Basic dental care should be available to ALL via Medicare

Paddy Byers

Oct 31, 2021, 16:33 GMT+11

It’s an old debate but lack of easy access for all Australians to basic dental care is a cause for ongoing concern. The link between poor oral health and the cost to the Medicare system of heart-related problems needs to be acknowledged and dealt with. Just because dental care is expensive shouldn’t mean that less well off, Indigenous, and elderly members of the community should be denied easy access via Medicare. Australian dental coverage does not compare well with many overseas companies.
Basic access to dental care should be available to ALL.

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Different states provide different levels of support. Two I am familiar with are…

https://www.dhhs.tas.gov.au/oralhealth

These provide dental services to those who meet the eligibility criteria…which is generally ‘less well off, Indigenous, and elderly members of the community’. The services are provided by these state governments in state government run dental clinics.

It is worth seeing what your own state government offers, and whether you are eligible. Many in the community aren’t aware of the state government services.

We have first hand experience of the ones in Tassie, and they provide an excellent service.

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Totally agree.

When we lived in Central Qld it was up to 3hrs to the nearest town with an orthodontist. We had a visiting dentist and a visiting optometrist who between them serviced a number of towns from shared consulting rooms. Each town serviced had to be fully equiped to handle needs but were in use on average one day each week. The costs were a premium. For the alternative there’s a cost of giving up a day plus the cost of driving to the big smoke and return.

Free access in Qld is very limited, per the link by @phb. It’s not a free service accessible to all. And what they provide is only basic care.

Note:

Eligibility

Adults

For adults and their dependants to be eligible for free public dental care they must be a Queensland resident and, where applicable, in receipt of benefits from any of the following concession cards:

  • Pensioner Concession Card issued by the Department of Veterans’ Affairs
  • Pensioner Concession Card issued by Centrelink
  • Health Care Card
  • Commonwealth Seniors Health Card
  • Queensland Seniors Card

Children and adolescents

For children to be eligible for free public dental care they must:

  • be a Queensland resident or attend a Queensland school; and,
  • be eligible for Medicare; and,
  • meet at least one of the following criteria:
    • be aged four years or older and have not completed Year 10; or,
    • be eligible for the Medicare Child Dental Benefits Schedule; or,
    • hold, or be listed as a dependent on, a valid Centrelink concession card
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While eligibility is defined regular reports in Vic suggest the wait for service can be years, not weeks or months.

Most countries sqib on dental care. Countries that rely on insurances also have comparatively trivial benefits compared to medical support. Our ‘extras’ reflect that but are still better than many places.

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The mouth can not be quarantined off from the rest of the body, because we are just starting to understand the wider ramifications of poor oral health. According to the Mayo Clinic these include pregnancy and birth complications, and pneumonia and other respiratory diseases in addition to the cardiac issues already mentioned…

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Are Australian taxpayers prepared to pay for the costs of Medicare dental care with a tax on their income?. And let’s make it a serious one. Tax on gross income before any deductions and tax minimisation measures are able to be applied.
I think not.
Is the dental industry prepared to reign in their prices and agree to basic services like fillings under conditions like bulk billing?
I think not.

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Is that the best question to ask?

Alternately, are a majority of Australians in favour of adding basic dental health needs to the Medicare schedules?

How it is funded can be the same as for all other items. The less you earn the greater the relative benefit. The more one earns the lesser the relative benefit. Private extras cover can remain an option if it suits.

In the end we are all paying for the Dentists we use one way or another. With Medicare it would share the cost risk benefit across the whole of the community, instead of the burden of uncertainty.

For those with dental plates or other non optional orthodontic work the costs can be considerable. The same can be said of the costs for those who have diabetes or cancer or tear knee ligaments playing in the back yard. It remains at odds that one can get medical support for all these ailments, and eye health to pregnancy. Dentistry support for all due to a lack of political will remains excluded.

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Maybe before/along with publicly funded dental through Medicare (at what cost and where is money to come from?) people should first be responsible for their own personal dental health hygiene.
How many clean their teeth properly after a meal to ensure their teeth/gums stay in good condition?
While it may be too late for some older adults certainly every child should be taught/know how to properly brush their teeth on a regular (twice a day) basis.

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And how many eat junk food loaded with sugar?

I read an article recently regarding residents of Hobart having 3 generations. grandparents, parents and children, all with dentures as they treat it as normal.

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How many are so poor that even though they work long hours can’t afford proper dental care. Making judgements about people is not the way to fix this problem. It seems when it comes to properly funding the service our wallets are too thin or perhaps our pockets are too shallow as a nation. Is it a case of “I’m alright so stuff the others”?. Dental healthcare is just as important as any other healthcare we support. Again I say Judging others is not the way to fix it.

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Australians are already often paying for the consequential health maladies. It is mainly the lower socio-economic status (SES) people who are affected by poor dental care. When those lower SES people have heart issues, or pneumonia, or pregnancy and birth complications they are unlikely to be using private health; they will be going public. Who pays for that? Australian tax $$.

