Canada - World Health Organization Regional Office for Europe

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Health systems in transition Canada
level of anxiety disorders in the Canadian population (4.6%) relative to the
Australian population (2.7%), although the rate of alcohol and drug dependence
was somewhat lower. Despite similarities in the levels and availability of mental
health providers, mental health consultations were lower in Canada (51.3%)
relative to Australia (64.6%).
5.12 Dental care
Almost all dental health services are delivered by independent practitioners
operating their own practices. Payment for these services is through PHI or
direct OOP payment. If a provincial or territorial resident is receiving social
assistance, then a portion or all of the costs for personal dental services may be
covered by the provincial or territorial government. Similarly, if an individual
is an eligible First Nation or Inuit, then a portion or all of the costs will be
covered by the federal government through the “non-insured health benefits”
programme. Almost 54% of all private-funded dental care is funded through
PHI, the majority of which is through employment-based benefit plans (Hurley
& Guindon, 2008). The remaining amount is funded directly by OOP payments.
Unlike most high-income countries, Canada provides a very low level of
public subsidies to access dental care. Currently, 95% of all dental services
are funded privately, a level that is similar to the United States, Spain and
Portugal, the only other wealthy countries with such high levels of private
finance for dental services (Grignon et al., 2010). This degree of dependence on
private funding, in the absence of other barriers to access, has produced high
levels of inequalities in terms of dental care (Leake & Birch, 2008; Wallace &
MacEntee, 2012). These inequalities are directly linked to the fact that lower
income Canadians visit dentists less often due to cost (Health Canada, 2010).
In order to address these inequities, a few targeted oral health and dental
service programmes have been initiated by governments. The first provincial
programme of this type, launched by the Government of Saskatchewan
in the 1970s, targeted school children. Utilizing dental nurses and dental
para-professionals, the Saskatchewan Health Dental Program proved to be
highly effective but was disbanded within a decade (Wolfson, 1997). This was
followed by a similar programme in Manitoba targeting rural children but it
too was eventually discontinued by a subsequent administration (Marchildon,
2011). Ontario has the CINOT (Children in Need of Treatment Program) as
well as Health Smiles Ontario, a low-income programme launched in 2010