NDP Leader Jagmeet Singh says his party was willing to be flexible on the first phase of the Liberal government’s dental care plan, but going forward the NDP won’t bend any further.
The government has agreed to introduce a federal dental plan for uninsured low- and middle-income families as part of a supply-and-confidence deal with the NDP.
In exchange for fulfilling its vision for dental care, among other priorities, the NDP agreed not to call an election before 2025.
The agreement stipulates that the government will provide dental care to children under 12 who meet the criteria until the end of this year.
Singh acknowledged in an interview that the timeline was ambitious, so the NDP was amenable to a temporary measure.  “That flexibility has allowed the government to deliver this in a flexible way.”
Instead of launching a full program, the government chose to deliver checks directly to eligible families.  The new benefit provides up to $650 for each eligible child and is based on their family’s income.
To access the money, families with a household of less than $90,000 must make sure their child does not have access to private dental coverage, will have unnecessary dental expenses for which they intend to use the money, and will be able to shows receipts.
The government has announced that the benefit will be a “first stage” while a more comprehensive program is being developed.
Singh said his party had agreed to the benefits plan on the condition that the full program would be ready for the next phase of eligible patients by the end of next year.
The program is supposed to be extended to all children under 18, people with disabilities and the elderly by the end of 2023 and apply to all eligible family members by 2025.
This is not the only line in the sand the NDP has drawn.
“It has to be the full, federally administered program by 2023,” Singh said.
That means, as far as the NDP is concerned, the government can’t force the provinces to hand over the dental care program like they did with child care.
The health minister’s office said in a statement that the government continues to work with partners, including provinces and territories, to improve access to dental care, and more details will come “in due course.”
The fact that the government is taking extra time to get the program right is good news, said Carlos Quiñonez, vice chancellor and director of dentistry at the Schulich School of Medicine & Dentistry at Western University.
“The best scenario, for me, would be if there was a significant corridor – one, two, even three years – to think about all the things that would have to be taken into account in order to achieve a possibility of success of a plan,” said Quiñonez , who was consulted by the federal government.
First, the government should carefully work out how to provide dental care to the uninsured without disrupting what is “on the face of it, a relatively good system,” he said.
Another requirement of the NDP is that the plan, once completed, includes “the highest possible coverage” of services that will protect people’s quality of life.
“We want to make sure that the quality of life is at the top: the best quality and the best practices,” Singh said, acknowledging that some services would be outside that scope.
However, that balance can be hard to find, Quiñonez said.
“For me, this is a very important issue because not only does it have to be scientifically defensible, but also ethically.”
It’s difficult to set hard and fast rules about the number of cleanings someone is entitled to per year, for example, because people with greater oral health needs may need more care, he said.  “These are exactly the reasons why I think it’s wise to take some time and really think about what the implications of all of this are.”
These questions are further complicated when you consider how health and aesthetics have become intertwined in dentistry, said Catherine Carstairs, a professor in the history department at the University of Guelph and author of The Smile Gap: a history of oral health and social inequality.  .
“I think it’s hard in dentistry to distinguish between what is necessary and what appears to be cosmetic, because there really is a mix there.”
Carstairs said she was disappointed with the recently introduced benefits program but still has high hopes for what the federal government can achieve in time.
“It’s not really going to go very far in addressing the needs that people have,” he said.  “But I’m still pleased to see that the program seems to be moving forward in some capacity.”
Legislation to allow allowance payments is expected to be tabled in the House of Commons once MPs officially return from their summer break.
This report by The Canadian Press was first published on September 17, 2022.