Minister Holland is “insulting,” say Quebec dentists

Photo: Patrick Doyle The Canadian Press Federal Health Minister Mark Holland at a press conference Tuesday in Ottawa

Michel Saba – The Canadian Press in Ottawa

07:34

• Canada

Quebec dentists consider it “insulting” that the federal Minister of Health, Mark Holland, makes them appear, they say, as “bad people who will abuse people” if they charge fees higher than those provided for in the new federal dental care plan which would be “fair”.

“Put yourself in our shoes. It’s like hearing that our regular fees are unfair. […] We are really very irritated by the minister's comments,” declared the president of the Association of Dental Surgeons of Quebec, Dr. Carl Tremblay, in an interview with The Canadian Press< /i>.

Dr. Tremblay insisted that the fees suggested to dentists by his organization are not too greedy. “Our fees are fair and reasonable. They are established according to the expenses that a dentist has to assume to provide you with the service,” he defended.

The professional union estimates that approximately 70% of the amounts billed are used to pay expenses to operate the clinic and the remainder goes to the dentist's remuneration. He also notes that the average income of Quebec dentists has decreased in recent years due to a more rapid increase in costs than in list prices.

The Canadian Dental Care Plan (CDCP) is set to become “the largest federal program in Canada,” according to Minister Holland. Ultimately, the nine million Canadians — or about a quarter of the population — who do not have private insurance and who have low or middle income will be covered.

The program will provide free care as long as the dentist follows the federal government's fee guide and the patient has an adjusted net household income of less than $70,000. Those with income between $70,000 and $90,000 will be required to pay a co-pay ranging from 40% to 60% of the costs. It will be mandatory to have filed your income tax return to be covered.

“Sickening” the dentists

Dr. Tremblay cannot digest Minister Holland's comments that dentists are “negotiating” with Ottawa to obtain “the best deal for their members” and that the government is seeking, conversely, “ the best deal for taxpayers.”

“What he says between the lines is that we ask the dentist to only accept what the plan will cover,” sighs Dr. Tremblay on the line. This is downright asking us for charity. »

Dentists will not “subsidize” the program by giving a discount to patients who qualify, he cautioned. And on this subject, “it is completely false” that they are trying to negotiate the fees.

“We will continue to charge our usual rates,” said Dr. Tremblay.

Although dentists are very supportive of a dental care program, their president warns that if Ottawa does not “reframe” its message and continues to “sicken” them, many of them could well end up unsubscribe from the program. “That would be very unfortunate,” he said.

Also read

• Dental plan under negotiation, says Minister Holland
• The federal dental insurance plan will be gradually implemented in 2024
• Asked about negotiations with Quebec regarding dental care, Holland speaks of uniformity

In Ottawa, the Minister of Public Services and Procurement and former Minister of Health, Jean-Yves Duclos, argued that “in the very, very large majority of cases” the reimbursement proposed by the federal government is “very close” to the rates dentists charge, generally “between 80% and 100%.”

He explained that the fee schedule developed by Ottawa is based on the “utility of care” and that, for example, preventive care will be almost entirely reimbursed since it has “the most impact” on the health of the population. population.

Mr. Duclos also assured that the government is not asking dentists to grant a discount to patients and that he has no objection to patients being billed the difference between the fees usually charged and what will be reimbursed by the regime.

“That’s how current private plans work,” he said. In most cases, reimbursement from private plans […] is around 80% and patients reimburse the balance directly to the dentist. »

But his colleague Holland rejected the idea that patients pay their dentist and then be reimbursed by Ottawa, as can be the case with private insurers. He called it “a red line” since it would hurt those who cannot afford to pay out of pocket. This implies that if a dentist refuses to register, his patient is likely to change clinics.

Dentists are also “insulted” by the fact that Ottawa wants to pre-authorize care, which they consider to be an attack on their professional judgment.

“We want to look over your shoulder because we don’t trust you, […] we think you would like to exaggerate,” illustrated Dr. Tremblay.

Many patients, few dentists

Prime Minister Justin Trudeau announced Tuesday that no less than 1.7 million seniors are now registered with the federal dental care plan. In Quebec, the program is particularly popular with more than 576,000 registrations.

“This clearly signals that there is a very important need in Quebec,” analyzed Minister Duclos. One of the reasons that seems to explain this great participation […] is that seniors in Quebec have less access to private health insurance plans that include dental care. »

Ottawa has been expanding the age ranges of Canadians invited to submit an application for several months. It is currently the turn of seniors aged 70 and over. In May, eligibility will be expanded to everyone age 65 and older. Those under 18 and people living with a disability will follow during the year. Those aged 18 to 64 will be able to register in 2025.

The first Canadians enrolled in the program should be able to begin getting their teeth cleaned and treated in May, but only from an oral health provider who has signed up to provide the care.< /p>

As for the number of dentists, independent hygienists and denturists who have registered, Ottawa refuses to reveal it, simply saying that there are “thousands” in the country. However, according to the Canadian Dental Association, the country has approximately 25,500 dentists authorized to practice.

In Quebec, Dr. Tremblay calculated from public data from Sun Life — the company that administers the plan — that approximately 650 dentists have registered while the province has nearly 5,500, or about 12%.

And the distribution of dentists is far from equitable across the region. Although there are many of them in the metropolis, there are none in Rouyn-Noranda, Val-d’Or, Sept-Îles or Rimouski.

The establishment of the federal dental care plan is one of the main elements of the agreement of support and confidence that the Liberal government of Justin Trudeau concluded with the New Democratic Party in order to maintain itself in power in exchange for supporting key votes in the House of Commons.