Discrimination towards the NIHB Program

There is discrimination in the dental care profession towards the Non-Insured Health Benefits (NIHB) Program in regards to the coverage and eligibility of specific dental procedures for Indigenous peoples. Many of the Indigenous peoples who rely on the NIHB Program say that it is often extremely hard to find a dentist and that, when they are available, dentists often charge additional fees or ask people to pay upfront for additional services (Carstairs & Mosby, 2020). Many dentists are unwilling to take many Indigenous people under their care because the fees paid by the NIHB program and other insurance companies are so low.

If dentists are willing to provide a service for Indigenous people through the NIHB Program, many services need to go through an unpredictable process called predetermination. Predetermination is asking for permission from the NIHB Program if a treatment may be covered under the plan and describing why there is a significant need for the procedure to be done. This permission has to be received from Health Canada before treatment can go ahead; however, the long expectancy of the approval or denial for permission of treatment is often outside the range for which the dental treatment needs to be dealt with before it progresses.

More often, the request for treatment for Indigenous people to receive specific and needed dental treatment is denied by the NIHB Program, especially when it comes to expensive dental procedures such as root canals or crowns. This means patients will need to pay directly for dental treatment. Due to the many socioeconomic determinants placed on Indigenous peoples, barriers to access dental care such as low household income and high costs for dental care prevents these vulnerable populations from getting adequate dental care.

References

Carstairs, C., & Mosby, I. (2020). Colonial extractions: Oral Health Care and Indigenous Peoples in Canada, 1945–79. Canadian Historical Review, 101(2), 192–216. https://doi.org/10.3138/chr.2018-0097