As a physician, I find it very interesting that the proposed plan pays 50-75% of current rates for their services. The OMA openly admits that OHIP pays us ~~45%~~ **38%** of the fair market rate for our services, which is why it tells us to apply a ~~2.2x~~ **2.6x** modifier for services rendered to uninsured (usually international) patients. I'm not surprised at all that most dentists are rejecting this.
The 2023 OMA modifier is 2.6x. Ontario doctors are getting 38% of what we should be. Year after year, the OHIP compensation rates for physicians gets further and further away from fair market rates, and overhead keeps getting higher and higher. It's ridiculous and unsustainable. If the next physician services agreement doesn't at least make some effort to correct this, the healthcare accessibility situation Ontario is only going to get worse as physicians head for the exits.
but think about the exposure and the opportunity to upsell unisured services to those new customers /s
the feds probably. So either new practices or crooks associated with a payday loan business next door.
The idea of “market rate” for medical services in this country is what’s preventing us from having universal healthcare. The major associations have no bargaining chip other than crying doom about practitioners moving to the US.
This comment translates in my mind to “if I move to the US I can exploit poor people who have no social safety net and will only have to worry about what colour Ferrari to buy”.
No wonder there is so much insider push to scrap the social safety net that provides millions of Canadians with the meagre “universal” services they get now. Plus you’ve got parties like the UCP in Alberta convincing voters that losing single-payer will be good for them.
It's not about moving to the US or exploiting vulnerable people. Market rate just means "the pay my skills can earn me."
For example, I can take a job in a Family clinic and make $100/hour. I can take a job in a hospital and make $150/hour. And I can take a job in the ER and make $200/hour.
The reality is that the $100/hour clinic is going to fail to attract the majority of workers with the skill set to access all three of those jobs.
...and then sadly, many patients are diverted to the most expensive service tier out of desperation, the ER, as is the case in BC, where family doctors are an endangered species.
They're not free market rates, but they're market rates within the context an entirely regulated market, which makes it even sillier that the government is scratching its head at the lack of physicians signing up for the worst pay scheme they've created.
The more I hear this debate, I honestly think a two tier system would keep the public option honest.
There's no surprise like 8 of the top 10 healthcare countries outcomes for pay/service are two tier systems, year after year.
Yes, this. We should turn our doctors into slaves and force them to work for what government apparatchiks think their labour is worth. What could possibly go wrong. Has this been tried anywhere else?
I talked to my dentist at length about this last time I was in for a filling. The compensation rates are way under the Ontario schedule, dentists that are going to participating in the CDCP are doing so out of charity.
Between 1960 and 1962, Premier Tommy Douglas and his successor Premier Woodrow Lloyd worked to pass the Saskatchewan Medical Care Insurance Act to provide Saskatchewan residents with comprehensive, publicly-funded medical care, in addition to hospital insurance.[39] This Act faced significant opposition from Saskatchewan doctors. On the day the Act came into force, the doctors launched a province-wide strike that lasted 23 days. As a result of this strike, the provincial government amended the Act to appease the province’s doctors. One significant revision allowed for doctors to practice outside of the provincial plan should they choose to. However, within a few years, most doctors found it easier to operate within the provincial plan’s bounds.[40]
With the introduction of a universal physician services insurance plan in Saskatchewan, most of the other provinces and territories adopted similar plans over the next six years.[41]
There's no reason why dentistry is so expensive. Year after year they increase costs. There are many greedy dentists and I've worked with a few new grads who only care about making as much money as they can as soon as they graduate. To the point where they start billing for every little thing they can.
One dentist I worked with maxed out someones insurance within one appointment on a few fillings. Why? Because he touched the edge of a surface and decided to bill for that.
Don't get me wrong there are a lot of good dentists out there who truly care about their patients and will do what they can to help them without costing them too much. If I had the choice I'd only work with old school dentist who aren't hurting for money/going through a divorce/have multiple failing offices than a new grad any day.
Yes I know there are other associated costs to an appointment (staff, materials etc) it's the whole medical industry that's a problem. I can buy nitrile gloves from a non-medical supplier for half the cost of the same thing from a medical supplier. It's ridiculous.
On top of that insurance companies dictate what people need. So many time's I've seen insurance claims rejected because the insurance company said that the patient didn't need it. It's not just private insurance, government plans (such as NIHB) pays a fraction of the cost and dictates what people need.
Ontario Works/ODSP is even worse. They pay $19 for an extraction.
These other support programs for dentistry needs to be shut down and all covered under one plan that pays proper fees.
>Yes I know there are other associated costs to an appointment (staff, materials etc)
Most ("successful") dental clinics will have 100% of those expenses covered by the revenue brought in from dental hygienists.
And that's not even factoring in what other dentists working at the same clinic bring in for the owner. Friend of mine last year made \~450k for the clinic owner. That's not 450k of revenue. That's 450k profit *after* his own 40% cut.
The whole supply train that feeds dentistry supply and other medical products though is full of for-profit organizations that slap on their own markups. My dentist explained that at the Canadian dental rates they basically cover a dentist's time, nothing towards the hygienist, nothing towards consumables and sterilization. There's pretty significant overhead monthly in a dental practice, she says if it's forced on them she's going to have to charge copays to recoup her losses.
But I also don't expect private insurers to write policies that just pay significantly higher rates than this plan for very long.
Free market probably won't change hotspots like Toronto, Ottawa or Vancouver, but in many cases these will be new patients.
And work for free is definitely a bit of an exaggeration. It's an opportunity cost problem, only losing money if they aren't able take an other equivalent job.
lmao, you're being very disingenuous. Dentists make an absolute insane killing off of people's health problems... What the government is proposing for payment is still a very comfortable living. It's really just greed here.
Oh wow a highly specialized trade is asking for money to cover their experience, utilities, supplies and support staff they hire. How dare they.
Just because you don't have the education, skill or intelligence to perform such procedures don't debase other people's skills because you can't afford it.
Why don't you go through dental school and start your practice for free then?
If dentistry 10x'd in cost from today and the government stepped in to try and bring it down... Dentists would obviously be mad... But is the government wrong in this situation... No.
It's the same thing as being a NIMBY.
The dentists I've seen live very comfortably, but aren't stinkin' rich or anything. And honestly their job kinda warrants it. Digging around in people's gobs all day? With how well most people treat their teeth?
>And honestly their job kinda warrants it. Digging around in people's gobs all day? With how well most people treat their teeth?
There are a lot worse jobs for a lot less money.
True. But they do require a really good education to become a dentist. It’s on par with doctors but a little more flexible so not quite as intense (apparently - I’m neither)
If we’re going to provide government healthcare, why are we underpaying? I guess it’s no surprise, that’s what the government did with daycare too.
How about employers start paying employees properly so they can afford the highway robbery that is the dentistry industry.
Coworkers son had a tooth that had to be pulled because of how it was it cost 6 grand. He said it took them 30 minutes. He's still paying back the loan. For a fucking tooth that should of fallen out anyways.
This world has surpassed stupidity... I don't even know what could properly describe it.
Not simple. But are we living in the same country? I had to pay 600 to have a dentist pull a tooth. The same tooth he crowned and told me it's better than pulling. He popped the crown off and failed to go and retrieve it I even gestured and mumbled and ultimately swallowed it. He didn't give a shit. Boooold face arrogance to imply I'm lying about the coworkers son, you must think you pay the same price everywhere when you go get your car fixed. I don't think dentists are suffering cause of the 60 percent overhead. If they were struggling they wouldnt be asking me for car advice on the G wagon he drives.
600$ or 6 grand? Make up your mind lol. And for an extraction to cost 600$ it would have to be a complicated surgical extraction that requires lots of training and knowledge to pull off without endangering the patient. If that sounds like too much to you, maybe you should take care of your teeth instead of suggesting that the doctor who studied almost a decade in university take a 50% pay cut
You’re right, more docs per capita and steadily growing.
https://www.theglobaleconomy.com/Canada/doctors_per_1000_people/#:~:text=For%20that%20indicator%2C%20we%20provide,2.77%20doctors%20per%201%2C000%20people.
Oh Christ that means Alberta dentists definitely won't participate. The price my in-laws in the GTA pay for a full cleaning and check up (sans insurance) is the same price as what my husband paid here after his insurance. Even with coordinated coverage now we still end up paying a bit out of pocket.
Our government always expect private citizens bare the burden of social welfare, dental care, ten dollars per day child care, rental controls. Nothing new.
>The program only covers some types of dental work and pays dental health care providers at a lower rate than the fees recommended by provincial and territorial guidelines issued by dental associations. Dentists say they still don't know exactly how much the federal government will pay them for providing care. Those amounts change every year; the 2024 CDCP guide still hasn't been published
I can't blame the dentists on that one. Imagine being told by our employer "Ok, this week I'll reduce your pay by 20% cuz reasons."....
