Research shows that 90% of all Australians have some form of tooth decay. 60% of low-income earners have not even been to the dentist in the last year, while 20% of those who did see a dentist did not follow through with the recommended treatment due to cost.
High costs are the main reason why an estimated two million people don’t go to a dentist when needed.
Because of the lack of regulation over dental care, the price of dental treatment varies widely. A simple check-up and basic clean can cost anything up to $200! Fillings, depending on complexity may cost up to $320, while a crown is likely to see people out of pocket by as much as $2000!
Currently states and territories spend a combined $836 million on public dental care. This pitiful amount means that our few still existing public dental services are extremely difficult to access and massively under resourced. You can wait up to a year for a basic check-up.
The federal government contributes another $108 million to public dental health, but they spend more than $700 million subsiding private health insurance rebates for dental claims. Much of this money is taken in profits by the insurance companies.
In the final week of the federal election campaign Labor promised an extra $2.4 billion over four years for dental care for pensioners and some retirees. This would have equated to around $500 a year for those who met the eligibility criteria. If you were lucky it would have covered a check-up and a filling. It was totally inadequate.
Unfortunately, the Coalition government are offering up even less, but more can be won if trade unions and community groups come together to fight for it. Medicare was originally resisted, but it was won thanks to an active campaign that included strikes.
According to a recent report by the Grattan Institute it is estimated that a proper universal dental scheme – meaning that all treatment is fully bulk-billed – would cost an additional $5.6 billion per year. While that sounds like a lot, it is comparatively very little. For example, the government currently spends around $35 billion a year on defence!
In actual fact, a universal dental scheme would eliminate enormous costs further down the line. Many studies have shown that prevention and early intervention, via regular check-ups, significantly lowers the risk of more serious future problems.
The Grattan Institute report correctly outlines the medium and long-term impacts of poor oral health including gum disease and severe tooth loss, as well as their subsequent impact on quality of life.
It highlights the fact that oral disorders are the sixth greatest source of non-fatal burden of disease in Australia and that low-income earners are disproportionately affected. Poor oral and dental conditions are also risk factors for several other serious conditions, including diabetes and cardiovascular disease.
Speech issues, low self-esteem and mental health issues can also result from dental problems.
While the Grattan report gives a good picture of the current poor state of dental health, it falls short when it comes to solutions. Rather than calling for a universal public dental system they propose that private dentists should be able to opt into a bulk billing scheme, and that fees should be monitored.
While this would encourage some private dentists to treat patients on lower incomes, it would still allow for private clinics to use taxpayer funds to increase their profits.
We have seen with other schemes, such as the rebates for specialist psychological support, that private providers use the opportunity to increase fees. Patients end up paying more in ‘out of pocket expenses’ while the private clinic tops up its profits with government funds.
It would be much better if we had a proper universal dental care system which was publicly owned and controlled. Patients could go to public hospitals or dental clinics which would be free at the point of service.
Dentists would be paid well but we could cut out the private clinics and insurance companies, who make immense profits at the expense of our health. These profiteers will not give up their perks easily, so we will need to fight for it, just like the previous generations fought for Medicare.
By Denise Dudley