Why Dental Care in Canada Costs More Than General Medical Care

Dental care and general medical care in Canada are often compared due to their differing levels of coverage under various insurance plans. While medical care is largely covered by provincial health insurance plans, dental care requires a different approach. This article explores the reasons behind the higher cost of dental care in comparison to general medical care, and the role of insurance in impacting these expenses.

The Coverage Landscape

In Canada, the healthcare system is divided into two main categories: general medical care provided by doctors (MDs) and dental care. Provincial health insurance plans cover general medical care 100% for residents, including visits to family doctors and specialists. Conversely, dental care is not covered under these provincial plans. This disparity often leads to confusion and misunderstanding among patients about what to expect from their healthcare costs.

The Role of Supplementary Insurance

Many employers in Canada provide supplementary health insurance that partially covers dental care, typically with a deductible. For instance, a 20% deductible on a dental visit might mean that an individual pays an initial 20% of the cost, while the remaining 80% is covered by the insurance. This structure can make dental care seem similar to general medical care in terms of out-of-pocket expenses, despite the 100% provincial coverage for general medical care.

Take a typical visit to a dentist. Based on the scenario presented, a 20% deductible on a dental visit might result in the patient paying an initial $80 out-of-pocket (20% of the total cost), with the remaining $400 covered by the insurance. This is not necessarily much more than the cost of a general medical visit, which is typically covered in full by the provincial health insurance plan without any co-pay or deductible.

Comparing Out-of-Pocket Expenses

Let's break down the actual costs to better understand the financial burden for patients. For a general medical visit:

No co-pay or deductible Total cost: $0 (fully covered by provincial health insurance)

For a dental visit with a 20% deductible:

20% deductible on the total cost Out-of-pocket expenses: 20% of the dental cost (e.g., $80 for a $400 visit) Total cost: $80 (20%) $320 (80% covered by insurance) $400

Comparing these two scenarios, it becomes clear that the out-of-pocket expenses for a dental visit are not significantly higher than for a general medical visit, provided the dental care is covered by supplementary insurance.

Implications for Patients

The differences in coverage can have a significant impact on patient behavior and financial planning. People may perceive that dental care is more expensive than general medical care, even if the actual out-of-pocket costs are similar. This can lead to delays in necessary dental care due to fear of financial strain.

Healthcare providers and insurance companies can play a role in clarifying these differences to patients. Providing clear information about what is covered by provincial plans and what requires supplementary insurance can help manage patient expectations and reduce financial stress.

Conclusion

In summary, the higher cost of dental care in Canada compared to general medical care is primarily due to the differing levels of provincial coverage. However, with the availability of supplementary insurance that often includes a deductible, the actual out-of-pocket expenses for dental care can be similar to those for general medical care. Understanding the structure of healthcare insurance in Canada can help patients make informed decisions about their healthcare and manage their financial responsibilities effectively.