Bridging the Financial Gap in Dental Care
Building a sustainable and effective federally funded program
Building a sustainable and effective federally funded program
Three-quarters of Canadians consult a dental professional every year, which is amongst the highest annual utilization rates for dentistry in the world.2 This is, in part, the outcome of Canada’s unique, high-functioning and efficient private dental insurance sector that has served the majority of working Canadians and their families for decades.
Private health benefits, particularly employer-provided dental benefits, are the essential core of dental care financing in Canada. About 95% of dental care is financed through private sources, either private insurance (55%) or out-of-pocket payments (40%).3
Unlike medical care, which is almost exclusively publicly financed in Canada, dental care generally falls outside the scope of provincial and territorial universal health insurance plans. When compared to the mix of funding sources for dental care in other high-income countries, Canada is the highest in its proportional use of private health insurance for dental care. Most Canadians’ dental insurance is via employer-provided benefits; approximately half of Canadians have it. Employer-provided benefits are integral to access to dental care in Canada, and the nation’s oral health is dependent on it remaining available to patients.
In 2021, the health insurance sector paid $30.4 billion in claims for 27 million Canadians. An estimated $9.5 billion (32%) was for dental care.4 The majority of employees consider basic dental care to be one of the most valued benefits. Many Canadians say that an unsatisfactory employer-provided benefit plan would cause them to look for a new job.5
Canadians with benefits and those who can pay out-of-pocket enjoy flexibility in their choice of dentists, minimal wait times and high-quality dental care with few limitations. Studies show that people who have dental insurance are more likely to visit the dentist and receive dental care, which contributes to better oral health outcomes.6 7 8 Policy instruments that could potentially impact employer-provided dental benefits to any extent must be carefully considered because they risk having significant and consequential impacts throughout the employment sector.
A recent poll of Canadians indicated that 78% support the federal investments in dental care, however support falls to 39% when the idea that it might impact existing employer-provided dental benefits is introduced. Also, 70% of Canadians with employer-provided benefits would be unable to, or not easily, afford dental care if those benefits were lost.1
During the pandemic, about 10% of Canadians lost or experienced a reduction in their private dental benefits.1 A recent Canadian Community Health Survey found 1 in 5 Canadians without private dental benefits avoided going to a dentist because of cost.9 A large proportion of Canadian seniors lose their private dental insurance after retirement. According to Statistics Canada projections, by 2030, close to one-quarter of the population could be aged 65 and older, up from 19% in 2022 and 14% in 2010.10 According to the latest census figures, Canada’s working-age population is also older than it has ever been, with more than 1 in 5 working adults now nearing retirement, and this group now makes up a larger share of the Canadian population than those aged 15 to 24.11
In the context of demographic and economic challenges, an effective and equitable oral health care delivery system in Canada is a blended model that includes a modernized and efficient private insurance sector as the essential core of dental care delivery with the addition of a properly designed and adequately funded public component.
