Dental insurance universal, a false good idea

Photo Agence QMI, Joel Lemay
Québec solidaire has recently promised to set up a dental insurance universal public if he was put in power.

Patrick Déry

Tuesday, 6 march 2018 15:45

UPDATE
Tuesday, 6 march, 2018 16:07

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Québec solidaire has recently promised to set up a dental insurance universal public if it were brought to power, a measure which the party evaluates the cost of nearly a billion. The proposal, without a doubt, well intentioned, seeks to fix what is not broken, or rather risk of breaking what does not need to be repaired.

Any proposal of public policy should be based on the reality that is encrypted, and not on perceptions. For example, we cannot ask for an increase in health care spending, saying that they have dropped a quarter in the last 25 years, while in reality they have doubled.

Québec solidaire wants so that 100% of dental care are reimbursed for persons under the age of 18 and recipients of social assistance, as are 80 % of preventative care (cleanings) and 60 % of the curative care (repair of tooth decay) for adults. The justification is that one-quarter of Quebecers say they do not have examination or dental care during the past 12 months, due to the cost of services. This corresponds to the estimate of the Commissioner of the health and well-being, which shows that some European countries are a little or even a lot better than us, while Ontario and the rest of Canada are a little less well. However, I do not agree with the reasons cited to explain this state of fact.

First of all, people who are receiving social assistance for at least 12 months can already receive dental care free of charge. For the others, if they do not have dental insurance, an annual review may represent costs about a hundred dollars. This is probably not the expenditure is the most fun to do, but it is important to keep in perspective that nearly two-thirds of adults in québec have a smart phone, and 84 % are subscribers to a television service, which may represent the expenditure of several hundred dollars per year.

What is the link? It may be that many Quebecers, like others, do not like to go to the dentist, and that this affects their priorities. The government offers free dental care for children up to 9 years of age and under, which includes an annual review. Yet, barely half of parents avail themselves of this service for their children.

Another funny argument is relied on to justify a universal coverage, is that dental caries would be the first cause of hospitalization for children of preschool age. As care are already covered in young children, the problem is clearly elsewhere. But one can hardly force people to brush their teeth or take care of their children!

(There also seems to be confusion with a study that had shown that caries was the origin of the third of day surgeries for children, which is not the same thing.)

The autonomy for hygienists

Another proposal of Québec solidaire would probably have an impact that is more immediate, more to be realistic. It is a question of allowing dental hygienists to practice without supervision by a dentist, as is done in other provinces. It is an excellent idea, which should decrease costs for the patient. Moreover, there is an analogy to do with the greater autonomy to be granted to nurses for acts for which they were formed, whether to extend the practice of superinfirmières or even authorize the establishment of clinical nurse without the doctor, the two ideas are self-evident and that Quebec is slow to embrace it fully.

Finally, the reason probably the most important to not to go to a dental insurance universal public is that the current system works well enough, that the dental health of people is constantly improving, and that in countries where one has put this type of measure in place, for example, Finland, the logic of quota has taken over, and access has become much more complicated, in particular because of time waiting important.

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To reach me : patrick.dery@iedm.org

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