Dear Valued Patients of Georgian Bay Family Dentistry,

The Government has recently released the details of the Canadian Dental Care Plan (CDCP) to the dental community. I am very disappointed with the proposed plan. After careful review and consideration, we will not be accepting it at Georgian Bay Family Dentistry. I understand that this will disappoint those who qualify for the program, and an explanation is warranted. I’m confident that once you are made aware of the underlying details of the plan, you will understand why I find the program unacceptable in its current form, and why it appears the majority of clinics in Canada, like myself, will not accept it.

Better access to dental care is to the benefit of everyone and will always have the support of the dental community. Dental associations and their members across Canada agree that the design of a fair and sustainable Government-subsidized dental care plan should:

1. Safeguard your access to dental care by respecting the current workplace, school and/or group dental insurance system.
2. Allow you to choose your own dentist in your community.
3. Ensure you can access the dental care you need without having to deal with needless administrative delays and red tape.
4. Fairly compensate the dental professionals who deliver the care.

Dentists and their associations brought these points to the Government, but were refused a seat at the table to participate in the design of the CDCP. Unfortunately, the structure of the CDCP does not deliver on any of our core recommendations and as a result, does not have our support. Not allowing the participation of the dental community that will be responsible for providing the care feels like a fundamental mistake on the part of the Government of Canada.

For our clinic, there are numerous flaws in the design of the CDCP that prevent our ability to participate. They fall into three broad categories:

1. Unfair contract terms.
2. Significant administrative burden.
3. Unfair remuneration.

Unfair Contract Terms

Dentists are required to register for the program if they choose to participate. This involves signing a contract that allows the Government to change the program unilaterally at any time. This means agreeing to any – and all – future changes, regardless of fairness or practicality. This is unprecedented. No private insurance plan or other Government-funded dental plan requires registration, or the signing of contracts. I cannot, in good-conscience, sign these documents. So long as this is a feature of the CDCP, we will not be participating.

No Direct Reimbursement

We are a ‘non-assignment’ clinic. Patients are billed by the office and receive direct reimbursement from their insurer. The billing policies of our office are long-standing and fundamental to the way the clinic operates. The CDCP will not allow direct patient reimbursement. There appears to be no justification for this, and it unfairly eliminates us, and all other non-assignment offices from the ability to participate in the program.

Administrative Burden

This program creates a significant additional administrative burden.

It requires repeated verification, pre-determinations and post-determinations to be done, and claims to be submitted through a specific portal. The extra steps involved in participating in the CDCP are onerous and are not in line with other programs. We do not have the staff available or systems in place for this type of program. The administrative burden was one of the core concerns of dentists regarding the CDCP and the resulting program is disappointing and unsustainable.

Unreasonable Remuneration

The CDCP has ignored the existing fee guides in all Provinces and imposed their own. The remuneration they offer is so low that it is unsustainable. This unfairly places the financial burden of the CDCP on the dental professionals providing the services instead of the Government who created the program.

Other Concerns

We were also very disappointed to discover that the CDCP covers far fewer procedures than the average patient would normally require. It is not comprehensive and has numerous exclusion criteria that are not in line with traditional coverage. It is also not ‘free’ to all of those who are eligible. There are tiers of co-pay depending on income and eligibility. The media talking points and the reality of the program are very far apart.

The dental community is concerned that this program will begin replacing other existing Government programs that are more generous to those who qualify, and that employers will begin cancelling insurance for their employees. There are also currently no guarantees to the level of future funding for the CDCP, which highlights the concern of its long-term sustainability.

Canada appears to be in the midst of an affordability crisis. A program of Government assistance to help those in need with the cost of their dental care would be a benefit to our whole society. It is simple in principle: set criteria to identify those in need and pay for the treatment they require. Instead we got a program with unprecedented contracts, unnecessary administrative burden, that only covers a fraction of the procedures that most patients require, and that unfairly unloads the expense of the program onto the dental community.

In my view, the CDCP had a chance to be one of the most significant benefits to Canadians in a long time. It is a genuine shame that the Government did not work with stakeholders to create a program that could have done wonders to increase access to dental care. I am thoroughly disappointed by the structure of this program. There are too many barriers to make participation possible for our clinic and there are significant concerns that the CDCP poses a threat to the quality and sustainability of future Canadian dental care.

For those of you who have qualified for this program, I hope you can now understand why I cannot accept the CDCP. I realize that this is disappointing. I support you in making the best choice for you, just as I must do what is best for my clinic and staff.

Please keep one thing in mind: nothing has changed at our office. We had no opportunity to have input on this program. If you are disappointed or frustrated, please direct those feelings where they belong – to the politicians who created an untenable program without collaboration with the dental community.

Sincerely, Dr. Rob Guthrie and the Georgian Bay Family Dentistry Team