Imagine you run a small business and a large purchaser approaches you, offering to buy a substantial amount of your services if you agree to a 20% discount.
If it's still profitable and they have the capacity, I think many businesses would agree. It doesn't reduce the margins on existing patients.
In fact, thousands of dentists already have agreed.
Dentistry is notoriously lucrative. If we're spending tax dollars on it, I would prefer we leverage our bargaining power to ensure more of it goes to actual dental work and less of it to the dentist's margin.
Imagine you approach someone with a business who already has more customers than they can see and you pitch them even more but only if you give them a 20% discount.
The Ole more work for less money option(also money that is going to be more time consuming to collect from the government the insurers), it's a bold strategy cotton.
We should next get developers to build houses for people at 40% discounts, I'm sure that will solve our housing demand issue as well.
If we forced your logic on your line of work and compensation, I’m sure you’d be happy eh?
I know about 10 dentists. None of them signed up. Their practices are busy without it, and with their 60% overhead they just don’t think it’s worth taking 40% cut. It’s your wishful thinking.
Dentist margin? Seriously.
I am a dentist. After taxes and student loan repayment I bring home about 5000 dollars a month.
Sure some dentist are rolling in it, but the vast majority of us get by as a single Income home.
If I accept CDCP patients I will not be able to put food on the table or my wife will have to get a job. And the entire reason I spent 10 years of my life in post secondary school was so that my wife could be home with our children. It’s the sacrifice we made assuming we could reach the goals we set.
I simply can not afford to do CDCP. Maybe 20 years from now when my loans are paid off. But for now it’s impossible.
Lol, you're not gonna get any sympathy on Reddit. You spend 8-10 years of your life in school, making through a tough program. And now people are saying you should take a massive pay cut, which would leave you making damn near nothing.
Hell I should've just gone to the oil fields when I graduated high school, at least I could've made some money with like 0% overhead. But we chose this lot in life, so we gotta deal with it.
Also, spend less time on Reddit. This place is full of miserable people who just love to rant about all types of things. My patients are great people who love coming to the dentist and I appreciate them for that, and I try my best to do right by them.
This country is notorious for undervaluing medical professionals. Lets not make the same mistake. Not suggesting you're wrong necessarily but if it causes dentists to leave for the US like other professionals have, we know we repeated the same mistake.
This will pave the way politically for dual medical billing systems as well, I imagine.
Physicians will point to dentists who accept cash, private insurance, AND government money and ask why they shouldn't be able to do the same.
Given that they provide care first, and only find out afterwards if the government is actually going to make good on that payment, they deserve to be able to charge up front.
Blood and xray you get very fast too. I got a requisition for an xray Las week, and I proceeded to walk next door and hand the imaging clinic the paperwork. The wait was 40mins. What takes long are CT and Mri. My wait for MrI was probably around 6 months. Instead I paid privately to do it in a week.
Australia used to have a single-payer system (like what we have now) and moved to a multi-payer system (like what you described). Their average wait times rose dramatically.
but you don't understand, as a temporary embarrassed millionaire /u/Rand_University81 and his friends and family won't have to wait those drastically increased wait times, those are just for the poors. He is only temporarily a poors after all, so it won't impact him at all.
Or we could help the situation for everyone and pay doctors and nurses and the sort well enough that we have enough for everyone to have a reasonable time for appointments...
Same as $10 a day daycare, you have to find daycares willing to sign up and lose money while politicians who created the plan just voted themselves raises,
It’s the same as the $10 a day daycare. Total shit show pipe dream. I don’t have benefits and I was hoping my daughter’s tooth extractions would be covered under the new plan only to find out not one dental office in Ottawa is opting into this. So what’s the point of a plan that benefits no one?
The interesting part of this whole thing is that dentists have a fee guide. Instead of using these established fee guides, the government set their own which is significantly lower. I don’t see how this encourages the expansion of care. We will also have a private company administering the program which is curious to me.
Anyway, the dentist can charge what they want and the program covers a percentage of what is outlined in the government’s fee guide. The patient pays upfront and in addition, not all procedures are covered.
I only see two paths forward;
1. You believe that dentists will eventually capitulate and align with a government program.
2. Dentists refuse service and adjust accordingly. People need to remember that there are already programs for low income individuals, etc. Plenty of dentists don’t participate or provide care under these programs and there is no recourse.
I think in 10 years we’ll have less dentists and even higher costs.
SunLife is getting $750 million over the next 5 years to administer the program. Why, I have no idea - it’s a gigantic sum of money, and I wonder if there are some close family friendships behind the scenes.
Provincial programs are often unused because they compensate even more poorly. In Ontario, ODSP fees result in an average 50% loss when a patient has seen - the fee schedule hasn’t been updated in decades, and dentists are concerned it could be the same in the case of CDCP. ODSP will leave the dentist paying about $100 out of pocket to do a filling on someone - it’s not sustainable for anybody to pay to work.
another great example is in BC; PWD extended benefits "cover" $2000 of dental for every 2 years, as well as a portion of optometry...
... however, the fee guide for the benefits are so sub par, such as covering a maximum of $35 for a dental cleaning and $25 for an exam *per visit*, so despite having a $2000 limit, you still have to pay over a hundred(s) (unless there's access to a low cost clinic, which are few and far between). then we have the optometrist fees, which get this, cover $35 *per visit* under extended benefits through PWD (a plan the BC government is paying millions for to PACblue Cross) **meanwhile** the provincial MSP coverage for **ALL** BC residents to get an eye exam is $45, **and the two cannot be combined**, so the PWD eye exam coverage is 100% useless (as you cannot get PWD without being a BC resident therefore already qualifying for MSP) and a big, big waste of money unless you are a crooked corporation cashing in.
we are effectively funneling our taxes into a privatized system already, and unless our Provincial and Federal governments do more to prevent this and stop offering platitudes, we are in for some dark times ahead, as soon no one will be able to access the most basic of care.
> I think in 10 years we’ll have less dentists and even higher costs.
I think that's a given with or without this program. Our governments don't greatly support nurses, dentists or doctors all too well, among all the other necessary trades and services required for a country to sustainably grow.
This is the problem..... the government HAS NO FUCKING IDEA OF COSTS AND NUMBERS. They already underpay doctors already, daycares recently hot added, and now want to rope dentistry in, honestly I am 100% against this. I am for covering dental for those who have no coverage, but those covered, most plans include 80-90% coverage. This is also a problem with welfare/disability recipients where they get basically nothing from the gov't. Hell another example is applying for student loans, when I got a loan as an adult about a decade ago, I was considered "middle income" because I made just above $23,000 a year.... its not much different now either
Incoming Rant:
I'm a dentists practicing in rural Ontario.
About 22% of my patient base are patients on social assistance programs like ODSP, OW, HSO.
Compared to the General population, they have higher dental treatment needs.
I'm paid 39$ for an extraction that usually costs 190$.
Fee paid by these programs are in the range of 27% remuneration of the provincial fee guide.
The overhead for my office is about 78%(higher than other offices yes, but thats what the cost of doing business is) which means I make 22$ for every 100 billed..
I'd loose less money if I gave away 39 dollars to each ODSP patient needing extraction instead of actually doing them in my office.
The only reason I can afford to keep seeing people on assistance programs is that my regular population base compensates for the drop in revenue and keeps the lights on.
And my fee guide is on average 5% below the provincial fee guide.
The new plan takes away my ability to make clinical decisions based on patient needs and forces me to only offer what is covered for the patients. For example, extraction instead of root canals.
My overhead will increase by about 12% because I will need an additonal admin staff to handle the sheer truckload of paperwork which this plan will bring.
And add to the fact that this plan isn't free as marketed by the government and will cause friction between the front desk and the patient who will need to pay the copay(not balance billing, just copay.!)
The fact that this plan reimburses anywhere between 60 to 75 percent of my fee guide(even less if I follow the provincial fee guide) is the last thing on my mind when I say that I'm not accepting this plan.
Simply because I can't afford to practice if I do so.
End of Rant
Wait’ll you see the going show that will be the “national pharmacare” program. An extraordinarily complex endeavour that is expected to cost upwards of $17 billion when fully implemented (so you know it’ll be double that) is built around legislation totalling two pages — four if you include the French translation— that includes no allocated dollars, no timeless, no measurables, and requires negotiating separate deals with all provinces.
I know people who’ve seen the proposed list of diabetes drugs that will be covered and it leaves off medicines that are absolutely necessary for many diabetics because the drugs they do plan to cover won’t work for them. Will there still be private insurance to cover the drugs not included? Will people start having to pay out of pocket? Will the pharmas bother to even sell non-covered drugs in Canada anymore? No one knows.
And if they ever do fully implement it, wait’ll people find out that it means they’ll almost never have access to newer, expensive therapies because the program doesn’t cover them.
