Towards equitable dental care in Canada: Lessons from the inception of Medicare

Abstract

AbstractDental care in Canada is primarily financed through private insurance plans and out‐of‐pocket payments. While Canada is internationally recognized for Medicare, a publicly‐funded health insurance system that covers hospital and physician‐provided services at the point of care, it remains one of the least equitable Organization for Economic Co‐operation and Development countries in terms of affordable access to dental care. Approximately one third of Canadians do not have access to dental insurance, including half of low‐income individuals, and individuals with the greatest dental care needs are often unable to reliably access dental services. Select populations—such as children, Indigenous peoples, seniors, and persons living with disabilities—receive some level of publicly‐funded dental services, amounting to approximately 6% of total dental spending nationwide. Despite the evolution of Medicare, dental care has been largely excluded from federal health legislation following World War II. However, in March 2022, the Liberal Party of Canada partnered with the federal New Democratic Party to advance common legislative goals, including a long‐term nationwide dental program for low‐ and middle‐income families. As an interim measure, Bill C‐31 was signed into law on 17 November 2022, and created the Canada Dental Benefit, which provides a fixed transfer payment to individuals with an annual household income under $90,000. This commentary reviews the origins of Canadian Medicare, discusses the factors that led to the continued exclusion of dental care from federal health legislation, examines the newly‐minted Canada Dental Benefit, and explores the potential for expanded public funding in Canadian dental care.