It would make an awful lot of sense spend a lesser amount of $ to ameliorate the dental problems before they become serious and cost lots and lots of $$ to Medicare.

Unfortunately, successive Governments have failed to wake up to the fact that providing preventative health assistance saves money in the long run.

The Government could somewhat control what Dentists charge in the same way as they do Doctors.

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Absolutely! The fees dentists charge are outrageous. And since it doesn’t make much difference which one you go to it makes one wonder if there is some sort of general agreement among them, which I thought was illegal.

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It’s important to consider that it’s not just the dentist who needs to get an hourly rate. There are the accumulated costs of also paying for an assistant, the receptionist, the premises, the dental equipment. There’s the daily cleaning and sterilising plus the book keeping costs, customer management system and very important, insurances.

Every dentist whether a line operator, small business with several dentists sharing the overheads, or a large clinic has the same underlying base costs. The dentist needs to build in allowances for annual leave, long service leave, payroll tax, quarterly gst returns, super and managing super. They are costs that relate to staff as well as personal income.

I’m not out to justify the actual amounts charged for dentistry. It’s important to consider that dentistry requires much more than just a room with a prescription pad, blood pressure monitor, thermometer and plastic models of ones inner bits. I’m not surprised dentistry work is expensive. Relative to a visit to the GP, a visit to the dentist may actually be good value. Note too that the GP can turn every test or scan into an extra Medicare item, mostly by an external provider, and then hit the Medicare system a second time for a follow up visit to tell you all the results are as expected!

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It’s a relevant question.

Similar also might be said of those who have cancer due to tobacco use, liver damage due to alcohol, black lung disease because they chose to work in coal mining, Covid because they chose not to get vaccinated, ……

One choice of the community is to discriminate against those who have made poorer life choices, many for no reason other than circumstances. The better choice and IMO that supported by the majority is as a community we are all in this together. Everyone needs equal opportunity. The current system limits access to good dental health purely on wealth. Some leaders are more aware of this need than others.

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The major problems are the cost and the control. As a dentist, I remember the ill-fated Chronic Diseases Dental Scheme with a cover of $4250 every 2 years. Poorly defined, open to rorting by both patients and dentists, and supposedly with the poor GMP as a gatekeeper. However, some hope has developed with the Child Dental Benefits Scheme (CDBS) - it gets to the children when they are developing their eating and hygiene habits (preventive) and covers most standard procedures. There has been talk of lowering the age but still waiting for Fed Govt to follow through. This has been more achievable and practical, but will take some years to filter through the ages.

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I have availed myself off the Dental care in the public system and while it is okay as far as it goes, the local clinics prior to COVID used a supply off dental students to supplement their staff when they reached their last year off dental schooling they were placed in State run clinics to learn more about patient care and actually see patients. Care was done under supervision off course and some clinics while they were good for fillings, teeth cleaning and things that weren’t too complicated once that complication arose it was either refer them to the larger clinics in Brisbane CBD or more often than not extract the tooth, this meant some people suffered for this and were worse off because off it.
Nowadays post COVID, because there are no students currently or very few students a voucher is given to the patient if the local clinic cannot accommodate them and they get to go to the dentist off their choice. It’s around $200 but in come cases that hardly covers what is needed.
I’ve been lucky and got referred to the larger clinics because I needed somethign the local clinics couldn’t do and that was metal dentures and have gone to them ever since, but they too use students through UQ but again COVID intervened so wait times in local clinics will now balloon out unless the Federal Govt comes to the party and funds low cost dental properly.
Labor did so many years ago for chronic suffers of various illnesses and the Coalition pulled the plug on that and have tried too cut funding ever since. They really dont worry about those under a certain pay grade but we’ll have to wait and see if a new broom comes into power next year. I do know the Greens are in favour off the Medicare funding situation but well they are not being listened too anymore as cross bench politicians rule the roost in Canberra.

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I am confused. The Greens sit on the crossbench, so are they ignored or do they rule the roost?

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The voucher system doesn’t mean that needed treatment can’t be accessed. If the work is too complex for the voucher amount the dentist is supposed to contact the Govt Dental service and request approval to exceed the amount or refer the patient back to the Govt service to take care of the more complex work.

Like you my wife and I use the service and have used the emergency vouchers and at times have had issues that exceeded the voucher amount but the dentist received approval to exceed the amount. If the voucher is for the normal “yearly” check which can be two yearly the amount is around $800 not the emergency amount of around $250 and it too can be exceeded on approval or the patient is referred back to complete the more costly work.

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Sorry syncretic, I should have said other cross bench politicians. Greens do get some thing done for their votes but a lot off time the others who sit n those benches are courted for what Greens wont pass.

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I did not know this grahroll. I thought that the voucher could not be exceeded under any circumstances, but now I know it will come in handy if I need to use one. I do need to go for a check up but have been waiting to be called up to the clinic in CBD s I’m on their wait list.

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