27 October 2024

We've had Medicare for 50 years, but where's the dental care?

| Jen White
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Empty dental chair

People are risking their overall health by avoiding the dentist’s chair. Photo: Image-Source.

Have you been to the dentist lately? If you haven’t, you’re not alone, according to the latest national report on dental health in Australia.

There are any number of reasons people put off going to the dentist, but the physical and mental health risks of delaying a visit for too long can be life-threatening.

The Australian Institute of Health and Welfare’s (AIHW) oral health and dental care report found that in 2022–23, more than 87,000 hospitalisations for dental conditions could have been avoided if patients had been treated earlier.

About one in three Australians aged 15 and over have untreated tooth decay, while about 30 per cent of adults have gum disease.

“Poor oral health can lead to the development of bad breath and problems with eating, communicating and sleeping,” the report says.

“But it can also have a more widespread effect on the body and is associated with a number of chronic conditions including cardiovascular disease, stroke, and diabetes.”

READ ALSO If you fear a visit to the dentist, you’re not alone – it’s almost normal

Frighteningly, the highest rate of potentially preventable hospitalisations was among children aged five to nine years old.

Consumers Health Forum of Australia CEO Dr Elizabeth Deveny was staggered by that figure – “what sort of country have we become where that is ok?”.

She said the health sector had known about the dire problem Australians have in accessing and affording dental treatment for some time.

“Yet every time it is discussed the same problems, namely the cost to implement a truly universal scheme, and solutions, starting out small investing in greatest need first, are put on the table.

“This only results in more Australians delaying or deciding to not get the care they need when they need it.”

And she’s dead right. The same AIWH report 10 years ago found that Australians’ dental health had not improved in recent years. Back then there had been a rise in the average number of children’s baby teeth affected by decay and an increase in the number of adults reporting adverse oral impacts.

That begs the question – why the bloody hell has nothing been done about it?

The AIHW report revealed one in five Australians say the cost of dental visits was why they had delayed or avoided treatment.

Public dental care is available but good luck with that – it has strict limits on who can access it and waitlists can be ridiculously long.

“Our public dental system is so bad, has been so neglected for so long, that we have adults in some parts of the country waiting 500 or 600 days to get in on the public dental system. This clearly isn’t a universal system which provides for all,” Dr Deveny added.

Choice looked at the cost issue last year and found, based on Australian Dental Association data from 2022, the average cost of a periodic check-up including an examination, scale and clean and a fluoride treatment was around $219.

But Choice also found there was a huge variation in cost between dentists, ranging from $162 to $309.

“Dentists are free to set their own fees. There are no standard fees for services provided by dentists or other dental professionals in Australia,” Choice said.

So next question – why doesn’t Medicare cover dental services? When Gough Whitlam’s government introduced Medibank (which later became Medicare) back in 1974, dental care wasn’t included. Many argue that was down to the cost and the politics – the government had faced a difficult time getting doctors to accept Medicare, without taking on the dental lobby as well.

READ ALSO It’s shear madness: So many barbers, so many bad haircuts

The argument today is still about cost – in the billions to introduce such a scheme – and the issue continues to divide politicians, dentists and health experts.

In 2023, a Senate inquiry into the provision of dental services in Australia recommended the Australian government work with states and territories “to achieve universal access to dental and oral health care … under Medicare or a similar scheme … over time, in stages”.

Health Minister Mark Butler has indicated there are no plans to include dental in Medicare in the near term.

Fair enough, but the government should be sitting down now and talking with those politicians, dentists and health experts who have put forward a myriad of sensible and affordable alternatives for many, many years.

And it can’t just be a talk fest – our nation has gone way beyond talking and needs action. The problem is not going to go away by itself.

The solutions will no doubt be costly, but when poor oral health results in hospitalisations and surgery, surely they must be worth the pain.

Original Article published by Jen White on Region Illawarra.