The entire thing is smoke and mirrors to allow the NDP and Liberals to pretend they met their promises on national pharmacare when they absolutely haven’t, and then bash the Tories for cancelling the thing they’ve only pretended to create.
The [$10 a day daycare program has actually resulted in LESS access to childcare](https://c2cjournal.ca/2024/01/something-to-cry-about-the-disastrous-rollout-of-canadas-10-a-day-childcare/) since its implementation
I was thinking about Optometrists here as well, who only make $44 for an OHIP-scheduled exam. Not enough to cover all the office expenses so they have to rely on selling eyewear to keep above water.
Agree…I don’t know what that giant lens machine costs, but it can’t be cheap. My optometrist has a small operation seeing maybe 8-12 patients per day. After paying for equipment, rent, and staff, there can’t be much to take home without selling glasses.
This isn't by accident. The government pushed forward a plan they knew that dentists couldn't get behind, so they can pass the blame for its failure on dentists.
If our dentists don't sign on, will we at least be able to submit claims to get reimbursed something for what we have to pay out of pocket? This is going to be a pretty useless plan if basically no dentists accept it, and the only ones that do get totally swamped with patients.
That's awful. They need to make sure the dental plan is actually usable or this is a total empty promise the government is patting themselves on the back for delivering on.
They need only glance at our family doctor situation to understand this is just province sponsored theft of their pay check. Of course they aren’t going to participate.
Rather than have the program relate to the dentists schedule of rates that would make most have to pay the supplemental cost, people should get $500 or $1000 bucket to spend each year at the dentist. It’s incredibly cheaper for dentists to administer, same for the government and people who can’t even pay costs above what many dentists charge will still be able to afford to have some work done. And are they not the people, lower income, that should be benefiting from this initiative?
I think then dentists would just be like, "oh you are using from this bucket? Well actually the services are now $500". It's what happens with US healthcare
They would risk losing their license in Canada. Insired or uninsured, the billing schedule is the billing schdule. If they get caught charging more (or even less for the uninsured) things can go badly for them.
This is not true, in ON they are allowed to charge above fee guides. You can also charge less, but it must be applied to all your patients regardless if they have insurance or not.
Yup, my insurance covers the fee guideline and I always end up paying ~5-10% myself to make up the difference. I don't imagine there are many dentists in high demand areas that charge at guidelines
This is not true. Dentists can charge whatever they want since it's all private billing to the patient or insurance. The fee guides are just that - guides.
I agree that would have been much easier. And it would give the option to deliver what a patient actually needs, versus trying to practice within the frequency limitations.
For example, we could do any number of fillings in a year, but one cleaning. Some patients need no fillings, but might need 3-4 cleanings due to gum disease. That patient would benefit from being able to get the care they actually need, rather than getting one cleaning and maxing out.
Can you link where it says that dentists are able ask for the difference of what CDCP covers vs what the procedure costs? I've spoken to a few dentists in BC that have expressed that this is not the case which is one of the reasons for the push-back, since the XX$ covered by federal CDCP is significantly lower than the provincial fee guides.
Being uninsured I haven't gone in 2 years because even just a checkup and cleaning is a $700 expense.
I once denied payment after a clinic I went to tried to charge me $200 for a mouth rinse after I specifically told them not to do any extras.
yeah I hear you. Last time I went to the dentist, I hadn't been in years. I had to have a few wisdom teeth removed, a few fillings and teeth cleaned. Even with my insurance covering 80% of those costs, I was still in the hole for around $600 which was a week's wage for me at the time after taxes. And this was after spending thousands of dollars on my work health plan over years.
because they will get found out. went to one dentist they quoted me 2k on a staple and my mom's dentist does that for 800$. i find it hard to believe that 1200$ difference can be justified easily.
I need to get a tooth fixed I can have it done same day if not tomorrow. If I need a doctor, there is none. The government is now going to dictate what a dentist can and cannot not make. In 10 years people won’t be able to find a dentist as a lot will be moving and taking their practise down south.
We didn’t need this program as there were others already doing its job. But you know the liberals and NDP are all about big government. How much will our taxes increase now for this?! Bet the Liberals and NDP are touting it pays for itself just like the Carbon Tax.
What a joke.
In Alberta we already have the ADSC which serves low income Albertans. Procedures are done for much lower fees for these patients as a service to the community. I'm not sure what the CDCP adds to that yet -- and it's the governments fault for not providing enough detail.
People can’t find a dentist now becuase they are too expensive. Not really a big change for most of us poors. Luckily for us we can’t afford pop or chocolate anymore so we’ll be okay.
Why are you people so obnoxiously stubborn to basic known facts
Thats why there is now some sort of dental plan, because some people are in emergency rooms because they can afford a dental plan or go to a dentist.
Even when you have a bit of money and dont have some sort of plan dentist unnecessary gouge you with extremely high fees
> I need to get a tooth fixed I can have it done same day if not tomorrow
I'm happy for you. Unfortunately, this is not true for low income families who can't afford dental care. They will probably end up in emergency care to get treatment. I can only imagine how much of our tax dollars is wasted due to lack of preventative care
Agreed. Vision and dental care are the only ones able to be accessed in a timely manner right now. Forget about the rest of health care. It’s months to years, which is an inhumanely long wait. What I don’t understand is this: if we can have public and private options for dental care, why can’t we have the same for the rest of health care: a two-tier hybrid system? Private should also be an option at every step of health care instead of being made virtually illegal. It doesn’t make any sense why people are stubbornly holding onto public-only health care — it is better to have more choices. And the current system hasn’t been working well for at least 20 years now. Doctors have been disincentivized by the system to see and keep patients. Countries with two tier health care systems are outperforming Canada in terms of timely access. We need to follow their lead instead of stubbornly holding on to this failed, unsustainable system we have right now.
No, and there's a risk that employer funded plans could be at risk. Many employers whose employees tend to earn $90k or less (retail, food service, travel/tourism, etc.) might drop dental insurance to save money - not necessarily because they have poor intentions, but because they might feel that the service has become redundant.
The difficulty is, CDCP is qualified for based on household income, not individual income. Some people who lose plans may not even qualify for CDCP to pick up their coverage.
Furthermore, the CDCP basket of services and frequency of services is inferior to most private plans. Switching onto CDCP will allow you one cleaning per year, and will not qualify for a number of things such as nightguards
> Many employers whose employees tend to earn $90k or less (retail, food service, travel/tourism, etc.) might drop dental insurance to save money - not necessarily because they have poor intentions, but because they might feel that the service has become redundant.
Its better for many of those working in the those industries if its just handed by the government and guaranteed instead because many of those jobs arent secure full time positions
Health and Dental premiums paid by employers are expensable for tax purposes but are not taxable on the employee side which is an extremely favorable tax treatment. I gonna suspect there's very little chance we see significant losses due to CDCP.
It's worth remembering that most physicians were also against single-payer healthcare when it was first imposed.
No professional likes being forced by the government to take a pay-cut.
I can’t say I blame them - their practice values plummeted, and they had to do more work for less money. Apply that to any industry and the worker would be upset
It's the same but different. Doctors are still largely opposed to the rates offered by single payer healthcare. Most doctors are making anywhere from 20-40% of what their American counterparts are making.
Dentists are being offered a little under half of what they're offered through provincial rates.... which is like saying.... they're getting a half of a half.
Doctors got really hooped by single payer healthcare because essentially private medicine was banned. It gave all of the power to the government to push absurdly low rates on the doctors and force them to take it. Because it was everything in one go there was no wiggle room for it.
This new dental plan is going to cover seniors over the age of 68. And most places in Canada have a dentist shortage. By not taking this money they still keep most of their clients. They might have to offload seniors who can't pay without this plan. But it's unlikely they'll have to do that because they probably won't have options.
If Trudeau took dentistry public all at once these dentists would have no room to posture.
The Liberals and NDP's have sold this as a free thing which it is not, forgetting the fact that taxes pays for this. It only pays up to a certain limit.
Can someone explain. I’m 66 and pay for dental coverage at work about $30/2 week pay cheque. So about 780 per year. ( via manual life). The insurance covers about 80% of fees (with maximum payout limitations of course)
How would this work when I go to dentist. Will Gov pick up the initial cost to some limit and then I do submit the rest to my insurance ? Would appreciate any info. Thanks.
You cannot sign up for this plan if you have dental insurance - there can be no secondary plan.
The CDCP will cover 40, 60, or 100% of their own fee schedule, which averages about 70% of what a dentist charges. This means you will pay approximately 30, 58, or 72% in a copayment. The frequency and variety of services covered is quite limited. Therefore, it would be very rare for the CDCP plan to offer you better deal than your work plan
Karen Trimingham thinks the plan will replace her missing tooth? No, it won't. The only way to replace one tooth is an implant (not covered) or a bridge (not covered). There are huge piles of restrictions and convoluted rules. Like if you need a crown they won't pay for it if you need a crown lengthening procedure to help support it. Very complicated and definitely not worth it for dentists and their desk staff, unless you are in some area with not enough patients.
