9
Volume1 Issue7
|
CDA
at
W
ork
TheAffordabilityGap
T
he recent report by theCanadian
AcademyofHealthSciences,
Improvingaccess tooralhealth
care for vulnerablepeople living in
Canada
, reveals thatCanada ranks
near thebottomamongOrganisation for
EconomicCo-operationandDevelopment
(OECD) nations in termsof public fundingof
oral healthcare. Canada’s changingpopulation
demographics alsomean that fewer Canadians
haveemployment-baseddental benefits. The
result—awideninggapbetween thosewho
canpay for dental careand thosewhocan’t—
is something that shouldconcernus all.
According to theCanadianHealthMeasures
Survey, 2007–09, about 75%of people living in
Canadavisit thedentist annually, but 17%of our
population reportedavoiding thedentist due
tocost—that’s roughly6millionpeople. Not
surprisingly,morepeople living in the lowest-
income families reportedcost as aproblem,
but the rangeof peoplewho struggle toafford
dental care isbroadening.
Canadian statistics show that thenumber of self-
employed, temporaryandpart-timeworkers—
peoplewith jobs that typically lackemployment-
baseddental benefits—ison the rise. Another
segment of Canadianswith limiteddental
benefits is seniors, ademographicwith low
ratesof insuranceandhigh levelsof dental
disease. For peoplewithout employment
based-dental benefits, the issueof
affordabilitycanoftendetermine their
choice toeither seekor avoiddental care.
Manyof thosewithdental insurancedon’t
necessarilyfind it financiallyeasier because
dental benefitshavebecome less
generous (e.g., limitedannual
maximumsor services, expanded
deductibles andco-payments) or aremore
flexible (e.g., plans that don’t earmark specific
amounts for dental services). Inmyownpractice
inNewfoundland, aprovincewithoneof the
lowest employment rates in thecountryand
its fair shareof temporaryemployment, I’ve
presented treatment plans tomypatientsonly to
have themdecideagainst it once theydiscover
their benefit planhas a sizeabledeductible. For
someof thesepatients, I’ve seenhow ignoringa
relatively small dental problemcanescalate into
muchcostlier treatment.
Cost is just oneofmany factorspreventing
people from seekingcare. Nevertheless, some
groups arequestioning if the fundingand
deliveryof oral healthcare inCanadacanbe
improved—and if so, how? TheCAHS report lays
out anumber of recommendations for achieving
avisionof “equity inaccess tooral healthcare
for all people living inCanada,” andnotes it
“cannot simplydependon thegoodactions
of dental professionals.” Rather, theanswers
will come throughengagementwithall levels
of government, other healthcareprofessions,
organizations representingvulnerablegroups
inCanada, andhealth insurancecompanies.
CDA is committed tobean important player
in theconversationand isworking toaddress
someof thecoreproblemsmentioned in the
CAHS report, suchas identifying targeteddental
programs for vulnerablegroups—whichaligns
withoneof the report’s key recommendations.
CDAwill facilitate thesediscussions through the
CanadianOral HealthRoundtable (formerly the
NationalOral HealthActionPlanSymposium)
planned for February26, 2015. It’s amajor
challenge tomakedental careaccessible for
thosewho stuggle toaffordcare. Yet likean
aching tooth, it’s an issue that can’t be ignored.
GaryMacDonald,dds
Access to care:
From thePresident
