The Minister of Health compares the concern of dentists to the provision of medical care

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OTTAWA — Dentists can't participate in the national dental care plan until they know how it will work, Canadian Dental Association president Heather Carr said Wednesday.

The federal health minister likened their fears to those caused by the introduction of national medicine in the 1960s.

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Carr, whose organization represents provincial and territorial dental associations, said the federal program should be available before registered seniors begin using it next month.

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“We need to know what we're agreeing to and what we can do to take care of our patients,” Carr said.

“I think we should get it from the beginning.”

The program, a key pledge of the Liberals' political pact with the NDP, is expected to provide dental coverage to uninsured families with household incomes below $90,000.

Enrollment has been phased in, and eligible seniors over age 65 are expected to begin coverage.

The Liberals are facing criticism for the program, which is estimated to cost $13 billion over five years, in part because of slow uptake by oral care providers.

Health Minister Mark Holland said on Wednesday the government was working to address dentists' concerns by making it easier to attend without formal registration and expected a “great turnout”.

“We're making it easier for them to participate and we're talking all the time and there are negotiations,” he told reporters on Parliament Hill, adding that “thousands” had already signed up.

He compared this phase of negotiations to the growing burden of establishing national medicine decades ago.

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“It reminds everybody of some of the challenges we had in the early days of health care,” Holland said.

“If you remember back in the 1960s, doctors had a lot of questions, concerns and fears about this expansion of coverage. So any time you expand your coverage and do something new, there may be some challenges.

Many dentists feel they don't have enough information to register at this point, said Carr, a dentist with 36 years of experience.

The fact that they have to register in the first place is something that oral care workers are not used to, she added, as dentists are used to working directly with patients.

If a dentist wants to wait for more information before making an appointment, they could be losing patients, Carr said.

“An existing patient may not be able to see you anymore because there's no case,” he said, calling the program's overall design “much more complicated than it needs to be.”

Groups representing dentists and hygienists have raised concerns about Ottawa's salary structure, saying the proposed payments are lower than what patients are currently paid.

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Dental associations have warned that some of their members are reluctant to participate in the program because of payment concerns.

In addition, patients are told the dental care program is completely free, Carr said, and in some cases there may be “out-of-pocket costs.”

“But we can't be sure about that,” he said.

Holland described the proposed fees as “fair,” but Dr. Carl Tremblay, president of the Quebec Association of Dental Surgeons, sees it differently.

The minister is asking his members to “subsidize” the federal program by offering reduced rates to those who qualify, Tremblay said.

Ottawa is “basically asking us for a handout,” he said, promising to “continue to get our regular rates,” dismissing the notion that it is trying to negotiate its own rates with the federal government.

Tremblay said Quebec dentists found it “insulting” that Holland portrayed them as “bad guys who take advantage of people.”

Tremblay said his organization's fees for dentists are not too greedy. “Our fees are fair and reasonable. They are set on the basis of the costs of the dentist to provide you services,” he said.

The professional association estimates that about 70 percent of the billed amount is used to pay clinic operating costs, and the remainder goes to dentist fees. He also noted that the average income of Quebec dentists has declined in recent years due to costs rising faster than list prices.

Conservative Party leader Pierre Poillevre has yet to take a public stance on the program; his office has not yet responded to media inquiries.

Holland said Stephen Ellis, a Nova Scotia MP and conservative health critic, has canceled a meeting to discuss the program.

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