Quiñonez NCOHR Working Papers Series 2013, 1:1
http://www.ncohr-rcrsb.ca/knowledge-sharing/working-paper-series/content/lay-quinonez.pdf
ncohr Working Paper series
Why was dental care excluded from
Canadian Medicare?
Carlos Quiñonez*1
Lay Summary
This paper examines the factors that played a role in determining why dental care was excluded from Canada’s national
system of health insurance (Medicare). Internationally, health policy analysts are often surprised that Canadian Medicare does
not include dental care. Recently, many Canadians have also expressed concern that dental care is not included in Medicare.
Examining the historical reasons for why dental care was excluded from Medicare can inform current domestic and international policy debates on dental care. This study found five interrelated reasons for why dental care was not incorporated
into Medicare. These reasons can be classified as legislative, professional, socio-cultural, economic, and epidemiological.
Essentially, dental care was not included because of the significant decreases in dental caries that were observed, and
the limitations in dental human resources that were present, as the country’s health legislation was taking shape. This was
coupled to the introduction of community water fluoridation, which was a more cost-effective alternative option to largescale treatment services, and to the belief that brushing one’s teeth was largely an individual responsibility, not a social one.
Reflecting on these historical reasons provides an important perspective for current international and domestic efforts at
expanding public support for dental care.
Keywords: Dentistry, History, Health insurance, Health policy, Public financing, Health systems
* Correspondence: carlos.quinonez@utoronto.ca
1
Discipline of Dental Public Health, Faculty of Dentistry,
University of Toronto, Toronto, Canada
© 2013 Quiñonez; licensee NCOHR. This paper is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-ncnd/3.0), which permits the work to be copied, distributed and transmitted, provided the original work is properly cited.
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