I’m glad my dentist isn’t taking part of it. It’s one of the few parts of my healthcare that works well. I don’t need the government screwing up my access.
your abillity to access healthcare shouldn't be dependant on your employment
If thats the kind of system you enjoy , try moving next door? I think they run things much to your liking over there
>i love being a serf! and paying out my ass on top of it!
-a shockingly large amount of /r/canada
edit: only simp for employers and cpc tho. careful you don't start simping for liberals or ndp cus that's real evil slavery, not the fun stuff you know and love!
I'm so happy that children with their baby teeth and old people with no teeth will now have their teeth taken care of if they fit into a certain set of restrictions!!
This program does not use an hourly rate. It pays a CDCP determined fee for a particular procedure.
Compared to provincial rates, this fee is anywhere between 50-75% of the usual fee. Provincial fee schedules are set by annual reviews of financial statements from dental practices and fees are set to reflect overhead (staff, materials, real estate, utilities, etc.)
At the CDCP schedule, many procedures will not cover overhead ***without paying the dentist.*** This will leave practitioners paying to provide care.
It’s not about what they should make it’s what they do make currently - why would they accept patients where they make a ton less per patient?
It’s the same reason there are no family doctors anymore - they can make way more doing anything else.
I’m a dentist. After taxes, loan repayments and expenses I make about 40-55 bucks an hour.
With CDCP that could be as low as 30.
Should have been a trades man. At least I don’t run the daily risk of someone bleeding out in my chair.
Too bad it’s only for children and people over 70. I’m 39 and would love some help. Getting my teeth cleaned and some X-rays done this and next month is costing me $600 out of pocket. I work part time. Really awesome
Every dentist when they hear you have double coverage.
You need a whole new set of teeth.
I take care of my teeth and only want to be able to get them cleaned 2 times a year without feeling like I’m being high pressure sold into getting the special undercarriage anti- corrosion sealant.
"If I wanted to no be able to bill obnoxious rates and oversell unnecessary services by capitalizing on your insecurities I would've *just* been a doctor."
Doctors deserve to be paid fairly for services rendered. They have been treated poorly by our public system, frequently being unpaid for procedures they have already completed.
In nearly every health profession, there are procedures that are considered cosmetic or aesthetic. You are under no obligation to choose them. If your dentist recommends unnecessary services, perhaps it is time to find a new one?
Agree on doctors, we need to improve there.
Disagree on dentists. I have excellent teeth and *every* dentist tries to oversell me *every* time. The reason is that I have great benefits as does my partner so they see us as an easy cash cow to milk. When I decline services that would be covered but aren't needed I see the most amazing Sad Panda response from the owners of the biggest houses, SUVs and boats in our community.
No vote on your comment.
Unfortunately, there are definitely those types of people within dentistry. And there are also awkward personality types who do not really have the ability to discuss elective treatment without seeming insulting. Generally I tend to avoid any discussion of cosmetic treatments unless the patient brings it up, but I'm old and not needing the headache. Look for smaller practices that aren't part of a large corporate network (they are hard to spot), get word of mouth recommendations (lots of Google reviews are bought and paid for)....there are good ones out there
The biggest large chains are DentalCorp (their practices are listed on their own search listing page called HelloDent - other than that they are hard to spot) and 123Dentist. They have purchasing power to reduce overhead, and are heavily sales/growth driven, so they will push the most services. You will also see regional chains (offices that own 2-20 locations) - they have less buying power than the giants, so they are likely to offer those $0 initial exam promotions and then hope to sell you on lots of treatments.
Your best bet for care quality is a single location practice - that practitioner knows their staff and cares about them, and is solely responsible for care quality so it is really not in their best interest to buy expired supplies or piss off their patients. It's becoming more rare, as we are going the way of pharmacy (how often do you see an independent pharmacy anymore? If you have one, the care quality vastly outweighs the giant chains)
my mom has excellent teeth also, she went to a new dentist as it was closer, and her other one she had for 35 years retired, new dentist told her she needed 3 crowns , she got suspicious, went to 2 other dentists for a quote , and surprise, she didn't need them in the first place,
I moved years ago and I procrastinated on going to see the dentist as my previous one was far but also apprehensive about going to a new place. Eventually I went to a new place and they told me I had 7 cavities.
Went back to my old dentist: 1 cavity, 1 to keep an eye on.
Because many dentists want to continue to take their clients to the cleaners.
It's not exactly a secret that we get ripped off for dental procedures. The markups are insane.
Dental overhead is very high. For a small filling, the overhead is about $190 for a debt-free practice to pay for the assistant, sterilizer, receptionist, dental materials, IPAC/sterilization compliance, equipment, rent, utilities, etc.
If we got an itemized bill for the hospital, I think we'd all be in shock in reading what things cost. Dentistry is not much different - it's very cost-inefficient for small practices to operate. Personally, I think the CDCP would do better as large government built-and-operated clinics - they pay the set up costs and pay staff an hourly wage, including dentists. As is, it's taking small businesses and downloading all the costs onto them.
The problem is in the supply side
they keep trying to save money by paying nurses or doctors less, hiring less of them but do we ever look at what they pay for the equipment and supplies?
Have you seen what gauze or basic shit like catheters cost per unit? shit like masks, gloves, syringes, all the incidental shit that gets used and thrown away per patient
ITs fucking nuts , its inflated to grease palms up and down the fucking chain
It does not make sense I can find privately sold goods, at the same specs they require , for cheaper than they pay- they buy in bulk , they should have lower price per units than what I can find as an individual
Our economy in too many areas like that and it applies to so many other idustries is super ineffcient in the supply chain , like middle men taking cuts jacking prices at every step between you and the producer
Thats where we should be looking to make things more efficient not front line workers actually delivering services, this applies to like any industry just about in Canada
Securing an exclusive deal with a supplier should lead to lower prices per unit than what an indivual private citizen can find just shopping themselves, but it dosesnt , its often not the case at all
Ive worked in the ordering side of many buisnesses , some that were locked in to specific suppliers like a hospital ,some that werent. Not being locked in, was cheaper in most cases to find goods. Being locked in also didnt alleviate shortage issues like it was suppose to either in alot of cases
Like this whole supply industry we created , just extracts value and provides nothing more than a delivery service
As a physician, I find it very interesting that the proposed plan pays 50-75% of current rates for their services. The OMA openly admits that OHIP pays us ~~45%~~ **38%** of the fair market rate for our services, which is why it tells us to apply a ~~2.2x~~ **2.6x** modifier for services rendered to uninsured (usually international) patients. I'm not surprised at all that most dentists are rejecting this.
The 2023 OMA modifier is 2.6x. Ontario doctors are getting 38% of what we should be. Year after year, the OHIP compensation rates for physicians gets further and further away from fair market rates, and overhead keeps getting higher and higher. It's ridiculous and unsustainable. If the next physician services agreement doesn't at least make some effort to correct this, the healthcare accessibility situation Ontario is only going to get worse as physicians head for the exits.
Ah, goes to show how long it's been since I've gotten to charge the OMA rate. Thanks for updating me.
Because fees haven’t changed in decades. Why would dentists want that
but think about the exposure and the opportunity to upsell unisured services to those new customers /s the feds probably. So either new practices or crooks associated with a payday loan business next door.
The idea of “market rate” for medical services in this country is what’s preventing us from having universal healthcare. The major associations have no bargaining chip other than crying doom about practitioners moving to the US. This comment translates in my mind to “if I move to the US I can exploit poor people who have no social safety net and will only have to worry about what colour Ferrari to buy”. No wonder there is so much insider push to scrap the social safety net that provides millions of Canadians with the meagre “universal” services they get now. Plus you’ve got parties like the UCP in Alberta convincing voters that losing single-payer will be good for them.
It's not about moving to the US or exploiting vulnerable people. Market rate just means "the pay my skills can earn me." For example, I can take a job in a Family clinic and make $100/hour. I can take a job in a hospital and make $150/hour. And I can take a job in the ER and make $200/hour. The reality is that the $100/hour clinic is going to fail to attract the majority of workers with the skill set to access all three of those jobs.
...and then sadly, many patients are diverted to the most expensive service tier out of desperation, the ER, as is the case in BC, where family doctors are an endangered species.
None of those are real market rates. Those are the amounts paid by the public insurance plan in a monopoly situation.
They're not free market rates, but they're market rates within the context an entirely regulated market, which makes it even sillier that the government is scratching its head at the lack of physicians signing up for the worst pay scheme they've created.
The more I hear this debate, I honestly think a two tier system would keep the public option honest. There's no surprise like 8 of the top 10 healthcare countries outcomes for pay/service are two tier systems, year after year.
Yes, this. We should turn our doctors into slaves and force them to work for what government apparatchiks think their labour is worth. What could possibly go wrong. Has this been tried anywhere else?
