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Canadian dentists desperate for details on federal dental care plan

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News release from Canada’s Provincial and Territorial Dental Associations

Canadian dentists to MPs: We need answers about the Canadian Dental Care Plan

Lack of consultation with provincial and territorial dental associations is worrying

There are only two months left before the Canadian Dental Care Plan (CDCP) becomes available to many more Canadians. Yet more than 25,000 dentists nationwide are in the dark about how the Government of Canada will safeguard access to dental care.

In a letter sent to Members of Parliament (MPs) this week, the presidents of provincial and territorial dental associations across the country asked how the government will:

  • Safeguard employer-provided dental plans that two-thirds of Canadians currently have access to?
  • Ensure that a strong federal program can be coordinated with existing provincial programs?
  • Protect patient choice and maintain the patient-provider relationship?
  • Ensure minimal, efficient administration that promotes timely access to care?
  • Respect the costs of delivering dental care to maximize provider participation?
  • Increase the number of dental assistants and dental hygienists to meet the demands of the CDCP?

Dentists want to champion a CDCP that will respect patients, providers, and taxpayers. The provincial and territorial dental associations are concerned that the CDCP has been compromised by a lack of meaningful consultation with dentists – who will be expected to deliver on the government’s promises.

The CDCP is currently in final planning stages, with a potential rollout in 2024 that will attempt to increase access to uninsured Canadians under 18, people with disabilities, and seniors who have an annual family income of less than $90,000. Dentists believe all Canadians need access to dental care. If not done properly, two-thirds of Canadians who have great employer-provided dental plans could lose their coverage and be forced into a worse plan. Costs would then skyrocket, which means the $13 billion over five years the government set aside would not be enough to sustain the plan.

Let’s take the time to get it right. We can increase access to dental care right now through an expansion of the interim measure already in place – the Canada Dental Benefit. This establishes a fixed dollar amount that a patient can use to be reimbursed for dental-related expenses.

Facts:

  • Canada’s provincial and territorial dental associations represent more than 25,000 licensed dentists working in more than 16,000 offices. They treat more than 30 million Canadians every year and employ at least 50,0001 oral health care workers.
  • Over 60 per cent of Canadians have a dentist they visit on a regular basis.2
  • A recent survey commissioned by Health Canada found that nearly nine out 10 Canadians are satisfied with the Canada Dental Benefit.3

Quotes:

“To succeed, this plan needs to work for both patients and providers, and to work in each province. What we are recommending is based on decades of experience and caring for the oral health needs of the more than 30 million people that come into our dental offices across the country every year.” — Dr. Bruce Yaholnitsky, President, Alberta Dental Association

“Poorly designed programs do not improve access to care, and they leave the most vulnerable people in society behind. This is an historic opportunity, but only if the government gets it right. Dentists have the expertise, experience, and skills to know what it takes to ensure good oral and overall health.” — Dr. Rob Wolanski, President, British Columbia Dental Association

“As dentists we are excited to be a part of this Canadian dental care program, but there are key critical issues that need to be included for this program to be successful.” — Dr. Scott Leckie, President, Manitoba Dental Association

“New Brunswick dentists are already extremely busy with the recent spike in population and the backlog in demand for services related to Covid-19. This program was intended to provide dental care to the 35 per cent of Canadians who are uninsured. It needs to be easy to understand and to administer, and to be fair to all parties, including patients, dental care providers and taxpayers. Canadians need to know what benefits are being provided and which are not, before they arrive at the dental clinic.” — Dr. Joanah Campbell, President, New Brunswick Dental Society

“The new program must be sustainable in terms of funding, and easy to understand and access. It has to be patient-centred and work for everyone.” — Dr. Shane Roberts, President, Newfoundland & Labrador Dental Association

“While the CDCP has the potential to improve the lives of many Canadians, this can only be achieved if it’s done right. To ensure the greatest possible outcome, we must consider all of the moving pieces and take a patient-centred approach.” — Dr. Juli Waterbury, President, Nova Scotia Dental Association

