Where’s the public dental care we were promised?

The pitiful state of public dental care in Victoria, courtesy of Dental Health Services Victoria:

The situation (if you click on the link) is similar for children. Most Australians are simply not eligible.

Given that dental problems can, if not treated properly, develop into far more serious (and, ultimately, much more expensive) problems, why is it that you can’t bulk bill dental care? Why is it that the poor – which includes people without health care cards – cannot reasonably get treatment, and are encouraged to leave their problem until it becomes extremely serious?

What is the reason for the distinction between dental care and other medical care (also underfunded, but at least covered by Medicare)? And, most importantly, when will a Health Minister simply end it? It’s not impossible. Other countries cover dental care in their national health schemes. It can’t seriously be beyond us.

Sorry, sorry. I forgot – we’re too busy panicking about a couple of thousand asylum seekers to pay attention to something that actually affects every single one of us. Carry on.

(Next: why the hell can’t the deaf get hearing aids?)

21 responses to “Where’s the public dental care we were promised?

  1. narcoticmusing

    While I agree with you Jeremy, the issue is, as always, more complicated than that.

    Workforce issues are a major prohibitive factor for many forms of care, dental care is no exception. If you look at the waiting periods for care, there are serious issues relating to a lack of dentists and dental nurses – ie they can’t meet the current demand. This is similar to the situation with public transport – many people believe it should be free, and while that is a debate in its own right, there isn’t the capacity to meet the current demand let alone the additional demand if it were free or the eligible class expanded. It also similar to elective surgery issues (think hip replacements) – we can’t meet the current demand due to purely logistical issues (workforce + available theatres) so how would we manage if we increased the eligibility?

    Demand for these services is infintite – as demonstrated everytime Governments attempt to do one off ‘blitz’ funding to decrease waiting lists – it is consumed with nothing to show for it because the mere advertising of the additional funding creates further demand etc etc. It is a potential bottomless pit. I don’t know the answer, but it is a cyclical, complex issue that can’t be so overly simplified as ‘Govt should fund x’

    Nevertheless, the lack of dental care provided does, indeed lead to people seeking help when the issue is much further escalated. This in turn leads to more pressure on emergency departments and hospital acute and sub-acute beds, thus continuing the cyclical outstripping of CPI in growth/demand by hospitals year on year.

    If we were to adequately prevent major dental issues by treatingthem early, we would have one part of a many part demand mitigation strategy for hospitals (the rest of which pretty much sits in the preventative health space) – but that would take a Government who dared to look more than a single term. Ie. not going to happen.

  2. jordanrastrick

    Free universal healthcare that no one is prepared to pay for is a political nightmare for governments. It makes for a wonderful society with great health outcomes, but the health system only ever leads to negative media coverage (I miscarried in a hospital and the nurses weren’t sympathetic….) while the costs balloon far faster than revenue ever can, since we are living longer, we consume medicine most in our old age, and new expensive health technologies that everyone wants are always getting invented.

    So, only really brave reforming governments ever want to expand the system, even though it would make more sense from an outcomes point of view to say reduce funding for regular medical services to put dentistry on to medicare.

    What governments should be doing is innovative preventative stuff; e.g. pay people a small incentive to get a regular medical and dental checkup for cheap and accurately detected problems that have the potential to get a lot worse. This saves a huge amount in the long run.

    The other side of the coin is that as governments are investing so much in people living longer and healither lives, it needs to be reciprocated; the state need to extract more of an economic return to prevent the long term fiscal nightmare of a worsening dependence ratio. The retirement age should go up by 1 year, per year, for the next 6 or 7 years at least. But that’d probably take an even braver government than expanding dental care.

  3. “The retirement age should go up by 1 year, per year, for the next 6 or 7 years at least.”

    I was wrong you really are a lefty aren’t you? Good idea. I reckon make the retirement age ninety, after all, people can still walk and talk at that age. Maybe we could turn them out of their hospital beds, check their teeth, then send them off to the local restaurant where they can be waiters, maybe chefs. There’s a shortage of bricklayers in Perth I believe.

    I love the thought of some old man or women dribbling in my soup. But hey they would have nice sterile mouths under your plan.
    Hey why not just euthanize the old people that would save the state a motza.We could have a compulsory forfeiture of old peoples property and pay the proceeds into the state coffers. After all they wont need their hearing aids and wheel chairs, working under ground in the Pilbera.

    I wonder just what was the union movement was thinking when they finally got the children out of working in the mines? How I remember the forty hour week that was really going to bankrupt the country. I reckon whilst we’re at it lets get rid of workers compensation, you can still work with one leg. In the fifties they used to get the aged and infirmed counting paper clips and putting them into natty little boxes Yea!!!!!!!!!!

