key votes. The federal insurance-like program is expected to provide coverage to uninsured families with a household income under $90,000, starting in May, with seniors the first to be invited to take part. The plan is slated to cost $13 billion over five years.
But the Canadian dental care sector is not fully on board. Associations representing dentists and hygienists have criticized the federal government's payment structure, saying that the proposed fees are lower than the ones their members bill patients. Holland's office, however, has described the proposed fees as "fair."
In Quebec, the association of dental surgeons has come out strongly against the fee structure, arguing that the federal government is asking that they subsidize dental care for low-income Canadians. Providers want patients to pay the difference between the proposed federal fee guide and what they usually charge.
Holland on Monday refused to say how many dental professionals -- dentists, independent hygienists and denturists -- have signed up to participate in the federal insurance plan. He would only say "thousands" have so far committed to taking part.
According to the Canadian Dental Association, the country has approximately 25,500 licensed dentists. It says nearly 61 per cent of dentists surveyed by their provincial associations last month indicated they did not intend to register with the federal system.
Time is running out, as the first patients enrolled in the program should have access to subsidized dental care in May, but only from a registered provider. For several months, Ottawa has been expanding the age ranges of Canadians eligible to apply to the program, which is currently open to people 70 and older.
About 1.6 million people have signed up. In Quebec, the program is particularly popular, with 576,000 registrations.
Over the course of the year, eligibility will be expanded to all people aged 65 and over, those under 18 and people living with disabilities. Those aged 18 to 64 will be able to enrol in 2025. The insurance plan is administered by Sun Life Canada.
Asked about the reluctance of providers to participate in the program, federal NDP Leader Jagmeet Singh said he is not concerned. Decades ago, when universal health coverage started in Canada, "the same thing" happened and doctors "were against it." And yet, he noted, medicare is now working.
This report by The Canadian Press was first published April 9, 2024.
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