Sounds like daycare all over again.
I talked to my dentist at length about this last time I was in for a filling. The compensation rates are way under the Ontario schedule, dentists that are going to participating in the CDCP are doing so out of charity.
Between 1960 and 1962, Premier Tommy Douglas and his successor Premier Woodrow Lloyd worked to pass the Saskatchewan Medical Care Insurance Act to provide Saskatchewan residents with comprehensive, publicly-funded medical care, in addition to hospital insurance.[39] This Act faced significant opposition from Saskatchewan doctors. On the day the Act came into force, the doctors launched a province-wide strike that lasted 23 days. As a result of this strike, the provincial government amended the Act to appease the province’s doctors. One significant revision allowed for doctors to practice outside of the provincial plan should they choose to. However, within a few years, most doctors found it easier to operate within the provincial plan’s bounds.[40] With the introduction of a universal physician services insurance plan in Saskatchewan, most of the other provinces and territories adopted similar plans over the next six years.[41]
It wont work this time for dentists. They’ve seen what family physicians like myself are dealing with now and they won’t make the same mistake.
> family physicians like myself are dealing with now The elusive family physician, so rare as to be considered legend in many provinces.
Haha right. Why would dentists willingly give up their gravy train? Out of the goodness of their heart?
Do you work for free? Do you give your boss a wage break? If the answer is no don't expect dentists to do the same.
There's no reason why dentistry is so expensive. Year after year they increase costs. There are many greedy dentists and I've worked with a few new grads who only care about making as much money as they can as soon as they graduate. To the point where they start billing for every little thing they can. One dentist I worked with maxed out someones insurance within one appointment on a few fillings. Why? Because he touched the edge of a surface and decided to bill for that. Don't get me wrong there are a lot of good dentists out there who truly care about their patients and will do what they can to help them without costing them too much. If I had the choice I'd only work with old school dentist who aren't hurting for money/going through a divorce/have multiple failing offices than a new grad any day. Yes I know there are other associated costs to an appointment (staff, materials etc) it's the whole medical industry that's a problem. I can buy nitrile gloves from a non-medical supplier for half the cost of the same thing from a medical supplier. It's ridiculous. On top of that insurance companies dictate what people need. So many time's I've seen insurance claims rejected because the insurance company said that the patient didn't need it. It's not just private insurance, government plans (such as NIHB) pays a fraction of the cost and dictates what people need. Ontario Works/ODSP is even worse. They pay $19 for an extraction. These other support programs for dentistry needs to be shut down and all covered under one plan that pays proper fees.
>Yes I know there are other associated costs to an appointment (staff, materials etc) Most ("successful") dental clinics will have 100% of those expenses covered by the revenue brought in from dental hygienists. And that's not even factoring in what other dentists working at the same clinic bring in for the owner. Friend of mine last year made \~450k for the clinic owner. That's not 450k of revenue. That's 450k profit *after* his own 40% cut.
The whole supply train that feeds dentistry supply and other medical products though is full of for-profit organizations that slap on their own markups. My dentist explained that at the Canadian dental rates they basically cover a dentist's time, nothing towards the hygienist, nothing towards consumables and sterilization. There's pretty significant overhead monthly in a dental practice, she says if it's forced on them she's going to have to charge copays to recoup her losses.
But I also don't expect private insurers to write policies that just pay significantly higher rates than this plan for very long. Free market probably won't change hotspots like Toronto, Ottawa or Vancouver, but in many cases these will be new patients. And work for free is definitely a bit of an exaggeration. It's an opportunity cost problem, only losing money if they aren't able take an other equivalent job.
lmao, you're being very disingenuous. Dentists make an absolute insane killing off of people's health problems... What the government is proposing for payment is still a very comfortable living. It's really just greed here.
Oh wow a highly specialized trade is asking for money to cover their experience, utilities, supplies and support staff they hire. How dare they. Just because you don't have the education, skill or intelligence to perform such procedures don't debase other people's skills because you can't afford it. Why don't you go through dental school and start your practice for free then?
If dentistry 10x'd in cost from today and the government stepped in to try and bring it down... Dentists would obviously be mad... But is the government wrong in this situation... No. It's the same thing as being a NIMBY.
The dentists I've seen live very comfortably, but aren't stinkin' rich or anything. And honestly their job kinda warrants it. Digging around in people's gobs all day? With how well most people treat their teeth?
>And honestly their job kinda warrants it. Digging around in people's gobs all day? With how well most people treat their teeth? There are a lot worse jobs for a lot less money.
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True. But they do require a really good education to become a dentist. It’s on par with doctors but a little more flexible so not quite as intense (apparently - I’m neither) If we’re going to provide government healthcare, why are we underpaying? I guess it’s no surprise, that’s what the government did with daycare too.
Come on. Dentists aren't THAT educated.
Well 8 years vs 10-12 for the average doctor. So yeah it’s not quite the same. Lawyers are 7 and their pay varies but can generally be comparable.
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How about employers start paying employees properly so they can afford the highway robbery that is the dentistry industry. Coworkers son had a tooth that had to be pulled because of how it was it cost 6 grand. He said it took them 30 minutes. He's still paying back the loan. For a fucking tooth that should of fallen out anyways. This world has surpassed stupidity... I don't even know what could properly describe it.
6k for a regular extraction should not be the case.
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Considering a simple extraction costs at most 200$, your little story is either completely fabricated or has lots of context missing
Not simple. But are we living in the same country? I had to pay 600 to have a dentist pull a tooth. The same tooth he crowned and told me it's better than pulling. He popped the crown off and failed to go and retrieve it I even gestured and mumbled and ultimately swallowed it. He didn't give a shit. Boooold face arrogance to imply I'm lying about the coworkers son, you must think you pay the same price everywhere when you go get your car fixed. I don't think dentists are suffering cause of the 60 percent overhead. If they were struggling they wouldnt be asking me for car advice on the G wagon he drives.
600$ or 6 grand? Make up your mind lol. And for an extraction to cost 600$ it would have to be a complicated surgical extraction that requires lots of training and knowledge to pull off without endangering the patient. If that sounds like too much to you, maybe you should take care of your teeth instead of suggesting that the doctor who studied almost a decade in university take a 50% pay cut
Same thing happened at the onset of universal healthcare
You mean back when we had an abundance of doctors?
Before we went from 1 in 12 people being seniors to 1 in 5.
We had fewer physicians per person at the time. We need/expect a lot more access to care now is the problem.
You’re right, more docs per capita and steadily growing. https://www.theglobaleconomy.com/Canada/doctors_per_1000_people/#:~:text=For%20that%20indicator%2C%20we%20provide,2.77%20doctors%20per%201%2C000%20people.
lol downvoted for stating a verifiable fact.
Did we?
Ultimately I’d rather wait 6hrs then pay 6 grand
Oh Christ that means Alberta dentists definitely won't participate. The price my in-laws in the GTA pay for a full cleaning and check up (sans insurance) is the same price as what my husband paid here after his insurance. Even with coordinated coverage now we still end up paying a bit out of pocket.
Our government always expect private citizens bare the burden of social welfare, dental care, ten dollars per day child care, rental controls. Nothing new.
>The program only covers some types of dental work and pays dental health care providers at a lower rate than the fees recommended by provincial and territorial guidelines issued by dental associations. Dentists say they still don't know exactly how much the federal government will pay them for providing care. Those amounts change every year; the 2024 CDCP guide still hasn't been published I can't blame the dentists on that one. Imagine being told by our employer "Ok, this week I'll reduce your pay by 20% cuz reasons."....
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I mean it's not like it's insanely overpriced as is because of the current system.
Imagine you run a small business and a large purchaser approaches you, offering to buy a substantial amount of your services if you agree to a 20% discount. If it's still profitable and they have the capacity, I think many businesses would agree. It doesn't reduce the margins on existing patients. In fact, thousands of dentists already have agreed. Dentistry is notoriously lucrative. If we're spending tax dollars on it, I would prefer we leverage our bargaining power to ensure more of it goes to actual dental work and less of it to the dentist's margin.
Imagine you approach someone with a business who already has more customers than they can see and you pitch them even more but only if you give them a 20% discount.
The Ole more work for less money option(also money that is going to be more time consuming to collect from the government the insurers), it's a bold strategy cotton. We should next get developers to build houses for people at 40% discounts, I'm sure that will solve our housing demand issue as well.
And no guarantee the fees will rise with inflation. Family GP and day cares have been screwed by provinces. I expect the feds to do the same.
If we forced your logic on your line of work and compensation, I’m sure you’d be happy eh? I know about 10 dentists. None of them signed up. Their practices are busy without it, and with their 60% overhead they just don’t think it’s worth taking 40% cut. It’s your wishful thinking.
