Hon. Pat Duncan: Honourable senators, I rise to speak to third reading of Bill C-31, An Act respecting cost of living relief measures related to dental care and rental housing.

You may have heard the phrase, “Sometimes, the hurrier I go, the behinder I get.” Anyone who has tried to make a hand-crafted gift with a deadline — Christmas is coming — or tried to assemble a bed intending to sleep in it that night will in all likelihood agree with that statement. In other words, sometimes we need to take things a little slower or at least obey the speed limit to get to our destination.

Honourable senators, we’ve heard several times in this chamber, and will likely hear several more times, that the goal should be the good rather than the perfect. I’ve also heard legislation compared to sausage making: You really don’t want to be aware of all the ingredients and effort it takes to make a tasty end product.

Legislators are also likely familiar with Miscellaneous Statute Law Amendment bills. These are bills that need to be introduced when renumbering is required, the French translation is not quite correct, the English translation is not right or there’s a minor name change, and are sometimes referred to as housekeeping bills. These are not popular with either the opposition or the government.

Bill C-31 has clearly been prepared fairly quickly as there are a number of details yet to be ironed out. We’ve been advised that it’s an interim measure. Although Bill C-31 is not as finely tuned as we in this chamber might like, if approved in the chamber, it will provide relief to Canadians paying a substantial portion of their limited income on rent and provide money for dental care for young Canadians without a family dental plan. The intent of this bill is absolutely necessary, and in these challenging times, it is absolutely essential that this money be provided as soon as possible. I support this bill and its immediate passage. My remarks will be brief and focused on the dental provisions of this legislation only.

Honourable senators, I cannot in all good conscience vote in favour of Bill C-31 without ensuring that a serious concern is placed on the record — to use the words of another political adage, to “hang a lantern on the problem.”

Repeatedly, through the media and at the Senate’s National Finance Committee, we’ve been made aware that the details of the dental health program will be modelled after the Non-Insured Health Benefits program — or NIHB, as it is called. Allow me a few moments to provide some background.

In the words of Manitoba’s then-premier Gary Doer back in 2000, when the Western premiers were discussing — oh, surprise — more money for health care, Canada is the fourteenth province or territory at the federal-provincial-territorial health care table. Canada has a fiduciary responsibility for the health of First Nations, Métis and Inuit Canadians. There are other federal responsibilities, like that of the Canadian Armed Forces. I’m focusing my remarks today on the Indigenous recipients of health care services that are provided through the NIHB program. At the very practical level, let me explain the Yukon situation.

If you’re over 65, your Yukon health care card entitles you to several services that are beyond the usual publicly funded services — for example, prescription glasses, dentures and certain pharmaceuticals. These are all approved and paid for at the territorial level through the Government of Yukon’s health care services — unless you’re a status member of a First Nation. For these Yukoners, the drugs are approved and paid for through NIHB, as are glasses and dental services. This presents the first very serious concern with this bill. Dental services are already provided to Yukon First Nations children. The bill does not apply to Indigenous children in Canada except that, in the administration of this temporary program, any services over and above those provided by NIHB and paid for by parents might be reimbursed up to $650 or according to any other program adjustments that are made by the government. I’m compelled to raise serious red flags with the government’s intent to model the NIHB system or to use something similar, even temporarily, to provide these necessary dental services.

Honourable senators, allow me to share another example that I shared with my colleagues at the National Finance Committee. In British Columbia, the provincial fee schedule sets out a dental primary complete exam at $87.30; the Non-Insured Health Benefits program covers $65.94. In Alberta, the fee is $77.18, and the NIHB program covers $74. The fees in the Yukon are $118, and NIHB covers $95.97. This means that under the Non‑Insured Health Benefits program, there’s 76% coverage in B.C., 96% in Alberta and 81% in Yukon. That’s two provinces and one in three territories. There are different coverages by NIHB throughout the country.

Rather than simply accepting my entry of this issue into the record of this debate, I invite senators to review the Canadian Dental Hygienists Association’s submission to the National Finance Committee. Their letter, dated November 1, stated that the NIHB platform does come with challenges that governments should — and I would say must — address to ensure a seamless and less cumbersome process for the authorized oral health professionals working with the program.

Senator Colin Deacon, in his question a few moments ago, made a very reasonable suggestion that I do hope the officials working on this program will take into account.

Honourable senators, I’m not the first senator to raise concerns regarding NIHB in this chamber. As recently as May 17, 2022, speaking to Bill S-242, our colleague Senator Yonah Martin, at page 1427 of the Debates of the Senate, said:

Colleagues, I appreciate this is delving deeply into the administrative details of the legislation. It is where the rubber hits the road. We want to ensure that these benefits are paid to those who need them and that the government’s intentions with this legislation are realized.

Ministers’ mandate letters contain the phrase “a whole-of-government” approach. This benefit program needs to take a whole-of-government lens to examine what works in some areas and what does not, to ensure that the benefits intended in Bill C-31 will use the information that is available and develop the very best program. I, for one — and I believe I can count on my colleagues at the National Finance Committee, as well as all of you, in our efforts of transparency and accountability — will be watching. We will be observing the results.

Honourable senators, I commend the government’s intention with the dental program and the rental program in Bill C-31 and I look forward to the performance results. I hope that with these comments, drawing your attention to the challenges of the NIHB program, and with the current attention to health care in Canada, perhaps with some semblance of federal, provincial and territorial cooperation, we will see a closer look being taken at services like Non-Insured Health Benefits and that First Nations, Métis and Inuit Canadians — all Canadians — can look forward to improved services that all Canadians deserve.

I’d like to express my sincere thanks to Senator Yussuff for his sponsorship of the bill and all my colleagues for their speeches. I certainly commend it to the House, to this chamber. Thank you very much for listening to my remarks today. Mahsi’cho. Gùnáłchîsh.

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