“The CDCP could be a game-changer for Canadians’ access to dental care. But we have one chance to get it right. Here in Ontario, we have seen that dental care programs developed without the input of dentists are doomed to fail. Just look at the Ontario Seniors Dental Care Program, where waiting lists are up to two years long in some areas, and some patients have to travel ridiculously long distances to receive treatment.” — Dr. Brock Nicolucci, President, Ontario Dental Association

“This new program has the potential to improve access to care for many Canadians. It must be sustainable, patient-centred, and easy to access for patients. A poorly designed program will not improve access to care which is something we would like to avoid. We want this to work for Canadians.” — Dr. Derek Thiessen, President, College of Dental Surgeons of Saskatchewan

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Addictions

Why can’t we just say no?

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From the Frontier Centre for Public Policy

By Susan Martinuk

Drug use and violence have become common place in hospitals. Drug-addicted patients openly smoke meth and fentanyl, and inject heroin. Dealers traffic illicit drugs.  Nurses are harassed, forced to work amidst the toxic fumes from drugs and can’t confiscate weapons. In short, according to one nurse, “We’ve absolutely lost control.”

“Defining deviancy down” is a cultural philosophy that emerged in the United States during the 1990s.

It refers to society’s tendency to adjust its standards of deviancy “down,” so that behaviours which were once unacceptable become acceptable.  Over time, this newly- acceptable behaviour can even become society’s norm.

Of course, the converse must also be true — society looks down on those who label social behaviours “wrong,” deeming them moralistic, judgemental or simply out of touch with the realities of modern life.

Thirty years later, this philosophy is entrenched in British Columbia politics and policies. The province has become a society that cannot say “no” to harmful or wrong behaviours related to drug use. It doesn’t matter if you view drug use as a medical issue, a law-and-order issue, or both – we have lost the ability to simply say “no” to harmful or wrong behaviour.

That much has become abundantly clear over the past two weeks as evidence mounts that BC’s experiment with decriminalization and safe supply of hard drugs is only making things worse.

recently-leaked memo from BC’s Northern Health Authority shows the deleterious impact these measures have had on BC’s hospitals.

The memo instructs staff at the region’s hospitals to tolerate and not intervene with illegal drug use by patients.  Apparently, staff should not be taking away any drugs or personal items like a knife or other weapons under four inches long.  Staff cannot restrict visitors even if they are openly bringing illicit drugs into the hospital and conducting their drug transactions in the hallways.

The public was quite rightly outraged at the news and BC’s Health Minister Adrian Dix quickly attempted to contain the mess by saying that the memo was outdated and poorly worded.

But his facile excuses were quickly exposed by publication of the very clearly worded memo and by nurses from across the province who came forward to tell their stories of what is really happening in our hospitals.

The President of the BC Nurses Union, Adriane Gear, said the issue was “widespread” and “of significant magnitude.” She commented that the problems in hospitals spiked once the province decriminalized drugs. In a telling quote, she said, “Before there would be behaviours that just wouldn’t be tolerated, whereas now, because of decriminalization, it is being tolerated.”

Other nurses said the problem wasn’t limited to the Northern Health Authority. They came forward (both anonymously and openly) to say that drug use and violence have become common place in hospitals. Drug-addicted patients openly smoke meth and fentanyl, and inject heroin. Dealers traffic illicit drugs.  Nurses are harassed, forced to work amidst the toxic fumes from drugs and can’t confiscate weapons. In short, according to one nurse, “We’ve absolutely lost control.”

People think that drug policies have no impact on those outside of drug circles – but what about those who have to share a room with a drug-smoking patient?

No wonder healthcare workers are demoralized and leaving in droves. Maybe it isn’t just related to the chaos of Covid.

The shibboleth of decriminalization faced further damage when Fiona Wilson, the deputy chief of Vancouver’s Police Department, testified before a federal Parliamentary committee to say that the policy has been a failure. There have been more negative impacts than positive, and no decreases in overdose deaths or the overdose rate. (If such data emerged from any other healthcare experiment, it would immediately be shut down).

