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Time To Add Dental To Medicare
It's no secret public dental programs in Australia are failing to meet the increasing demand for services.
Families are struggling to cope with the soaring cost of living. Private dental care is becoming more unaffordable, and millions of Australians are left without access to the treatment they desperately need.
This dental divide is not just affecting quality of life, but also leads to potentially avoidable costs to the healthcare system as a whole.
Dental problems can impact everything from life expectancy and general health to job prospects. The dental divide between the rich and the poor mirrors broader disadvantages that exist in this country.
It is no wonder there is mounting pressure for a Medicare-style universal insurance scheme for dental care, or the inclusion of dental care into Medicare itself.
Why wasn't dental included in the first place?
When the Whitlam Government introduced Medibank (the precursor to Medicare) in 1974, dental care was left out due to cost and political reasons.
Back then, doctors were opposed to the new healthcare insurance plan, which was challenging enough without taking on dental groups as well.
Apart from economic concerns, there are two primary reasons why dental care was excluded:
Medicine and dentistry have always been treated differently by the healthcare system, health insurance funds, policymakers, and the public. Despite evidence of the importance of oral health, it is often viewed as a luxury rather than a necessity.
The responsibility for providing public dental health services is seen as the duty of states and territories. Public dental services historically targeted children, low-income adults, and other disadvantaged groups. The Australian Constitution may grant dental services the same status as medical services, but the Commonwealth doesn't have to fund these services.
How can we fix a broken dental health system?
Depending who you ask, expanding Medicare to include dental services will cost the federal government an extra $5.6b to $7.5b per year.
But this doesn't account for the potential savings in healthcare costs due to preventable dental issues, which the Australian Dental Association estimates at $818 million per year.
It also ignores the impact on productivity. And implementing such a scheme would require increases in the Medicare levy, increased taxation, and/or cuts to the private health insurance rebate.
There may be a case for means testing access to Medicare Benefits Schedule items for dental care. This would mean some families might qualify for free or subsidised dental care, while others that earn more may not. But some say this could lead to means testing for other healthcare services. And no one wants that.
A Denticare model that works similarly to Medicare could be the answer. But doing that would require evidence-based decision-making on who and what is covered, how it is funded, and what happens to existing federal- and state-funded dental programs.
Easier fixes (for now) could include prioritising cost-effective investments such as fluoridation and preventive services. Many preventive actions needed to address issues like obesity, such as promoting breastfeeding and limiting sugary beverages, would also have a positive impact on dental health.
Additionally, expanding emergency dental services in hospital emergency departments and creating a 'Dental Health Service Corps' of dentists and other medical professionals to assist in rural and remote areas could work.
The Bottom Line
A Senate Select Committee is currently conducting an inquiry into dental services in Australia. Until then, expect worsening waiting lists and increasing costs for dental patients.
Public hearings, which will inform the committee's final report, are scheduled for later this year. Hopefully, this will make politicians see that dental care as essential to health and wellbeing.
We also encourage households to speak to a health insurance agent to see if you can find and/or afford private health insurance that does include dental cover.