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Capital Retro5:16 pm 23 Oct 24

I am now in retirement but I still find at least $1000 a year to keep my teeth in good shape and I pay a similar amount for podiatry so I can still be active. There are exercise classes etc. that cost, also.
I am happy to pay the gap when I visit a GP.
They are my choices.
I have many friends who always have the latest devices and tech is more important than health. Eating out and cruising is more of a priority than paying for medical and dental services.
Retirement is miserable enough without having no teeth and chronic lifestyle diseases.

Incidental Tourist12:16 am 23 Oct 24

Private dental cover (extras) is by far cheaper than more expensive and largely useless private hospital health cover supported by taxpayers. Private hospital cover is more tax minimisation strategy than healthcare product. We should look at health insurance landscape holistically and get better value out of money.

Private hospital cover is not a tax minimisation strategy, the best we can hope for is that it lowers the surcharges that are paid in addition to our taxes. And, after doing the sums, it makes no sense to pay more $$$ than what you can offset – thus I certainly can’t recommend it as a financial strategy (note: not a licenced or accredited financial adviser, you are required to do your own research and get professional advice).

Incidental Tourist10:43 pm 23 Oct 24

Almost all insurers have cheapest hospital cover product which costs less than medicare surcharge. It is targeted to clients who want to avoid medicare surcharge while the cover itself is irrelevant. This is pure waste of money which end up in insurers pockets. Coincidentally cheapest hospital cover costs similar to decent extras cover. So by simply tweaking the tax system we can direct money from useless cheapest hospital cover to cover dentists, glasses, and many other “extras” at no extra taxpayer cost.

How about we get Medicare right first before adding ‘dental’ 🙄

It was right until they started tinkering with it, removing items that were previously covered and reducing the percentage of costs recoverable from Medicare.

It’s been 50 years since Medibank (as it was then called) was introduced and since then we’ve learned the high cost to people and the nation of poor dental care. We need to use the research finding to upgrade our healthcare system to meet its original goal for all people to get the healthcare they need. That means including dental care.

We need to get dental covered by Medicare and we need to increase the rebates for doctor visits. I was charged $121 for a short doctor visit recently – a got back about $42 from Medicare. I am fortunate enough to be able to afford it, but there must be so many people who can’t. I feel like Medicare is starting to fail us.

Many people here bag out the Greens but the Greens have for a long time been wanting to get dental included in Medicare.

And a recent visit I had to a dermatologist/skin care doctor had a total cost of $205 of which Medicare refunded about $42 – a standard GP refund amount. I am grateful for the refund – but I would be a lot more grateful if it more closely reflected the amount I had to actually pay!

A healthcare system that does not include dental care does not look after people’s health.

Preventative care at the very least should be freely available, as the cost savings from preventing lost teeth, later health emergencies and chronic illnesses would be huge.

Just pay for it yourself instead of expecting everybody else to.

Marty Dickon2:19 pm 22 Oct 24

would pay for yours too numpty

I already pay for mine. I don’t want to pay for other peoples. Especially considering half the population pay little to no tax. It’s another set of grubby, poor hands in people who have worked hards pocket to fund another handout for you freeloaders.

Only an ignorant and privileged elitist would believe that everyone could pay for themselves.

I don’t care if others can pay for themselves, psycho. They aren’t my responsibility. You can pay my share then, Mother Teresa.

@Ken M
I’m sure the “grubby poor” appreciate your contribution to their general medical needs, and I’m sure they will be equally grateful for your contribution towards their dental costs.

Actually I don’t think they give a rat’s, but I find it amusing knowing how much your Medicare, indeed any welfare, benevolence grates on you.

That’s fine JS. I evade so much tax via various minimisation strategies that it’s almost criminal, and you’re still mad about it. 🤣

@Ken M
Nah, you flatter yourself. The fact that you get your white collar welfare handouts, just puts you in the same bucket of recipients you like to condemn. Just as Centrelink recipients are legally entitled to their government handouts, so are you.

