NDP should control government costs instead of dental bills

Spending time in a dentist's chair, necessary as it is, is unlikely to replace the beach as a favourite summertime activity. Whether it's cleaning the pearly whites, or enduring cavity repairs and root canals, caring for one's teeth has a certain eat-your-broccoli sense of duty about it.

But dentistry experiences aside, the provincial government's latest command-and-control intervention in prices - the province wants dentists to cut their fees by more than the Alberta Dental Association and College's recommended three per cent - is evidence of power-tripping and hypocrisy.

When the college released its new fee guide, Health Minister Sarah Hoffman signalled her government's discontent: "Obviously there will be a bit of a negotiation ... they got the message loud and clear that three per cent just isn't enough."

The guide recommends, but does not mandate, prices for dentists.

Being self-employed, I pay my own dental bills. From repairing a cracked tooth to regular checkups, I write the cheques. I have everything to gain from a more dramatic cut to dental fees.

But I prefer that the soft Alberta economy, competition between dentists for patients and insurance industry pressure spur dental bill declines, not government politicking accompanied by veiled threats.

The last thing Canadians need is yet another sector where input costs and entrepreneurial risk-taking count for less than political machinations.

Interference in price signals doesn't help clarify the actual cost or demand for any service or good; such interference instead pollutes the possibility for clarity.

The reason that matters is illustrated by a conversation I once had with Dr. Brian Day, owner and founder of Vancouver's Cambie Surgery Centre.

Day has long battled with politicians who protect the ineffective status quo, government-insured, government-delivered health care approach, as opposed to thinking about how to provide universal health care but through a variety of providers and insurers: private, government and non-profit alike.

I recall Day because a Vancouver hospital once asked him to help design pricing for out-of-country patients.

The hospital, properly, did not want to accidentally subsidize a foreign patient by undercharging.

To ensure that didn't happen, the hospital first had to figure out what their input costs were, for example, for a trekking tourist who might have broken a leg.

Day was happy to help, but the request illustrated how government-run services are provided: with little knowledge of input costs and no incentive to grasp such measures. That's because Canadian hospitals are mostly run on budgets handed down from governments.

Even if hospital administrators desire efficiencies and effectiveness, which they do, there is little natural pressure to provoke reforms to that end. (If their budgets came from a variety of government, private and non-profit payments, healthcare delivery would quickly reform to be more patient-friendly.)

Which brings us back to dentists: Political pressure on a dentist's association runs the usual risk of government-mandated prices, irrespective of costs.

That's a recipe for lousier service and fewer options. It's already evident in the mostly government-run primary health care sector in Canada. It is why we have waiting times for medically necessary treatment.

There is another reason provincial politicians should avoid lecturing dentists, or anyone else in the private sector about costs: Because the NDP, since coming to power in 2015, has done nothing to reduce its own burden on taxpayers - public sector wages and pensions that exceed similar positions in the private sector, as an example.

Or more broadly, since coming to power in 2015, the new provincial government has consistently raised input costs for the private sector: From the carbon tax to its plan to hike the minimum wage by nearly 50 per cent over four years ($15.00 in 2018 compared with $10.20 in 2014), the province has not practised what it now preaches to dentists: rein in costs. Mark Milke is a Calgary author and columnist.


Originally published in the Calgary Herald, September 2, 2017, A10

Mark Milke