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View Don Davies Profile
View Don Davies Profile
2020-02-25 16:59 [p.1534]
Mr. Speaker, it is an honour to stand in this chamber and speak about something that has been a core gap, an omission in our national health care system for almost half a century.
Canadians are justly proud of our public health care system. It is an accomplishment that defines us as a nation. It is an affirmation that we will take care of each other and our most vulnerable. It is a reflection of our commitment to equality and justice. However, it is not perfect and it is not complete. Many important health services remain uncovered in Canada. For these, patients remain at the mercy of their ability to pay.
Canada's New Democrats are proud to introduce the motion before us today because it would help address one of the most glaring gaps in our public system: dental care.
Our proposal calls on the Liberal government to target its tax plan currently before the House to those earning less than $90,000 per year and use those savings to make a down payment on universal dental care by immediately extending coverage to millions of currently uninsured Canadians.
To be clear, Canadians earning over $90,000 a year do not need a tax cut, but those earning less do need help, and the NDP plan is based on this position.
The omission of dental coverage from our universal health care system is both a pressing public health concern and a social justice issue.
Many would be surprised to learn that the most common non-communicable diseases are oral diseases. Studies have also linked poor dental health to serious health conditions, including cardiovascular disease, dementia, respiratory infections, diabetic complications, renal disease complications, premature birth and low birth rate. Numbers cannot begin to quantify the pain, social impacts, and economic losses suffered by those with untreated dental problems, yet as we speak, 35.4% of Canadians today have no dental insurance, and nearly seven million Canadians avoid the dentist every year because of the cost.
Unsurprisingly, this hurts poor and marginalized Canadians the most. Canada's most vulnerable citizens have the highest rates of dental decay and disease but the worst access to this much-needed service.
According to the Canadian Academy of Health Sciences, 50% of low-income Canadians have no dental coverage whatsoever, along with the majority of seniors over the age of 60. Indigenous populations have nearly twice as much dental disease as non-indigenous Canadians, and income-related inequalities in oral health are greater in women than in men.
Moreover, at a time when wages have flatlined and their job prospects have grown increasingly insecure, young people have also seen benefits like dental insurance rapidly scaled back or completely eliminated by employers. Today only 50% of millennials have access to dental insurance. This deficiency harms career prospects and is a matter of fundamental intergenerational inequity. According to Statistics Canada, young Canadians aged 18 to 34 are the most likely group to report cost as a barrier to dental care.
If we can agree that everyone in Canada should have equal access to health care regardless of their age, income, job status or where they live, then we simply cannot justify the continued exclusion of oral health care from our public health care system.
However, at present, Canada ranks second-last in public financing for dental care among OECD countries. The motion before us today would begin to change that. By making a small modification to the government's tax plan, we can extend dental coverage to 4.3 million uninsured Canadians right away.
I will now provide a brief overview of how we can get this done.
In December 2019, the Liberal government announced its intention to increase the basic personal amount tax credit in 2020. It has marketed this proposal as a “middle-class tax cut”. However, according to the Parliamentary Budget Officer, individuals with net incomes between $103,000 to $160,000 will receive the largest average reduction in their income taxes at $347 annually, while individuals with net incomes below $15,000, the poorest Canadians, will receive the smallest average reduction, at $1.00.
Overall, this tax plan will cost $6.9 billion per year once it is fully implemented. New Democrats believe that this funding should be focused on Canadians who are struggling to make ends meet. We are proposing that the government target this tax plan to those making $90,000 per year or less, with a phase-out beginning at $80,000, and use the $1.6 billion in annual savings to invest in dental care for uninsured Canadians with household incomes below $90,000.
According to the Parliamentary Budget Officer, providing dental coverage for uninsured families making less than $90,000, which is the median income in Canada, meaning 50% of Canadians in this country, would cost $1.8 billion in the first year and approximately $830 million for every year after that.
This program would give immediate help to 4.3 million people and save our health care system tens of millions of dollars every year. After all, emergency room visits due to dental emergencies already cost taxpayers at least $155 million annually.
Under the NDP's plan, there would be no cost for individuals with a household income under $70,000, while copayments would be required on a sliding scale for those with a household income between $70,000 and $90,000.
We are proposing comprehensive care for these Canadians. The minimum basket of services covered would include diagnostic services, preventive services, restorative services, endodontic services, periodontal services, prosthodontic services, oral surgery, orthodontic services and adjunctive services as well.
This program would be the next big expansion in our health care system after pharmacare, which the NDP is also driving forward in this Parliament. This program could be administered by the federal government or by provinces and territories upon agreement. Existing provincial and territorial programs that provide the same services could continue.
I wish to conclude my remarks today by outlining the path forward toward full universal dental care in Canada.
During the last election, New Democrats heard from many Canadians who were struggling to afford necessary dental care. We heard heart-rending stories from Canadians in every province and territory of the physical, emotional, social and economic pain of dental illness. That is why at their first meeting following the campaign, the leader of the NDP pressed the Prime Minister to work across party lines in this minority Parliament to address this urgent health concern.
It is ludicrous that we cover the entire body and then carve out the piece of our mouth and cover it from the tonsils back, but leave Canadians uninsured for the tonsils forward. It is absurd.
I was pleased to see the government acknowledge this NDP priority in its Speech from the Throne and I was heartened that the Minister of Health's mandate letter contained a direction to “Work with Parliament to study and analyze the possibility of national dental care.” The NDP is turning a possibility into reality with the motion here today.
I moved the motion at the Standing Committee on Health at the very first committee meeting dealing with business. I was proud that my colleagues accepted my motion to undertake that study on the development of a national dental care program and I call on my colleagues on the health committee to give this study the upmost priority, but as we prepare to embark on the tremendously important task of developing a national dental care program for Canadians, there is no reason we cannot get started right away, because the need is clear and before us we have a realistic plan to achieve it.
I want to pause for a moment and remind my fellow Parliamentarians why we do not have dental care today. The 1964 Royal Commission on Health Services, which formed the original framework of our public health care system, called for the inclusion of dental services. That was always intended to be part of our public health care system. However, it was not brought in at that time simply because there was a shortage of dentists, a shortage so acute that they believed it was impossible to implement a universal system.
Nevertheless, the commission stated explicitly that it believed that it was imperative for the government to immediately establish a public system for children, expectant mothers and public assistance recipients that could be scaled up, as resources expanded, to a universal system. In fact, it said the program was one of the highest priorities among their proposals. Unfortunately, it was never established by any Liberal or Conservative government to this day.
However, today we have turned Canada's dentist shortage into a surplus, and thereby resolved the original impediment to implementing universal dental care.
It is time to roll up our sleeves and begin the work necessary to make this overdue health care service a reality for Canadians. I therefore call on all members to take that first step today. Let us demonstrate our commitment to universal dental care by making a down payment that immediately extends coverage to 4.3 million people, and then we will do the work to make sure every Canadian gets access to necessary dental care on a universal basis, as was originally intended over 50 years ago.
Canadians have waited long enough. It is time to finally ensure that access—
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