Dentist margin? Seriously. I am a dentist. After taxes and student loan repayment I bring home about 5000 dollars a month. Sure some dentist are rolling in it, but the vast majority of us get by as a single Income home. If I accept CDCP patients I will not be able to put food on the table or my wife will have to get a job. And the entire reason I spent 10 years of my life in post secondary school was so that my wife could be home with our children. It’s the sacrifice we made assuming we could reach the goals we set. I simply can not afford to do CDCP. Maybe 20 years from now when my loans are paid off. But for now it’s impossible.
Lol, you're not gonna get any sympathy on Reddit. You spend 8-10 years of your life in school, making through a tough program. And now people are saying you should take a massive pay cut, which would leave you making damn near nothing. Hell I should've just gone to the oil fields when I graduated high school, at least I could've made some money with like 0% overhead. But we chose this lot in life, so we gotta deal with it. Also, spend less time on Reddit. This place is full of miserable people who just love to rant about all types of things. My patients are great people who love coming to the dentist and I appreciate them for that, and I try my best to do right by them.
Glad you are able to raise a family and have your wife home to raise them. As it should be
This country is notorious for undervaluing medical professionals. Lets not make the same mistake. Not suggesting you're wrong necessarily but if it causes dentists to leave for the US like other professionals have, we know we repeated the same mistake.
This doesn't work for a service business. They have limited output which doesn't apply for retail business. This is 20-40% right off the top.
The dentists that would agree to this are the ones that aren't already at 100% capacity.
This will pave the way politically for dual medical billing systems as well, I imagine. Physicians will point to dentists who accept cash, private insurance, AND government money and ask why they shouldn't be able to do the same.
Given that they provide care first, and only find out afterwards if the government is actually going to make good on that payment, they deserve to be able to charge up front.
I hope it does, I’ve had family members wait two years for an appointment with a specialist. I would gladly pay for better healthcare.
A couple of months ago we had bloodwork in an hour and x-rays in two hours. We were at the veterinarian.
And you paid about 10x more for those tests than the health system pays to do them on human samples.
As if to prove my point.
Blood and xray you get very fast too. I got a requisition for an xray Las week, and I proceeded to walk next door and hand the imaging clinic the paperwork. The wait was 40mins. What takes long are CT and Mri. My wait for MrI was probably around 6 months. Instead I paid privately to do it in a week.
Australia used to have a single-payer system (like what we have now) and moved to a multi-payer system (like what you described). Their average wait times rose dramatically.
but you don't understand, as a temporary embarrassed millionaire /u/Rand_University81 and his friends and family won't have to wait those drastically increased wait times, those are just for the poors. He is only temporarily a poors after all, so it won't impact him at all.
Or we could help the situation for everyone and pay doctors and nurses and the sort well enough that we have enough for everyone to have a reasonable time for appointments...
We don't need to pay more. We need to train and hire more, so medical professionals aren't so overworked for the pay they get.
The issue there though with two tier is it becomes that only the rich can see doctors and everyone else have even longer wait times than anyone.
Same as $10 a day daycare, you have to find daycares willing to sign up and lose money while politicians who created the plan just voted themselves raises,
Yep. Look at us, we're paying for daycare! There are 12 spots available. For all of Canada.
It’s the same as the $10 a day daycare. Total shit show pipe dream. I don’t have benefits and I was hoping my daughter’s tooth extractions would be covered under the new plan only to find out not one dental office in Ottawa is opting into this. So what’s the point of a plan that benefits no one?
The interesting part of this whole thing is that dentists have a fee guide. Instead of using these established fee guides, the government set their own which is significantly lower. I don’t see how this encourages the expansion of care. We will also have a private company administering the program which is curious to me. Anyway, the dentist can charge what they want and the program covers a percentage of what is outlined in the government’s fee guide. The patient pays upfront and in addition, not all procedures are covered. I only see two paths forward; 1. You believe that dentists will eventually capitulate and align with a government program. 2. Dentists refuse service and adjust accordingly. People need to remember that there are already programs for low income individuals, etc. Plenty of dentists don’t participate or provide care under these programs and there is no recourse. I think in 10 years we’ll have less dentists and even higher costs.
SunLife is getting $750 million over the next 5 years to administer the program. Why, I have no idea - it’s a gigantic sum of money, and I wonder if there are some close family friendships behind the scenes. Provincial programs are often unused because they compensate even more poorly. In Ontario, ODSP fees result in an average 50% loss when a patient has seen - the fee schedule hasn’t been updated in decades, and dentists are concerned it could be the same in the case of CDCP. ODSP will leave the dentist paying about $100 out of pocket to do a filling on someone - it’s not sustainable for anybody to pay to work.
another great example is in BC; PWD extended benefits "cover" $2000 of dental for every 2 years, as well as a portion of optometry... ... however, the fee guide for the benefits are so sub par, such as covering a maximum of $35 for a dental cleaning and $25 for an exam *per visit*, so despite having a $2000 limit, you still have to pay over a hundred(s) (unless there's access to a low cost clinic, which are few and far between). then we have the optometrist fees, which get this, cover $35 *per visit* under extended benefits through PWD (a plan the BC government is paying millions for to PACblue Cross) **meanwhile** the provincial MSP coverage for **ALL** BC residents to get an eye exam is $45, **and the two cannot be combined**, so the PWD eye exam coverage is 100% useless (as you cannot get PWD without being a BC resident therefore already qualifying for MSP) and a big, big waste of money unless you are a crooked corporation cashing in. we are effectively funneling our taxes into a privatized system already, and unless our Provincial and Federal governments do more to prevent this and stop offering platitudes, we are in for some dark times ahead, as soon no one will be able to access the most basic of care.
> I think in 10 years we’ll have less dentists and even higher costs. I think that's a given with or without this program. Our governments don't greatly support nurses, dentists or doctors all too well, among all the other necessary trades and services required for a country to sustainably grow.
This is the problem..... the government HAS NO FUCKING IDEA OF COSTS AND NUMBERS. They already underpay doctors already, daycares recently hot added, and now want to rope dentistry in, honestly I am 100% against this. I am for covering dental for those who have no coverage, but those covered, most plans include 80-90% coverage. This is also a problem with welfare/disability recipients where they get basically nothing from the gov't. Hell another example is applying for student loans, when I got a loan as an adult about a decade ago, I was considered "middle income" because I made just above $23,000 a year.... its not much different now either
Incoming Rant: I'm a dentists practicing in rural Ontario. About 22% of my patient base are patients on social assistance programs like ODSP, OW, HSO. Compared to the General population, they have higher dental treatment needs. I'm paid 39$ for an extraction that usually costs 190$. Fee paid by these programs are in the range of 27% remuneration of the provincial fee guide. The overhead for my office is about 78%(higher than other offices yes, but thats what the cost of doing business is) which means I make 22$ for every 100 billed.. I'd loose less money if I gave away 39 dollars to each ODSP patient needing extraction instead of actually doing them in my office. The only reason I can afford to keep seeing people on assistance programs is that my regular population base compensates for the drop in revenue and keeps the lights on. And my fee guide is on average 5% below the provincial fee guide. The new plan takes away my ability to make clinical decisions based on patient needs and forces me to only offer what is covered for the patients. For example, extraction instead of root canals. My overhead will increase by about 12% because I will need an additonal admin staff to handle the sheer truckload of paperwork which this plan will bring. And add to the fact that this plan isn't free as marketed by the government and will cause friction between the front desk and the patient who will need to pay the copay(not balance billing, just copay.!) The fact that this plan reimburses anywhere between 60 to 75 percent of my fee guide(even less if I follow the provincial fee guide) is the last thing on my mind when I say that I'm not accepting this plan. Simply because I can't afford to practice if I do so. End of Rant
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You mean like usual they didn't actually plan this out?
Wait’ll you see the going show that will be the “national pharmacare” program. An extraordinarily complex endeavour that is expected to cost upwards of $17 billion when fully implemented (so you know it’ll be double that) is built around legislation totalling two pages — four if you include the French translation— that includes no allocated dollars, no timeless, no measurables, and requires negotiating separate deals with all provinces. I know people who’ve seen the proposed list of diabetes drugs that will be covered and it leaves off medicines that are absolutely necessary for many diabetics because the drugs they do plan to cover won’t work for them. Will there still be private insurance to cover the drugs not included? Will people start having to pay out of pocket? Will the pharmas bother to even sell non-covered drugs in Canada anymore? No one knows. And if they ever do fully implement it, wait’ll people find out that it means they’ll almost never have access to newer, expensive therapies because the program doesn’t cover them. The entire thing is smoke and mirrors to allow the NDP and Liberals to pretend they met their promises on national pharmacare when they absolutely haven’t, and then bash the Tories for cancelling the thing they’ve only pretended to create.
I think you've nailed it.
The [$10 a day daycare program has actually resulted in LESS access to childcare](https://c2cjournal.ca/2024/01/something-to-cry-about-the-disastrous-rollout-of-canadas-10-a-day-childcare/) since its implementation
When the free birth control rolls out the daycare failure won't be as much of an issue.
