Why was dental care excluded from Canadian Medicare?
The Network for Canadian Oral Health Research (NCOHR) has introduced a working paper series. The summary in this post is based on the first paper in the series.
The Network for Canadian Oral Health Research (NCOHR) is committed to supporting knowledge exchange among researchers, community partners, and the public. The working paper series attempts to fulfill this commitment by providing a means to disseminate well-written, but not yet published, research.
Internationally, health policy analysts are often surprised that Canada’s national system of health insurance (Medicare) does not include dental care. Understanding the historical reasons for its exclusion can inform current domestic and international policy debates on dental care.
This paper proposes five interrelated reasons for why dental care was not incorporated into Canadian Medicare (i.e. legislative, professional, socio-cultural, economic, and epidemiological).
In summary, dental care was not included because of significant decreases in dental caries and limitations in dental human resources as the country’s health legislation was being developed, alongside the presence of a viable alternative option to large-scale treatment services (i.e. fluoridation), and the belief that maintaining one’s oral health and the ability to seek out dental care were individual responsibilities, not social ones. Reflecting on these historical reasons provides an important policy foil for current international efforts at expanding the public financing of dental care.
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My view is that in simple economic terms the Saskatchewan CCF first introduced provincial Medicare as part of the ‘co-operative ‘ to prevent their members from not having to forfeit their farms in order to reimburse extensive medical bills for ‘serious illnesses’.( as is still the case with our southern neighbours!) Later with Tommy Douglas having moved to Ottawa to lead the NDP his party pushed for a Canada wide Medicare Plan and the Liberals under Mike Pearson adopted the proposal as part of their election campaign (they made the same move with introducing a distinctly Canadian Flag,also an NDP proposal) The initial thought process was not a plan covering removal of wax from someone’s ears, cauterizing warts, performing vasectomies, etc and certainly not treating dental disease as this ailment could be treated as necessary( ( no prevention) and if cash was in short supply dentistry could be bartered for as was often the case with minor medical treatment before the age of Medicare. The whole system has become bastardized into a Sick-care plan with very little onus on the patient to maintain a healthy lifestyle and the general Canadian public believing this coverage to be a ‘divine right’ and no current political party daring to tackle reforms( at their peril).