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New dental care program should give First Nations benefits more teeth: NDP

OTTAWA — Dental benefits for Indigenous people should be improved if the new national dental insurance plan offers better or more accessible services, NDP health critic Don Davies said Wednesday.
NDP Health Critic Don Davies responds to a question during a news conference on Parliament Hill in Ottawa, Monday, Nov. 14, 2022. Davies says government dental benefits for Indigenous people should be improved if the new national dental insurance plan offers better or more accessible services. THE CANADIAN PRESS/Adrian Wyld

OTTAWA — Dental benefits for Indigenous people should be improved if the new national dental insurance plan offers better or more accessible services, NDP health critic Don Davies said Wednesday.

The Liberals have dedicated $13 billion over the next five years to phase in a new dental insurance program for low- and middle-income Canadians as part of a confidence-and-supply agreement with the NDP.

The government provides dental benefits as part of a federal health-insurance plan for people with First Nations and Inuit status, called the Non-Insured Health Benefits Program, as well as urgent dental care for refugees.

Health Minister Jean-Yves Duclos said he is looking closely at that benefits program — which he said is solid, but not perfect — while his department works on the national dental insurance plan.

"I'm working with (Indigenous Services Minister Patty) Hajdu, who is responsible for the NIHB, to see how we can learn from their experiences and their lessons in order to provide a better program to non-Indigenous Canadians, based on what we do for Indigenous Canadians," Duclos said in an interview last month. 

However, the benefits offered under the Canada Dental Plan likely won't be a carbon copy of what is offered to First Nations and Inuit people, Davies said.

"I have actually given some thought to this issue," Davies said. "Were there to be any improvements to the to the Canadian Dental Plan that's being promoted over and above the NIHB, I do think that they should be made at same time to the NIHB."

Improvements are sorely needed, said Jan Martin, director of Indigenous relations for the Southwest Ontario Aboriginal Health Access Centre.

"We're on the lower rung, on NIHB," Martin said in an interview Wednesday from Sarnia, Ont. 

When it comes to dentures, for example, the federal program only allows people to replace them every eight years, though many dentists recommend that they be replaced after just five.

"They're going without their dentures and they're saying it hurts, it cuts them because their mouth has shifted and they can't get another pair for five years," Martin said of some of her clients. 

She hopes the new emphasis on oral health by the federal government will carry over to Indigenous health, and that First Nations will be given the same consideration, "if not better."

"They've suffered long enough, our people, and it's been documented that our health needs are more chronic than the norm," she said. 

Duclos has already emphasized the importance of preventive care, such as regular cleanings, as part of the new program. The director of dental hygiene practice at the Canadian Dental Hygienist Association said thorough prevention is still lacking in the benefits for First Nations.

"NIHB does not cover a lot of prevention, which is really our focus at this point," Sylvie Martel said at a press conference in Ottawa last week. 

She said ideally, there would be a standard for care across the entire country that federal and provincial programs could abide by. 

Last year, the head of the Canadian Dental Association told the House of Commons Indigenous and Northern Affairs committee that she was concerned Indigenous people would be left behind by the new federal insurance program.

"As it currently stands, none of this funding targets the nearly one million First Nations and Inuit in Canada eligible for the NIHB program," Dr. Lynn Tomkins told the committee last May. "This may actually increase the significant oral health inequities between this group and the broader Canadian population."

The committee also heard that under the non-insured benefits program, some common procedures need to be pre-approved and that forces patients to wait for the care they need. 

In its final report to Parliament in December, the committee recommended the government work with First Nations and Inuit partners to review the benefits and make sure they are comparable to other dental programs, and that the approval process is similar as well. 

The new national dental care program is expected to launch before the end of the year, starting with coverage for uninsured people under the age of 18, seniors, and people living with disabilities.

It will be available to qualifying people whose households earn less than $90,000 per year. Those who make less than $70,000 won't won't have to make copayments.

The program is expected to be available to everyone without private insurance who is under the income threshold by 2025. 

This report by The Canadian Press was first published April 12, 2023.

Laura Osman, The Canadian Press

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