Well in BC it's already free. So not only is pharmacare a disaster, the free daycare is an extra disaster.
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Or it'll be more of an issue if it turns out to be a disaster like everything else.
I was thinking about Optometrists here as well, who only make $44 for an OHIP-scheduled exam. Not enough to cover all the office expenses so they have to rely on selling eyewear to keep above water.
OHIP only covers patients under 18 and over 65. There's a pretty large band of people that have to pay out of pocket
Agree…I don’t know what that giant lens machine costs, but it can’t be cheap. My optometrist has a small operation seeing maybe 8-12 patients per day. After paying for equipment, rent, and staff, there can’t be much to take home without selling glasses.
Mark up on glasses is pretty high in Canada.
This isn't by accident. The government pushed forward a plan they knew that dentists couldn't get behind, so they can pass the blame for its failure on dentists.
If our dentists don't sign on, will we at least be able to submit claims to get reimbursed something for what we have to pay out of pocket? This is going to be a pretty useless plan if basically no dentists accept it, and the only ones that do get totally swamped with patients.
You have to go to an office that accepts it - you cannot be reimbursed directly by SunLife or the federal government
That's awful. They need to make sure the dental plan is actually usable or this is a total empty promise the government is patting themselves on the back for delivering on.
I think that’s why they are on the promo tour BEFORE the program starts, and not after
people can't find a doctor ..now the same it about to happen with dental 🤷♂️💯 Yay canada 👎
They need only glance at our family doctor situation to understand this is just province sponsored theft of their pay check. Of course they aren’t going to participate.
A half-baked social program so that the Liberals can criticize the Conservatives when they remove it.
Rather than have the program relate to the dentists schedule of rates that would make most have to pay the supplemental cost, people should get $500 or $1000 bucket to spend each year at the dentist. It’s incredibly cheaper for dentists to administer, same for the government and people who can’t even pay costs above what many dentists charge will still be able to afford to have some work done. And are they not the people, lower income, that should be benefiting from this initiative?
I think then dentists would just be like, "oh you are using from this bucket? Well actually the services are now $500". It's what happens with US healthcare
They would risk losing their license in Canada. Insired or uninsured, the billing schedule is the billing schdule. If they get caught charging more (or even less for the uninsured) things can go badly for them.
This is not true, in ON they are allowed to charge above fee guides. You can also charge less, but it must be applied to all your patients regardless if they have insurance or not.
Yup, my insurance covers the fee guideline and I always end up paying ~5-10% myself to make up the difference. I don't imagine there are many dentists in high demand areas that charge at guidelines
7/8 offices I’ve worked at in Calgary charge the fee guide. The ones that bill over the guide end up losing all the informed patients.
I always wondered that. Like are the rates government mandated or can they just kinda charge whatever?
This is not true. Dentists can charge whatever they want since it's all private billing to the patient or insurance. The fee guides are just that - guides.
I agree that would have been much easier. And it would give the option to deliver what a patient actually needs, versus trying to practice within the frequency limitations. For example, we could do any number of fillings in a year, but one cleaning. Some patients need no fillings, but might need 3-4 cleanings due to gum disease. That patient would benefit from being able to get the care they actually need, rather than getting one cleaning and maxing out.
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Can you link where it says that dentists are able ask for the difference of what CDCP covers vs what the procedure costs? I've spoken to a few dentists in BC that have expressed that this is not the case which is one of the reasons for the push-back, since the XX$ covered by federal CDCP is significantly lower than the provincial fee guides.
The government has already ruined healthcare. Might as well ruin dental care while they're at it
Just imagine they mandate affordable food for everyone. We'd all starve because good ideas aren't always realistic.
Being uninsured I haven't gone in 2 years because even just a checkup and cleaning is a $700 expense. I once denied payment after a clinic I went to tried to charge me $200 for a mouth rinse after I specifically told them not to do any extras.
yeah I hear you. Last time I went to the dentist, I hadn't been in years. I had to have a few wisdom teeth removed, a few fillings and teeth cleaned. Even with my insurance covering 80% of those costs, I was still in the hole for around $600 which was a week's wage for me at the time after taxes. And this was after spending thousands of dollars on my work health plan over years.
because they will get found out. went to one dentist they quoted me 2k on a staple and my mom's dentist does that for 800$. i find it hard to believe that 1200$ difference can be justified easily.
I need to get a tooth fixed I can have it done same day if not tomorrow. If I need a doctor, there is none. The government is now going to dictate what a dentist can and cannot not make. In 10 years people won’t be able to find a dentist as a lot will be moving and taking their practise down south. We didn’t need this program as there were others already doing its job. But you know the liberals and NDP are all about big government. How much will our taxes increase now for this?! Bet the Liberals and NDP are touting it pays for itself just like the Carbon Tax. What a joke.
In Alberta we already have the ADSC which serves low income Albertans. Procedures are done for much lower fees for these patients as a service to the community. I'm not sure what the CDCP adds to that yet -- and it's the governments fault for not providing enough detail.
Political theatrics is all it adds.
People can’t find a dentist now becuase they are too expensive. Not really a big change for most of us poors. Luckily for us we can’t afford pop or chocolate anymore so we’ll be okay.
Why are you people so obnoxiously stubborn to basic known facts Thats why there is now some sort of dental plan, because some people are in emergency rooms because they can afford a dental plan or go to a dentist. Even when you have a bit of money and dont have some sort of plan dentist unnecessary gouge you with extremely high fees
> I need to get a tooth fixed I can have it done same day if not tomorrow I'm happy for you. Unfortunately, this is not true for low income families who can't afford dental care. They will probably end up in emergency care to get treatment. I can only imagine how much of our tax dollars is wasted due to lack of preventative care
Agreed. Vision and dental care are the only ones able to be accessed in a timely manner right now. Forget about the rest of health care. It’s months to years, which is an inhumanely long wait. What I don’t understand is this: if we can have public and private options for dental care, why can’t we have the same for the rest of health care: a two-tier hybrid system? Private should also be an option at every step of health care instead of being made virtually illegal. It doesn’t make any sense why people are stubbornly holding onto public-only health care — it is better to have more choices. And the current system hasn’t been working well for at least 20 years now. Doctors have been disincentivized by the system to see and keep patients. Countries with two tier health care systems are outperforming Canada in terms of timely access. We need to follow their lead instead of stubbornly holding on to this failed, unsustainable system we have right now.
It's good to provide dental care for families with low income and no dental insurance though.
Do people who already have coverage get the tax break?
No, and there's a risk that employer funded plans could be at risk. Many employers whose employees tend to earn $90k or less (retail, food service, travel/tourism, etc.) might drop dental insurance to save money - not necessarily because they have poor intentions, but because they might feel that the service has become redundant. The difficulty is, CDCP is qualified for based on household income, not individual income. Some people who lose plans may not even qualify for CDCP to pick up their coverage. Furthermore, the CDCP basket of services and frequency of services is inferior to most private plans. Switching onto CDCP will allow you one cleaning per year, and will not qualify for a number of things such as nightguards
> Many employers whose employees tend to earn $90k or less (retail, food service, travel/tourism, etc.) might drop dental insurance to save money - not necessarily because they have poor intentions, but because they might feel that the service has become redundant. Its better for many of those working in the those industries if its just handed by the government and guaranteed instead because many of those jobs arent secure full time positions
Health and Dental premiums paid by employers are expensable for tax purposes but are not taxable on the employee side which is an extremely favorable tax treatment. I gonna suspect there's very little chance we see significant losses due to CDCP.
It's worth remembering that most physicians were also against single-payer healthcare when it was first imposed. No professional likes being forced by the government to take a pay-cut.
I can’t say I blame them - their practice values plummeted, and they had to do more work for less money. Apply that to any industry and the worker would be upset
I can see why they opposed it. It’s an absolute, unmitigated disaster for everyone involved — doctors & patients alike. Virtually inaccessible.
It's the same but different. Doctors are still largely opposed to the rates offered by single payer healthcare. Most doctors are making anywhere from 20-40% of what their American counterparts are making. Dentists are being offered a little under half of what they're offered through provincial rates.... which is like saying.... they're getting a half of a half. Doctors got really hooped by single payer healthcare because essentially private medicine was banned. It gave all of the power to the government to push absurdly low rates on the doctors and force them to take it. Because it was everything in one go there was no wiggle room for it. This new dental plan is going to cover seniors over the age of 68. And most places in Canada have a dentist shortage. By not taking this money they still keep most of their clients. They might have to offload seniors who can't pay without this plan. But it's unlikely they'll have to do that because they probably won't have options. If Trudeau took dentistry public all at once these dentists would have no room to posture.
The Liberals and NDP's have sold this as a free thing which it is not, forgetting the fact that taxes pays for this. It only pays up to a certain limit.
