Dental care—holes to be filled

Parliament house flag post

Dental care—holes to be filled

Posted 6/09/2010 by Amanda Biggs


Calls for urgent action on dental care have been a feature of public debate in recent years and were raised yet again in the context of the recent Federal election. The issue remains high on the agenda, as evidenced by the recent agreement between the Greens and Labor which included a commitment to improving investments in dental care.


These calls for action are supported by reports of:
  • declining oral health status—one quarter of adults have untreated decay, with higher rates amongst the financially disadvantaged, rural and indigenous Australians
  • financial barriers—one third of Australians report delaying or avoiding dental treatment due to cost
  • service gaps, particularly in rural and regional Australia, and
  • long waiting lists for state public dental services—reportedly 650,000 adults are on public dental waiting lists.
Debate persists over the best way to improve and fund dental services, how these should be delivered and who should be the main beneficiaries. But the patchwork of current arrangements for funding dental care, introduced by various governments over the years, and a lack of consensus on various dental options will make progress a challenge.

The states and territories fund and deliver most public dental services, but these are largely targeted at children or the financially disadvantaged and long waiting lists apply. Under the Commonwealth funded Medicare scheme, funding for most dental services has been excluded until recently, as explained in this Overview of Commonwealth involvement in funding dental care. Traditionally, Medicare was limited to funding medical services so dental services which were mostly categorised as ancillary services, were beyond its scope. Thus, much of the cost of dental services in Australia has been borne by individuals—some $3.9 billion annually—with private health insurance and government sources meeting the rest.

But in recent years, Medicare arrangements have changed, so that a range of allied health services are now funded, including some dental services. The Howard government introduced these under its Allied Health and Dental Care initiative in 2004 (which was then expanded in 2007). This provides limited Medicare benefits for patients with a chronic condition whose poor oral health exacerbates their condition, provided they are being managed by a GP. While many chronically ill patients undoubtedly benefited from these new arrangements, questions over misuse of funds, cost blowouts and over servicing cast doubt on the effectiveness and viability of the program—which has now cost over $1 billion. The Rudd government promised to close it and redirect the funds to the states in the form of a revamped Commonwealth dental health program, and a Teen Dental Plan.

While a means-tested voucher for a dental check-up was introduced for eligible teenagers, the Rudd government’s proposed Commonwealth dental health program remained stalled. Additional funds were to be directed to the states and territories to expand the capacity of their public dental services and target the financially disadvantaged and other priority groups including those with chronic conditions, children and Aboriginal and Torres Strait Islander people. But efforts to close down the Howard government program and redirect funding to assist the states were opposed by the Coalition, the Greens and the Independent Steve Fielding in the Senate, as explained in this paper.

In late 2008, after months of consultation the National Health and Hospitals Reform Commission issued its final report which included a major recommendation on funding dental care. It proposed the establishment of Denticare Australia through which individuals would choose to either purchase subsidised dental insurance to cover a basic package of dental services, or rely on an expanded free public dental program. To be funded mainly by an increase to the Medicare levy which was estimated would raise some $4.1 billion annually, the proposal garnered a mixed response at the time, as outlined in The proposed Denticare scheme—an overview. Some questioned its cost assumptions, whilst others were concerned over equity issues. So far, neither major party has indicated support for this scheme.

Not to be confused with the NHHRC proposal is the Greens ‘Denticare’ proposal. Under this scheme, estimated to cost $4.3 billion annually, non-cosmetic dental services would be covered by Medicare with the aim of providing all Australians with access to comprehensive basic primary dental care. But if this scheme were to be pursued, it would need to overcome the opposition many in the dental profession have expressed over entrenching dental care under Medicare. Other proposals for financing dental services such as vouchers and dental savings plans, may also need to be considered.

Whatever model of funding dental care ultimately prevails and whether or not these are targeted or universal in coverage, a number of challenges will remain. Not least of these will be dental workforce issues including an ageing workforce, shortages particularly among the public dental workforce and geographic maldistribution, particularly in rural areas. More broadly, an ageing population beset with more chronic diseases will increase demand for dental health services, while poor dietary choices particularly amongst the young will impact on their dental health. The cost of dental care, consistent with other health services, is also trending upwards, adding to cost pressures on individuals and future government budgets. These broader issues will need to be considered in tandem with any proposals for increased funding of dental care.
Image Sourced from: Health Promotion Board, Singapore, http://www.hpb.gov.sg/diseases/article.aspx?id=368


Thank you for your comment. If it does not require moderation, it will appear shortly.

Add your comment

[Click to expand]

We welcome your comments, or additional information which is relevant to a post. These can be added by clicking on the ‘Add your comment’ option above. Please note that the Parliamentary Library will moderate comments, and reserves the right not to publish comments that are inconsistent with the objectives of FlagPost. This includes spam, profanity and personal abuse, as well as comments that are factually incorrect or politically partisan. We will close comments after three months.