Wison also confirmed that safe supply drugs are being re-directed to illegal markets and now account for 50% of safe supply drugs that are seized. Her words echoed those of BC’s nurses when she told the committee that the police, “have absolutely no authority to address the problem of drug use.”

Once Premier David Eby and Health Minister Adrian Dix stopped denying that drug use was occurring in hospitals, they continued their laissez-faire approach to illegal drugs with a plan to create “safe consumption sites” at hospitals. When that lacked public appeal, Mr. Dix said the province would establish a task force to study the issue.

What exactly needs to be studied?

The NDP government appears to be uninformed, at best, and dishonest, at worst. It has backed itself into a corner and is now taking frantic and even ludicrous steps to legitimize its experimental policy of decriminalization. The realities that show it is not working and is creating harm towards others and toward institutions that should be a haven for healing.

How quickly we have become a society that lacks the moral will – and the moral credibility – to just to say “no.”

Susan Martinuk is a Senior Fellow with the Frontier Centre for Public Policy and author of Patients at Risk: Exposing Canada’s Health-care Crisis.

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Fraser Institute

Bill Maher is right about Canadian health care

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From the Fraser Institute

By Mackenzie Moir

Recently, popular American comedian and talk show host, Bill Maher, took aim at some of Canada’s public policy failings in one of his monologues. In entertaining fashion, Maher highlighted our high housing costs, unemployment rates and “vaunted” health-care system.

Indeed, citing work published by the Fraser Institute, he explained that after adjusting for age, Canada spends 13.3 per cent of our economy on health care (2020), the highest level of spending by a developed country with universal coverage that year. And that Canada has some of the poorest access to timely appointments with family doctors when compared to our peers.

Unfortunately, while that’s where his segment on health care ended, the bad news for the Canadian system doesn’t stop there.

On top of Canada continuing to be one of the most expensive universal health-care systems in the world, we get little in return when it comes to both available medical resources and wait times. For example, among high-income countries with universal health care, Canada has some of the lowest numbers of physicians, hospital beds, MRI machines and CT scanners.

And in Canada, only 38 per cent of patients report seeing a specialist within four weeks (compared to 69 per cent in the Netherlands) and only 62 per cent report receiving non-emergency surgery within four months (compared to 99 per cent in Germany).

Unfortunately, wait times in Canada aren’t simply long compared to other countries, they’re the longest they’ve ever been. Last year the median wait for a Canadian patient seeking non-emergency care reached 27.7 weeks—nearly three times longer than the 9.3 week-wait Canadians experienced three decades ago.

This raises the obvious question. How do other countries outperform Canada’s health-care system while also often spending less as a share of their economies? In short, their approach to universal health care, and in particular their relationship with the private sector, departs drastically from the approach here at home.

Australia, for example, partners with private hospitals to deliver the majority (58.6 per cent) of all non-emergency surgeries within its universal health-care system. Australia also spends less of its total economy (i.e. GDP) on health care but outperforms Canada on every measure of timely care.

Even with restrictions on the private sector, Canada has some limited experience that should encourage policymakers to embrace greater private-sector involvement. Saskatchewan, for example, contracted with private surgical clinics starting in 2010 to deliver publicly-funded services as part of a four-year initiative to reduce wait times, which were among the longest in the country. Between 2010 and 2014, wait times in the province fell from 26.5 weeks to 14.2 weeks. After the initiative ended, the province’s wait times began to grow.

More recently, Quebec, which has some of the shortest wait times for medical services in the country, contracts out one out of every six day-surgeries to private clinics within the publicly-funded health-care system.

Maher’s monologue, which was viewed by millions online, highlighted the key failings of Canada’s health-care system. If policymakers in Ottawa and the provinces want to fix Canadian health care, they must learn from other countries that deliver universal health-care at the same or even lower cost, often with better access and results for patients.

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