Dental and health policy experts have welcomed a $4 billion dental health package from the Federal Government, which specifically targets children and pensioners.
The package provides $2.7 billion in new funding for subsidised dental care for more than 3 million children, and $1.3 billion for services for adults on low incomes, including pensioners and concession card holders.
“While Medicare and free hospital care have been a basic right for Australians for decades, millions of people in this country still go without adequate dental care,” Health Minister Tanya Plibersek said.
Stephen Leeder, director of the Menzies Centre for Health Policy at University of Sydney, said it’s never made sense that dentistry has fallen outside the Medicare basket.
“Fundamentally they’re rectifying a very simple problem, which is the exclusion of dental care from the philosophy of Medicare.”
The package will make an enormous difference to the 400,000 Australians on public dental health waiting lists around the country, said Mike Morgan, program leader for oral health at the University of Melbourne.
“We don’t know how many people are not putting themselves on public health waiting lists around the country because they think it’s too hard,” Dr Morgan said.
Universal access to publicly funded dental care is a major plank of The Greens’ policy, and improving the system was a key item pledged by Prime Minister Julia Gillard in return for the Greens’ support after the 2010 election. The additional $4 billion in spending comes on top of $515 million announced in the 2012-13 Federal Budget to target dental waiting lists and training and support for people in rural and remote areas.
“Cost is an issue, but so are other things like availability of services,” said Dr Morgan. “This not only reduces the cost but also promises workforces and infrastructure, particularly in the bush and those areas where there tends to be a greater level of low income and poverty.”
Children aged 2-17 in Family Tax Benefit Part A-eligible families will be entitled to subsidised basic dental treatment, capped at $1,000 per child over a two-year period. The government says this initiative aims to address dental decay in children, which has been increasing since the 1990s.
Ian McAuley, lecturer in public sector finance at University of Canberra, said the package is a well-targeted initiative.
“But as a targeted largely ‘welfare’ system it doesn’t make much progress to universalism, and makes no progress towards integration of dental with other aspects of health care.”
Mr McAuley said it’s a pity the government hasn’t done a cost-benefit analysis, as it would likely stand up very well.
“I suspect that it will have considerable offsetting public and private savings not only in dental care but also in other health care. In fact those benefits go beyond health care, because good dental health has wider benefits. For example, poor dental health is an impediment to overall workforce productivity.”
Mr McAuley said he gave the government high marks for squeezing money out of a tight budget and for filling in some gaps, but no marks for progress on systemic reform.
With the $4 billion to be spent over 6 years, Mr McAuley said some people will still fall through the gaps. “We spend $7.7 billion a year on dentistry (2009-10), of which $4.7 billion is out-of-pocket (i.e. not covered by either private or public insurance).”
Ms Plibersek said poor childhood health leads to poor adult oral health, which can have wide-ranging impacts on general health and wellbeing.
“There’s no doubt poor oral health will impact on general health so anything that addresses oral health is a good thing,” Dr Morgan said.
However Dr Leeder said he was less convinced of the linkage between oral health and general health, urging a focus on the issue at hand.
“I think we’ve got to look at dental care in its own right…We’ve got to press on with the main game which is to make sure people who need dental care, restorative or preventative, have reasonable access to it and are not denied it on the basis of cost.”
Dr Morgan said continued focus on water fluoridation and workforce development was required, but added the package was a “big win” for dentistry in Australia.