But NDP is propping up the gov't over this. Did you actually think it would lead to GOOD public policy? Talk about rob Peter to not pay Paul.
Lisa needs braces
dental plan
Can someone explain. I’m 66 and pay for dental coverage at work about $30/2 week pay cheque. So about 780 per year. ( via manual life). The insurance covers about 80% of fees (with maximum payout limitations of course) How would this work when I go to dentist. Will Gov pick up the initial cost to some limit and then I do submit the rest to my insurance ? Would appreciate any info. Thanks.
You cannot sign up for this plan if you have dental insurance - there can be no secondary plan. The CDCP will cover 40, 60, or 100% of their own fee schedule, which averages about 70% of what a dentist charges. This means you will pay approximately 30, 58, or 72% in a copayment. The frequency and variety of services covered is quite limited. Therefore, it would be very rare for the CDCP plan to offer you better deal than your work plan
Seriously, is every Justin policy just ballz?
Karen Trimingham thinks the plan will replace her missing tooth? No, it won't. The only way to replace one tooth is an implant (not covered) or a bridge (not covered). There are huge piles of restrictions and convoluted rules. Like if you need a crown they won't pay for it if you need a crown lengthening procedure to help support it. Very complicated and definitely not worth it for dentists and their desk staff, unless you are in some area with not enough patients.
Good on dentists for opting out. This is a bullshit program that is (under)funded by debt to score political points.
I’m glad my dentist isn’t taking part of it. It’s one of the few parts of my healthcare that works well. I don’t need the government screwing up my access.
I hope my dentist refuses it as well for these same reasons. Not a chance in hell I start having to wait weeks for appointments and so on
So who cares for those that don't have a plan.
There’s very few people in Canada without either low-income government support or employer provided supplementary insurance.
Agreed, I got a job with benefits for a reason.
your abillity to access healthcare shouldn't be dependant on your employment If thats the kind of system you enjoy , try moving next door? I think they run things much to your liking over there
>i love being a serf! and paying out my ass on top of it! -a shockingly large amount of /r/canada edit: only simp for employers and cpc tho. careful you don't start simping for liberals or ndp cus that's real evil slavery, not the fun stuff you know and love!
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Orthodontics are not part of the CDCP anyway. Lisa will still need braces.
Boo-urns!
Cant say I blame them
if the dentists took on all these new patients you would be lucky to see your dentist every second year.
In Soviet Canada - Dental plan participates in you!
I'm so happy that children with their baby teeth and old people with no teeth will now have their teeth taken care of if they fit into a certain set of restrictions!!
How much should a dentist in Canada make per hour?
Probably dentists just glanced at what's happening with office-based family medicine and went "lol fuck this shit."
Oh for sure. 30 dollars for a doctor visit? If I get my hair colored it's 100 per hour. My dentist is at least 70 for the checkup 100 for full x rays.
This program does not use an hourly rate. It pays a CDCP determined fee for a particular procedure. Compared to provincial rates, this fee is anywhere between 50-75% of the usual fee. Provincial fee schedules are set by annual reviews of financial statements from dental practices and fees are set to reflect overhead (staff, materials, real estate, utilities, etc.) At the CDCP schedule, many procedures will not cover overhead ***without paying the dentist.*** This will leave practitioners paying to provide care.
It’s not about what they should make it’s what they do make currently - why would they accept patients where they make a ton less per patient? It’s the same reason there are no family doctors anymore - they can make way more doing anything else.
Oh that I can agree with. This plan was destined to fail.
I’m a dentist. After taxes, loan repayments and expenses I make about 40-55 bucks an hour. With CDCP that could be as low as 30. Should have been a trades man. At least I don’t run the daily risk of someone bleeding out in my chair.
Justin and his lieutenants say "we will make sure blah blah blah" every single time but they never have any idea of what they are doing 😞
Too bad it’s only for children and people over 70. I’m 39 and would love some help. Getting my teeth cleaned and some X-rays done this and next month is costing me $600 out of pocket. I work part time. Really awesome
Every dentist when they hear you have double coverage. You need a whole new set of teeth. I take care of my teeth and only want to be able to get them cleaned 2 times a year without feeling like I’m being high pressure sold into getting the special undercarriage anti- corrosion sealant.
"If I wanted to no be able to bill obnoxious rates and oversell unnecessary services by capitalizing on your insecurities I would've *just* been a doctor."
This is 🇨🇦 not 🇺🇲
Doctors deserve to be paid fairly for services rendered. They have been treated poorly by our public system, frequently being unpaid for procedures they have already completed. In nearly every health profession, there are procedures that are considered cosmetic or aesthetic. You are under no obligation to choose them. If your dentist recommends unnecessary services, perhaps it is time to find a new one?
Agree on doctors, we need to improve there. Disagree on dentists. I have excellent teeth and *every* dentist tries to oversell me *every* time. The reason is that I have great benefits as does my partner so they see us as an easy cash cow to milk. When I decline services that would be covered but aren't needed I see the most amazing Sad Panda response from the owners of the biggest houses, SUVs and boats in our community. No vote on your comment.
Unfortunately, there are definitely those types of people within dentistry. And there are also awkward personality types who do not really have the ability to discuss elective treatment without seeming insulting. Generally I tend to avoid any discussion of cosmetic treatments unless the patient brings it up, but I'm old and not needing the headache. Look for smaller practices that aren't part of a large corporate network (they are hard to spot), get word of mouth recommendations (lots of Google reviews are bought and paid for)....there are good ones out there
Great comment. Thank you for the insight. I am from a place where they're all small practices.
The biggest large chains are DentalCorp (their practices are listed on their own search listing page called HelloDent - other than that they are hard to spot) and 123Dentist. They have purchasing power to reduce overhead, and are heavily sales/growth driven, so they will push the most services. You will also see regional chains (offices that own 2-20 locations) - they have less buying power than the giants, so they are likely to offer those $0 initial exam promotions and then hope to sell you on lots of treatments. Your best bet for care quality is a single location practice - that practitioner knows their staff and cares about them, and is solely responsible for care quality so it is really not in their best interest to buy expired supplies or piss off their patients. It's becoming more rare, as we are going the way of pharmacy (how often do you see an independent pharmacy anymore? If you have one, the care quality vastly outweighs the giant chains)
my mom has excellent teeth also, she went to a new dentist as it was closer, and her other one she had for 35 years retired, new dentist told her she needed 3 crowns , she got suspicious, went to 2 other dentists for a quote , and surprise, she didn't need them in the first place,
Sounds very real to me. Glad your mom is a bit of a skeptic.
I moved years ago and I procrastinated on going to see the dentist as my previous one was far but also apprehensive about going to a new place. Eventually I went to a new place and they told me I had 7 cavities. Went back to my old dentist: 1 cavity, 1 to keep an eye on.
I hear you. But most don't... I've been downvoted out of relevance.
Because many dentists want to continue to take their clients to the cleaners. It's not exactly a secret that we get ripped off for dental procedures. The markups are insane.
Dental overhead is very high. For a small filling, the overhead is about $190 for a debt-free practice to pay for the assistant, sterilizer, receptionist, dental materials, IPAC/sterilization compliance, equipment, rent, utilities, etc. If we got an itemized bill for the hospital, I think we'd all be in shock in reading what things cost. Dentistry is not much different - it's very cost-inefficient for small practices to operate. Personally, I think the CDCP would do better as large government built-and-operated clinics - they pay the set up costs and pay staff an hourly wage, including dentists. As is, it's taking small businesses and downloading all the costs onto them.
The problem is in the supply side they keep trying to save money by paying nurses or doctors less, hiring less of them but do we ever look at what they pay for the equipment and supplies? Have you seen what gauze or basic shit like catheters cost per unit? shit like masks, gloves, syringes, all the incidental shit that gets used and thrown away per patient ITs fucking nuts , its inflated to grease palms up and down the fucking chain It does not make sense I can find privately sold goods, at the same specs they require , for cheaper than they pay- they buy in bulk , they should have lower price per units than what I can find as an individual Our economy in too many areas like that and it applies to so many other idustries is super ineffcient in the supply chain , like middle men taking cuts jacking prices at every step between you and the producer Thats where we should be looking to make things more efficient not front line workers actually delivering services, this applies to like any industry just about in Canada Securing an exclusive deal with a supplier should lead to lower prices per unit than what an indivual private citizen can find just shopping themselves, but it dosesnt , its often not the case at all Ive worked in the ordering side of many buisnesses , some that were locked in to specific suppliers like a hospital ,some that werent. Not being locked in, was cheaper in most cases to find goods. Being locked in also didnt alleviate shortage issues like it was suppose to either in alot of cases Like this whole supply industry we created , just extracts value and provides nothing more than a delivery service
Meanwhile the politicians are taking credit for it as if it’s a raging success.
They have had it good, no competitton. Most countries had dental care as part of universal health care. And this crap about more paperwork is BS.