Modernizing the Canada Health Act

Oral health is a part of overall health

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The Canada Health Act (CHA) is Canada's federal legislation for publicly funded health care insurance. The primary objective of the CHA (1985) is "to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers." To receive funding for health care, each province must meet the five main principles described in the CHA (Canada Health Act, 1985). Once funding is received, the provincial government determines where the money will be allocated in the provincial public health insurance plans (Health Canada, 2018).

Dental care covered by the CHA includes surgical extractions as well as oral and maxillofacial surgery provided in a hospital setting. Each province then provides supplemental care to certain groups based on need. Some examples of provincial government funded dental programs include:

• Nova Scotia – Children’s Oral Health Program

• Ontario – Health Smiles Ontario Program

• Alberta – Dental Assistance for Seniors

Why is dental care limited in the CHA, leaving provinces and territories to select who “needs” publicly funded dental coverage? To answer that, we have to consider what impacted and shaped the CHA. According to Quiñonez (2013), there are five key reasons why universal dental care is not a part of the CHA; These reasons are: Legislative, professional, socio-cultural, economic and epidemiological. The CHA has not been changed to reflect today’s society however, and this is currently a topic of interest to Canadians.

Global News recently released a series exploring the Canadian health-care system. In the first installment "Canadian health care stuck in the '60s, expert says" by Mike Drolet (2019), light is shed on the reality that our health care system needs to be changed to protect Canadians with financial insecurity.

The second installment titled "Canadians support publicly funded dental care for those without insurance, Ipsos poll finds" by Jeff Semple (2019) of Global News focused on dental care and financial insecurity. This is particularly interesting to me as an oral health professional. Currently, approximately one third of Canadians do not have dental insurance and may not go to a dentist because of the cost (Semple, 2019). These individuals may end up with dental disease and pain, which eventually sends them to the doctor or even the hospital.

In 2015, the cost for dental problems addressed in the Ontario hospital setting alone was approximately $31 million (Ontario Ministry of Finance, 2019). These hospital visits usually end with antibiotics and painkiller prescriptions, not dental treatment. Emergency visits are often for dental pain; this can stem from a variety of oral health changes. According to the World Health Organization (2010), many painful dental diseases including caries and periodontitis are largely preventable.

If the CHA changed to increase access to dental care for those who cannot afford insurance, it could help lessen the instances of dental pain and visits to the emergency room. As a Registered Dental Hygienist and oral health care promoter, I consider any increase in access to dental care to be a positive change. Though universal dental care would be ideal, providing those without dental insurance access to dental care is a reasonable change that would benefit the Canadian health care system as a whole.

References:

Canada Health Act, R.S.C. (1985, c. C-6). Retrieved May 24, 2019, from https://laws-lois.justice.gc.ca/eng/acts/c-6/FullText.html

Drolet, M. (2019, May 14). Canadian health care stuck in the '60s, expert says. Retrieved May 23, 2019, from https://globalnews.ca/news/5268965/canadian-health-care-stuck-in-the-60s/ 

Health Canada. (2018, February 26). Canada's Health Care System. Retrieved May 24, 2019, from https://www.canada.ca/en/health-canada/services/health-care-system/reports-publications/health-care-system/canada.html

Ontario Ministry of Finance. (2019). Chapter 1, Section C: Protecting What Matters Most. Retrieved May 18, 2019, from http://budget.ontario.ca/2019/chapter-1c.html#s-8

Quiñonez, C. (2013) Why was dental care excluded from Canadian Medicare? NCOHR Working Paper Series, 1(1). 1-5.

Semple, J. (2019, May 15). Canadians support publicly funded dental care for those without insurance, Ipsos poll finds. Retrieved May 23, 2019, from https://globalnews.ca/news/5273773/canadians-support-publicly-funded-dental-care-for-those-without-insurance-poll-finds/?utm_medium=Facebook&utm_source=GlobalHalifax 

World Health Organization. (2010, December 07). Strategies and approaches in oral disease prevention and health promotion. Retrieved May 24, 2019, from https://www.who.int/oral_health/strategies/cont/en/