With the recent announcement by Premier Danielle Smith for the Alberta government to opt out of the Canadian Dental Care Plan (CDCP), Alberta dentists aren’t ready to sink their teeth into this decision until there’s more clarity and consultation on the situation.
In a letter sent by Smith to Prime Minister Justin Trudeau on June 25, it outlined that Alberta offers the most extensive, publicly funded dental coverage in Canada.
“Approximately 500,000 Albertans benefit from these dental plans, including low-income families and other vulnerable individuals such as children in care,” Smith wrote. “Alberta began offering dental programs in 1973 and, since that time, has developed the expertise to successfully design, implement and maintain these much-needed programs.”
She further explains that the CDCP replicates the coverage many Albertans already receive, the confusing nature of implementing another dental plan, eligibility concerns, and that health care planning and delivery is an area of provincial jurisdiction, which she says the new federal plan infringes upon.
“We anticipate our respective officials can negotiate mutually agreeable terms within a two-year timeframe and plan to opt out by 2026,” Smith outlined.
In a press release by the Alberta Dental Association (ADA), it outlines that without further details, opting out of the federal program would complicate an already complex issue for both dentists and patients.
President-elect of the ADA Dr. Hans Herchen said the ultimate reality of the situation is that no one really knows how this would affect both dentists and patients in Alberta.
“There’s a lot of complexity when there's two levels of government trying to provide a service to the same demographic; so a lot of systems and structures would need to be sorted out,” Herchen explained. “This proposal is welcome, but it also needs a lot of clarification.”
Although Alberta’s programs are among the most diverse in the country, Herchen said they are both outdated and limited the care for both patients and dentists. With coverage at a very modest level, he outlines it is extremely challenging for Alberta dentists to provide care with the current provincial dental programs.
“Most of the provincial dental programs are currently covering our fees at 45 per cent,” he said. “I think Albertans would be shocked that this is indeed the case, [and] this speaks to how good Alberta dentists have been, in terms of accepting this.”
With low fee coverages, it risks driving up dental fees in general, due to the nature of certain costs not being covered. Alongside a slow administrative process, Herchen explained that there’s also additional work to even establish if the procedure would get covered at 45 per cent of their rates.
From a dentist’s point of view, he said that these patients are often the most complicated.
“When we have patients with medical or employment problems, and some of them are unemployable, these are the most difficult patients,” Herchen said. “They need the most care dentally, and yet we have the lowest coverage.
“It increases the risk of hospitalizations and it increases the risk of them losing even more teeth simply because the coverage doesn't cover what's needed in a timely manner.”
When looking at communities like Cochrane, Herchen said it is yet to be determined how opting out of the CDCP would affect residents outside of the city.
“The CDCP has relatively low enrolment in rural areas, so that may be an issue if the provincial government opts out,” he said. “On the other hand, the provincial programs have higher enrolment from dentists, so we would have to establish if the provincial enrolment can exceed the federal enrolment.”
In terms of an actual discussion with the provincial government, Herchen said first and foremost it is critical that they restore a contract with the province.
“It surprises many people to hear that the provincial dentists of Alberta have worked without a contract for seven years,” Herchen said. “We're simply providing our service out of respect for our patients, but doing it without a contract.”
Second, he outlines that there needs to be a clear plan that allows clear verification with a coverage level that is realistic, while also not placing a burden on the rest of the patients in the dentist’s office.
“We don't want to divide our patients into two groups,” Herchen said. “We don't want to have one group of patients with one coverage level and another group of patients from the provincial government, that can't get acceptable care because of low coverage levels.
“We need that resolved," he stated.
In closing, Herchen notes that the CDCP carries and insurance risk that people need to understand.
“If the federal government creates a dental plan, that becomes an alternative to the current plans that many employers are offering, and that creates the risk that employers let go of their employer plan and replace it with the CDCP,” he said. “And now the patients of Alberta lose their outstanding employer plans, and have it replaced with a government program.
“I don’t think that’s good for the patients of Alberta, and that’s a very real risk over time.”
Herchen said it is time for the province to come to the table with dentists in Alberta and work out a plan that benefits everyone inside and out of the dentist’s office. He said that this has been a long-standing issue for a long time, adding that the lack of an agreement has now made it no longer tenable for patients in Alberta.
“I really believe that it's time for the provincial government to sit with the dentists of Alberta, and work with us to design a plan that is good for patients,” Herchen said. “Not a plan that’s politically driven, but a plan that is actually great for patients. That time is now.”