    Yep your a real lefty.

  4. jordanrastrick

    “I was wrong you really are a lefty aren’t you?”

    Nope, not by your mindless ideological standards I’m not, and I’ve never pretended to be. I’d have thought you might have gathered that from my frequently repeated stances on issues like Nuclear power?

    I’m broadly progressive – I’m in favour of a higher rate of wealth distribution, both nationally and globally. I prefer government-based solutions to market-based ones where there are strong socio-political reasons (education), economic ones (natural monopolies like roads), or empirical evidence (health) to do so. My “social” values are liberal – I support gay marriage, drug decriminalisation, and so forth.

    But I don’t buy into any reflexive bullcrap just because “that’s what a lefty should think.” I don’t care about your labels. When the retirement ages of around 65 were set in the Western world, most people had manual labor intensive jobs, were quite unhealthy and infirm by 65, and were typically dead by 70.

    None of these facts holds any longer. People are healthy into their 80s. It won’t be long before many people are healthy into their 90s. Furthermore, retirement is bad for most people’s health. The swich from full time employment to complete leisure causes depression and a whole bunch of assoicated health problems – dementia, cardiovascular disease, etc. This is why many people voluntarily choose to continue to work, at least on a part time or volunteer basis, into their 70s, and they generally end up healthier and happier as a result.

    In the meantime, it is simply not feasible for a shrinking population of 18-65 year olds to pay for a growing per capita demand for health services from a growing base of 65 – 100 year olds. You can keep taxing the young more and more, but considering they must spend an ever growing amount of time and money educating themselves to gain employment, and have ever diminishing opportunities to access housing which is locked up in the ownership largely of older generations, there is a limit. Marginal income tax rates for all of over 50%, not to pay for investments in education or in infrastructure or new services but just to maintain the fiscal and social status quo despite the radical shifts in our demography, are an inevitability.

    There are better ways to spend our resources. There’s nothing progressive about demanding young people pay for the 30 year retirements for old people when those old people themselves only paid for 5 year retriements of the previous generation.

  5. “I’d have thought you might have gathered that from my frequently repeated stances on issues like Nuclear power?”

    Forgive me, what is your stance? A lefty can be pro or anti nuclear power. Personally I’m pro nuclear power (Not for Australia – Too expensive and no need) And I’m very left (relative to my Australian country people.

  6. Oh, and I’m with you with regard to retirement ages.

  7. “Nope, not by your mindless ideological standards I’m not, and I’ve never pretended to be. I’d have thought you might have gathered that from my frequently repeated stances on issues like Nuclear power?”

    You are not a lefty by any one’s mindless standard, or for that matter,any one’s progressive, or enlightened, standard.

    Because governments have made a complete F.U. up the economies they have control of, and couldn’t run a pub chook raffle. I know lets make the old people, and sick pay for it pay for it. Your comment about young people and taxes is a hoot, I left school at fourteen and have being paying taxes in Baghdad whilst you were in dads bag. Most young people today in comparison to when I left school in 1968, are still at school when I left the armed forces.

    Spare me your mindless economic lesson, no one is buying it.

  8. jordanrastrick

    I’m pro nuclear power, in australia and elsewhere. Concentrated solar can and should be bountiful here but its already more expensive than nuclear and past a certain point it runs into inherent diseconomies of scale (at 0% CSP market penetration, desert land has huge supply and no demand. At 50 % that equation would begin to reverse.)

    Burning uranium is hugely preferable to selling it from a proliferation viewpoint.

    Besides, climate and energy are global issues. Places with abundant resources like australia need to export them, not hoard them, if the globe is to havea sustainable future. The worlds aluminum processing and the asia pacific’s data centres should be located here.

  9. Dental care isn’t bulk billed because dental surgeries are treated like a business by the government and are expected to run and be competitive like a business. My mother (a dentist) went into a big rant about this when she read an article in the Canberra Times about a poor person who was complaining about not being able to find any dentists who bulk bill.

  10. jordanrastrick

    Lynot, I apologize for the excessively defensive tone of my first response to you, in particular the use of the word mindless. Your sarcasm toward me seems pretty devoid of substance but I had no right to assume your actual disagreement with my position reflects any lack of thought on your part. I stand by the content of what I said of course.

  11. narcoticmusing

    Don’t be too fussed Jordan, I too don’t meet the lofty heights of Lynot’s expectations of what it takes to enter the ‘lefty’ club. Most of my views fall very much on the left (to the extent that I qualify to be called a wingnut by SB). I however have conservative and/or mixed views on several topics, such as drug decriminalisation and sentencing (being a victim of crime has a tendency to change your views on some things).