Captcha
Generate a new image
Type characters from the image:

Facebook LinkedIn Twitter Add | Email Print

FlagPost

Flagpost is a blog on current issues of interest to members of the Australian Parliament


Parliamentary Library Logo showing Information Analysis & Advice

Archive

Syndication

Tagcloud

Refugees asylum climate change immigration Australian foreign policy parliament social security elections welfare reform welfare policy school education Australian Defence Force health financing higher education emissions trading indigenous Australians women private health insurance people trafficking Employment illicit drugs gambling health reform federal election 2010 disability Sport Australian Bureau of Statistics statistics United Nations Asia Afghanistan income management Middle East Medicare health forced labour Australian Sports Anti-Doping Agency World Anti-Doping Agency United States federal budget Industrial Relations Carbon Pricing Mechanism politics dental health Australian Electoral Commission WADA criminal law transport aid child protection environment poker machines Australia in the Asian Century steroids National Disability Insurance Scheme detention aged care 43rd Parliament slavery health system ASADA Law Enforcement Australian Federal Police Fair Work Act Australian Public Service governance labour force people smuggling debt taxation international relations constitution New Zealand food Australian Crime Commission pharmaceutical benefits scheme corruption pensions public service reform children's health Aviation federal election 2013 foreign debt gross debt net debt defence capability parliamentary procedure Senate Senators and Members ALP Newstart Parenting Payment multiculturalism Youth Allowance sea farers election results voting mental health Federal Court terrorist groups science social media Higher Education Loan Program HECS federal state relations accountability Papua New Guinea youth paid parental leave same sex relationships coal seam gas customs planning doping OECD crime health risks International Women's Day Gonski Review of Funding for Schooling sex slavery Special Rapporteur Northern Territory Emergency Response social policy violence against women domestic violence China ADRV terrorism transparency research and development welfare ASIO intelligence community Australian Security Intelligence Organisation carbon tax mining High Court military history electoral reform employer employee renewable energy regional unemployment fishing by-election European Union family assistance skilled migration banking United Nations Security Council Australian economy forestry food labelling vocational education and training Drugs UK Parliament welfare systems Indonesia children Constitutional reform local government codes of conduct terrorist financing homelessness Parliamentary remuneration money laundering Trafficking in Persons Report energy social inclusion human rights paternalism disability employment Tasmania integrity standards NATO Australian Secret Intelligence Service sexual abuse World Trade Organization Australia public health housing affordability bulk billing political parties water productivity health policy Governor-General US economy trade unions export liquefied natural gas foreign bribery firearms question time speaker superannuation public housing expertise public policy climate Intergovernmental Panel on Climate Change leadership Department of Agriculture Fisheries and Forestry regulation Pacific Islands reserved seats new psychoactive substances synthetic drugs UNODC carbon markets animal health middle class welfare Census Indigenous constitutional recognition of local government referendum consumer laws PISA competition policy royal commission US politics language education baby bonus Leaders of the Opposition citizen engagement policymaking Australia Greens servitude Trafficking Protocol forced marriage Population rural and regional alcohol entitlements ministries Hung Parliament social citizenship maritime Iran ANZUS regional students school chaplains federal budget 2011-12 salary Medicare Locals primary care Building the Education Revolution China soft power education Fiji India Disability Support Pension Antarctica Diplomacy by-elections state and territories Bills anti-corruption fraud bribery corporate ownership whistleblower G20 economic reform innovation Members of Parliament Scottish referendum early childhood education Middle East; national security; terrorism social services Criminal Code Amendment (Misrepresentation of Age to a Minor) Bill 2013 online grooming sexual assault of minors ACT Assembly national security smoking plain packaging tobacco cigarettes Asia; Japan; international relations Work Health and Safety Migration; asylum seekers; regional processing China; United States; international relations fiscal policy Racial Discrimination Act; social policy; human rights; indigenous Australians Foreign policy Southeast Asia Israel Palestine asylum refugees immigration political finance donations foreign aid Economics efficiency human rights; Racial Discrimination Act employment law bullying asylum seekers Animal law; food copyright Australian Law Reform Commission industry peace keeping contracts workplace policies same-sex marriage disorderly conduct retirement Parliament House standing orders prime ministers election timetable sitting days First speech defence budget submarines workers financial sector Canada Somalia United Kingdom GDP world heritage political engagement leave loading Trade; tariffs; safeguards; Anti-dumping public interest disclosure whistleblowing Productivity Commission limitation period universities Ireland cancer gene patents genetic testing suspension of standing and sessional orders live exports infant mortality honorary citizen railways disciplinary tribunals standard of proof World Health Organisation arts international students skilled graduate visas temporary employment visas apologies roads Italy national heritage NHMRC nutrition anti-dumping Rent Assistance obesity evidence law sacrament of confession US presidential election international days DFAT UN General Assembly deregulation Regulation Impact Statements administrative law small business Breaker Morant regional engagement social determinants of health abortion Members suspension workplace health and safety marine reserves hearing TAFE Victoria astronomy resources sector YMCA youth parliament Korea fuel rebate Australian Greens presidential nomination Racial Discrimination Act political parties preselection solar hot water Financial Action Taskforce Horn of Africa peacekeeping piracy Great Barrier Reef Stronger futures political financing political education Social Inclusion Board early childhood National Quality Framework for Early Childhood Education and Care Murray-Darling Basin sanctions Norway hospitals republic President Barack Obama Presidential visits qantas counselling Korean peninsula Work Choices biosecurity hendra environmental law federalism federation preselection therapeutic goods Therapeutic Goods Administration plebiscites computer games pests suicide nuclear COAG Ministerial Councils floods ADHD stimulant medication advertising electricity extradition conscience votes poverty preventative health rural health coastal erosion Parliamentary Budget Office work-life balance

Show all
Show less
Back to top