Federation

• As dentistry scholars, we believe Koop also deserves credit for something else.
• Americans who rely on the traditional Medicare program for their health insurance get no help from that program with paying their dental bills aside from some narrow exceptions.
• This group includes some 24 million people over 65 – about half of all the people who rely on Medicare for their health insurance.

‘Medically necessary’ exceptions

• The list of circumstances that would lead patients to be eligible is short.
• Some examples include patients scheduled for organ transplants or who have cancer treatment requiring radiation of their jaws.
• But we believe that dental care is necessary for everyone, especially for older people.

Chew, speak, breathe

• While many working Americans get limited dental coverage through their employers, those benefits are usually limited to as little as $1,000 per year.
• And once they retire, Americans almost always lose even that basic coverage.
• Rich Americans with Medicare coverage are almost three times more likely to receive dental care compared to those with low incomes.

Connected to many serious conditions

• Having diabetes makes you three times as likely to develop gum disease because diabetes compromises the body’s response to inflammation and infection.
• At the same time, treating diabetes patients for gum disease can help control their blood sugar levels.

Chemo can damage your teeth

Many cancer treatments can damage teeth, especially for older adults. As a result, Medicare has started to reimburse for dental bills tied to tooth decay or other oral conditions after they get chemotherapy or radiation treatment.

More than nice to have

• Doctors and dentists are educated separately, and doctors learn very little about dental conditions and treatments when they’re in medical school.
• Most dental electronic health records aren’t linked to medical systems, hindering comprehensive care and delivery of dental care to those in need.
• Medical insurance was designed specifically to cover large, unpredictable expenses, while dental insurance was intended to mainly fund predictable and lower-cost preventive care.

Medicare Advantage plans

• Until Medicare expands coverage to include preventive dental services for everyone, alternative plans such as Medicare Advantage, through which the federal government contracts with private insurers to provide Medicare benefits, serve as a stopgap.
• In 2016, only 21% of beneficiaries in traditional Medicare had purchased a stand-alone dental plan, whereas roughly two-thirds of Medicare Advantage enrollees had at least some dental benefits through their coverage.

Frank Scannapieco is affiliated with The Task Force on Design and Analysis in Oral Health Research, and consults for the Colgate-Palmolive Company. Ira Lamster is a member of the Santa Fe Group. He currently receives consulting fees from Colgate, and research support from the CareQuest Institute.

• FPF Submits Comments to the Office of Management and Budget on AI and Privacy Impact Assessments
  On April 1, 2024, the Future of Privacy Forum filed comments to the Office of Management and Budget (OMB) in response to the agency’s Request for Information on how privacy impact assessments (PIAs) may mitigate privacy risks exacerbated by AI and other advances in technology.
• As privacy impact assessments are a well-established means for both public and private entities to assess privacy risks in their services, products, and programs, there is a tremendous opportunity for federal agencies to apply learnings from existing data privacy to the challenges that AI presents as a rapidly evolving technology.
• Ensuring that the scope and substance of a PIA for AI tools account for role-specific responsibilities and capabilities in the AI system lifecycle.
• “Whether conducted by the public sector, private companies, or other entities, privacy impact assessments can play an important role in evaluating and mitigating certain risks associated with technology.

• Recent education policy changes and protests about sex education reveal increasing concern and polarization over how sex and gender identity are taught in public schools in Canada.
• They also expose the significant role now played by school boards in constructing the meaning of gender identity and gender expression.
• Changes in how words and terms are used can impact our ability to know about people’s lives and protect their rights.
• Significant shifts are taking place around how we define and understand sex and gender in education and public policy in Canada.

Sex, gender and law

• Yet sex, gender identity and gender expression are not defined in human rights legislation in Canada.
• They should be able to express their concerns and participate in open discussions about the meaning of words we share.

Changes in the definition of sex

• The Charter of the United Nations prohibits sex discrimination.
• The United Nations Universal Declaration of Human Rights precludes discrimination based on sex.

Changes since 2018

Since 2018, the word sex is increasingly defined by the federal government as something that is “assigned at birth.” But there is no consistency across federal departments and agencies. Some continue to define sex as a biological question of male or female. Those that define sex as assigned at birth do not consistently explain how sex is assigned or by whom.

Conceptual shifts around word ‘woman’

• Similar conceptual shifts are taking place around the word woman.
• The word woman was formerly linked to sex and used to refer to female people.
• Now, government departments including the Department of Justice increasingly use the word woman to refer to all people who identify as women.

Defining gender identity

• When gender identity was added to federal human rights legislation, the Department of Justice defined gender identity as:
  “each person’s internal and individual experience of gender.
• A person’s gender identity may or may not align with the gender typically associated with their sex.”
  “A person’s internal and deeply felt sense of being a man or woman, both or neither.
• A person’s gender identity may or may not align with the gender typically associated with their sex.”

School boards define terms differently

• Researchers have identified that secular boards across Ontario define gender identity and gender expression differently from one another.
• Some school boards now define gender identity as something everyone has.

Data collection shifts away from sex towards gender

• A shift away from sex and towards gender (identity) has occurred in data collection practices at the federal government level.
• In 2018, the Treasury Board of Canada Secretariat and the Department of Justice Canada recommended “ways to modernize how the Government of Canada handles information on sex and gender.” They recommended that “departments and agencies should collect or display gender information by default, unless sex information is specifically needed.” They used “sex” to refer to biological characteristics, and “gender” to refer to a social and personal identity.

Open discussions are overdue

As Canadian society shifts to accommodate the legal recognition of gender diversity, there will be tensions. Ultimately, courts will be tasked with deciding how some of those tensions are resolved, when sex, gender identity and gender expression are all protected in human rights laws. In the meantime, as a society, we need to openly and transparently grapple with some increasingly important questions:
First, how will foundational concepts such as sex, gender identity and gender expression be defined and given effect in education, law, public policy and beyond?
Second, how will tensions between experiences, interests and rights associated with sex and those associated with gender identity and/or gender expression be resolved?
Third, who is best placed to decide how these questions are answered in education, law, public policy and beyond?
Everyone who may be impacted by the answers to these questions should be included in the conversation.
Debra M Haak receives funding from the Social Sciences and Humanities Research Council, the Canadian Bar Association Law for the Future Fund, and the Queen's University Faculty Association Fund for Scholarly Research.

• Dr. Chana Poomee, along with the TCMA Board, outlined the long-term direction of TCMA, which is a collaboration nexus of leading Thai cement producers.
• TCMA, over the next two years, 2024-2026 will accelerate its efforts to join forces with all sectors to achieve the key missions in four areas:
  1.
• Accelerating the expansion of maximize resource-efficiency mining practices according to the Minerals Act B.E.
• TCMA, with this action aims to reduce greenhouse gas emissions not less than 6.9 million tons of carbon dioxide in 2030.