  12. “Concentrated solar can and should be bountiful here but its already more expensive than nuclear “

    Can you expand on that, considering there is no nuclear power generation in Australia. The project was canned in 1974. Also the expertise isn’t here either. Energy security, you would agree is vital and to be secure we’d need to build our own reactor which would take twice as long as buying them from other nations (and cost heaps more). Thus it would take us up to a decade to get a plant online (according to a report on PM last night). Also nuclear reactors use vast amounts of water for cooling, something Australia doesn’t have (yeah there’s the sea….and Fukushima). Then there’s the problem of waste.

    Since Australia is dripping in renewables and sunlight and natural gas I propose shifting from coal to natural gas in the mid term for ‘baseload’ until there are viable baseload solutions from renewables. (tidal can and one day will provide baseload as will solar)

    Australia’s problem (as I see it) is it’s love of coal, why on earth is Germany the world leader in Solar? (John Howard and Warwick Parer). Ausra was once an Australian company, they’re Californian now and we will be paying other countries for technology that should have been developed here…

    Thorium might be a viable, far less volatile fuel than uranium. Thing is you can’t make nukes with thorium and let’s face it, nuclear power was driven by the cold war and desire for bombs.

    For the burgeoning energy needs of nations like India and China I think nuclear power is a good (mid term) solution.

  13. jordanrastrick

    Narcotic, we all fall victim to identifying with our political views instead of merely believing them, which is why so little of our political discourse is rational or civil. I don’t self identify as left wing where I can avoid it for precisely that reason. But my values are broadly progressive ones and my family has been heavily involved in left wing causes in australia since long before even Lynot’s days of serving this country, so I can still be touchy when mocked on those grounds. I strive to be content to let the merits of my views stand on their own ground, but to err is human…

    Rob, a couple of points. Theres no threat to our energy security if we boot strap our nuclear expertise from nations that have it like france our the U.S.

    fukushima was a pre-chernobyl reactor, australia doesn’t get 9.1 quakes or tsunamis, many modern designs don’t use water as a coolant, and we’ll never get the chance to use fancy new tech like thorium if we’re unwilling to consider the current state of the art in a fair, rational fashion.

    Gas is nice but green groups aren’t wild about it, for a mixture of good and bad reasons.

  14. narcoticmusing

    Rob J – what about Lucus Heights? It serves many purposes and its smaller reactor isn’t used, but it still has one reactor online producing power doesn’t it? I am quite out of date on these things…

  15. “Free universal healthcare that no one is prepared to pay for is a political nightmare for governments.”

    I’m prepared to pay for it. I suspect many others are, too.

  16. jordanrastrick

    Lucas Heights doesn’t produce commercial power. Energy is physically produced – its a reactor – but its not the same as a power plant. However, our nuclear expertise is certainly far from non-existant.

    I’m prepared to pay for it. I suspect many others are, too

    So am I. But in politics you have to convince a majority that a major tax increase to pay for these things (which is what’s required) is a good idea. And that’s hard.

  17. baldrickjones

    More to the point – have you asked why aboriginal people have free dental care? Sounds like a race based policy to me. Aren’t those type of things outlawed?

  18. narcoticmusing

    have you asked why aboriginal people have free dental care? Sounds like a race based policy to me

    I suppose it is ageist to give free dental to old people too – hell, half of them don’t even have teeth. And while we are at it, why should a person without a home get free dental? [end sarcasm]… no wait [exaggerate sarcasm further] ooo why don’t we help the rich white guys, no one’s giving them hand outs ever, someone feel sorry for them!

  19. narcoticmusing

    PS Baldrick – I am assuming you are jesting, hence my jesting reply…

  20. Good on you Jeremy. This is one of those things that just defy belief. And I feel very strongly about this as I know what it’s like to have a raging toothache and no money. I once found out what the entire dental profession costs in Australia and it was quite a bit less than the useless subsidies we shovel each year into the private health insurance system.

    Let’s axe the subsidy for private health and give everyone free dental treatment.

    Brendan O’Reilly

  21. jordanrastrick wrote n politics you have to convince a majority that a major tax increase to pay for these things (which is what’s required) is a good idea. And that’s hard.

    Actually I don’t think it’s too hard at all. A universal dental scheme would involve an increase of perhaps two per cent in the total tax take. The trouble with our Labor governemnt is they can’t argue in favour of anything vaguely progressive. So yes it is hard to convince people if you never even try.

    Brendan O’Reilly

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