Well, except that we have established that you are a complete financial illiterate, because me paying less of my money that I have earned to the government isn’t a handout. It’s me handing out less of what’s mine.

Maybe I’ll go buy and negatively gear a couple of houses today to upset you further. 🤣

@Ken M
Yeah you keep on saying you “pay less of my money that I have earned to the government”, but have yet to explain how that works with your PAYG deductions each payday.

Negative gearing is about getting a return of PAYG from the ATO, after the end of the financial year. So, like I said it’s your annual handout from the government.

Wrong again, Oliver Twist. Negative gearing allows a person to offset their costs incurred to earn a rental income against their total personal income. The whole not requiring an ABN to rent out a house makes that income personal income. The fact I have to explain this to you, yet again, is very telling.

The government returns the amount they have overcharged (without interest, on what is basically a loan from a taxpayer, I might add) each financial year. It is the government returning money that rightfully belongs to that taxpayer. The tears this generates from the likes of you is the real reward here.

Ken M
Yes, I get it, your government gives you an annual handout based on its calculation of the tax it has allowed you to get around. That works for me.

“The whole not requiring an ABN to rent out a house makes that income personal income”

Only the hopelessly uninformed or a fool would believe an ABN might be required to sequester personal income components, as is already done with personal capital and ordinary income. It’s on your tax form. When I demonstrated this previously you became quite upset. I suggest you bite the dog for relief.

No, what happened was I laughed at your suggestion and ignored your ridiculous nonsense. Rental income is personal income. That’s how it is. You making up how you’d like things to be because you are upset that you can’t afford to do these things is irrelevant.

Capital income (and loss) is also personal income, yet is distinguished on your tax form and treated uniquely for tax purposes. You will find Capital income at Item 18.

Item 11 distinguishes dividends and franking, also personal income, treated uniquely for tax purposes (potential franking credit refund).

Item 21 distinguishes rental income, already freely available to be treated uniquely for tax purposes should a government choose.

Of course your reply abandons your claim an ABN is needed, because that is simply and obviously wrong.

Really, across this and other areas your actual knowledge proves so meagre that I wonder whether you are like Rokuchan in Dodes’ka-den.

My knowledge of these things is just fine, byline. You just don’t like the reality of how the tax system works. Your little communist dream of stealing money from people who have done better in the game of life than you isn’t happening.

So why did your “knowledge” fail completely if it is “just fine”? You were hopelessly wrong, and you keep digging.

I noted elsewhere here that you declared you *evade* tax. Are you confessing to criminal behaviour or did you mean “legally minimise”?

Do you not know enough about that subject to express yourself clearly either? Is it another example of how you blunder along as you have with regard to the lack of need for an ABN to distinguish personal taxation components?

Keep up the silly insults by the way; it tells other readers all they need to know; but not about me.

LOL
I was 100% correct on everything I have said about rental income. You are harping on about how you would like things to be, to satiate your rabid jealousy of people who own investment properties. The simple fact is that rental income, and expenses to earn that income are treated as personal income, which is why you can offset those expenses against your PAYG income. That’s how it is. Your communist fantasy is just a fantasy. If you put as much effort into making your own money as you do whining about other peoples money, you might one day have enough to invest in something yourself.

“not requiring an ABN to rent out a house makes that income personal income”

And that was 100% garbage you continue not to defend in further posts. An ABN is not relevant. Personal income is comprised of multiple distinguished revenue streams. Should a government choose to sequester operating losses on rental income to future income then they would be acting exactly as they do with capital gains; no ABN required. Thus, negative gearing would be expunged, simply and easily. You know it is true, but prefer to display what you do not.

Stephen Saunders8:03 am 22 Oct 24

Good reminder, Jen, thanks. If we can afford half a mil migrants a year, unlimited tax breaks for resource miners and real-estate speculators, not to mention an off-the-scale NDIS, we can probably afford decent dental care for the lower orders.

‘the lower orders’?

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