Public coverage of dental care: universal or targeted?

Abstract

This paper analyses the impact of public dental care coverage - universal versus targeted- on access, pricing, and public spending in a model with two competing dental practices and heterogeneous patient income groups. We evaluate two types of reimbursement schemes: fixed subsidies and cost sharing. Our findings show that public coverage improves access for low-income patients but increases producer prices due to reduced price elasticity of demand. Targeted coverage provides greater access at lower public cost compared to universal coverage, especially under cost-sharing schemes. With fixed subsidies, both schemes achieve similar access, but targeted coverage remains more cost-efficient. The policy that maximises utilitarian welfare is targeted coverage with a fixed subsidy, balancing improved access for low-income patients against higher prices for high-income patients. This trade-off highlights challenges in implementing targeted policies but provides insights for designing efficient and equitable public dental care systems.