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PAT CULLEN: Dental program needs more money

“There are no plans to make further changes to Newfoundland and Labrador’s Adult Dental Program,” the July 5 statement from the Department of Health reads.

The statement is disappointing, short-sighted and brutal in its clarity. For it means impoverished seniors and the working-poor, the unfortunate who are not covered by private dental insurance and can’t afford to pay for their treatments out-of-pocket, will continue to endure the infection and pain caused by rotting teeth.

It is also a foolish policy and it is all this that angers Anthony Patey, executive director of the Newfoundland and Labrador Dental Association. His group has been lobbying government to have some components of the Adult Dental Program for these groups reinstated, but it is not willing to give any more money.

“They’re just saying there’s no money to give,” he said. “We had a battle on our hands to keep the children’s program because (government) are not really wise spenders and there lies the problem.”

But they have had no success in negotiating any service for the 65-plus group, indigent seniors receiving Old Age Security and the Guaranteed Income Supplement and low-income adults under the Access plan. Both groups have some prescription drug coverage under the Newfoundland and Labrador Prescription Drug Program. Their dental benefits, which included fillings, extractions and dentures, were cut in the 2016 budget to save the province money, and never brought back.

What Patey doesn’t understand is why government refuses to pay “$150 or $200” for a filling and yet fork over thousands when the person ends up in the operating room with complications from infected teeth. It makes no sense to him or to me, “but government can’t see that,” he says.

Suzanne Brake, the seniors’ advocate, says those 65 and over are winding up at hospitals where they’re given “antibiotics and pain-killers” as a cure for their dental problems. If they’re ending up at hospitals, they’re probably ending up in emergency rooms and the taxpayer is footing the bill. Each visit to an emergency room cost around $140 excluding “fee-for-service physician billings,” an email from Eastern Health read.

Moreover, seniors pay a $6 dispensing fee on every prescription they have filled and for those taking multiple medications that becomes a tremendous hardship – too much hardship for an old-age pensioner with very little.

For the working- poor there is a co-pay, based on assessment. Both groups are also wasting the time of overworked doctors and possibly heading down the road to opiate addiction. And the fault rests solely with the provincial government.

Linda Fallon is a St. John’s senior who circulated a petition about 18 months ago to have a dental program instituted for those 65 and over. It made the rounds among friends and people, mainly seniors, whom she met casually. The petition asked the government for financial help to pay for cleanings, fillings, extractions and dentures. It got about 100 signatures and getting them, she said, was not a problem. 

“It’s hard on seniors,” Fallon explained. “I’m not asking them to pay it all. I’d just like (them) to chip in something to help us.”

Her petition has been presented to provincial and federal politicians but she says it has been ignored. Brake, who attended a meeting of seniors at her home, described Fallon as “an amazing advocate,” but so far her advocacy has fallen on deaf ears.

Patey would be satisfied initially with government treating infection by filling or extracting teeth, which he estimates will cost around $4 million yearly. This would exclude a denture component which could double that figure or raise it to $10 million by his accounting.

But I am not satisfied with this compromise and I suspect the people who find themselves in this position aren’t either. People unable to chew properly are deprived of adequate nutrition. They may also isolate themselves through embarrassment causing mental and social problems. If they are of working age, it will be impossible for them to get a job. Few employers want people who look bad and have difficulty talking. I hope when Patey and his people meet with government again on Sept. 26, they will take these issues into account.

As for the politicians, David Brazil, the official Opposition health critic, said his party would establish a Health Council where the public, including seniors, would occupy a key role in determining health-care priorities. The Progressive Conservatives are also looking at a private dental plan for those on low income where the cost would depend on the provider, the number using the service and what that service entailed. He also mentioned thresholds – certain people would be fully covered, others partly, depending on economic circumstance.

His party is also looking at “efficiencies” within the health-care system through such measures as sharing services and reducing the number of administrators and then channelling the savings into medical necessities which could include a dental program.

“We’ve got too many blue suits, I call it, and not enough white coats,” Brazil said.

The Tories would keep the dental program for low income and seniors on fixed incomes, but the type of service would be determined by the industry, the clients and the cost. They would also make special authorizations “in unique situations” easier and faster. That means a medical professional could intervene on a patient’s behalf more readily. For example, someone with an ill-fitting denture plate wouldn’t have to wait eight years for a replacement.

The NDP plans to negotiate some moneys from government’s $22-million contingency fund and the approximate $111 million in OilCo, Nalcor’s Oil and Gas division into projects they want. Leader Alison Coffin says she will try to convince the Liberals to move money already allocated for specific projects and place it into “things important to New Democrats and important to a lot of other people here in the province that believe in the same things we do,” such as quality dental care for those who can’t afford it.

The NDP was the only party that committed to reinstating the Adult Dental Program for these two groups as part of its election platform. When Coffin says she plans to “rearrange priorities,” she is spot on.

By contrast, Premier Ball’s statement that  “Our goal is to achieve a healthy population living in healthy communities throughout our province” is mere hypocrisy when he ignores the oral health of its impoverished elderly and working-poor. You can’t be healthy with a rotting tooth in your mouth and it is time his government took steps to rectify it.

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A note to readers regarding Arulvalan Lourdunathan, a man working in Carbonear whose immigration problems were highlighted in last month's column. He was granted permanent residency status by Immigration, Refugees and Citizenship Canada on Wednesday, June 26.

Pat Cullen is a journalist who lives in Carbonear. She can be reached at 596-1505 or cullen.pat1@gmail.com.

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