Opposite sides unite to slam dental scheme

This is an article by Adam Cresswell that was recently published in The Australian – Sydney, New South Wales, Australia.

THE proposed .7 billion plan for a universal dental health scheme is facing mounting opposition amid fears it could fuel rampant fee inflation or spark

a boycott by dentists.

Dental experts from opposite sides of the healthcare debate have united to condemn the plan, and even some private insurers—who would receive

hundreds of millions of taxpayers dollars through the scheme—have joined the condemnation.

The planned Denticare scheme, one of the key elements of the National Health and Hospitals Reform Commission final report delivered this week, had

been one of the commission’s most popular ideas when first unveiled in an interim report in February. But the health fund NIB, the fifth-largest private

health insurer with a 7 per cent market share, yesterday said it was flatly against the scheme’s introduction. NIB managing director Mark Fitzgibbon

said while it was “crucial” to give disadvantaged Australians better dental care, the fund was “totally opposed” to Denticare.

“Instead, governments should allow the existing private health insurance mechanism to connect the disadvantaged with dentists by direct subsidy of

premiums,” Mr Fitzgibbon said. “A duplicate funding mechanism will merely increase administrative costs.”

NIB’s intervention is unlikely to make it any easier for the federal government to sell the scheme to the public, who are expected to need some

convincing it is worth paying 0.75 percentage points more in tax, through an increased Medicare levy.

If Denticare were approved, every Australian would be entitled to subsidised dental care, with patients able to opt either for treatment in the totally

free public system or alternatively under a private plan.

Patients choosing the private route would have premiums paid on their behalf by Denticare, and would then be able to see a private dentist as most

do now. Although private patients would still pay a gap out of their own pockets, these gaps would be much smaller than now, with 85 per cent of

the fee being covered.

Denticare has already come under fire from opposite sides of the dentistry profession, with professional groups such as the Australian Dental

Association on the one hand and reform advocates on the other both condemning the scheme, albeit for different reasons.

The ADA says there is no need for universal dental coverage as the wealthy can afford to look after themselves, and any scheme should be limited

to the neediest patients.

Others, such as Hans Zoellner, chairman of the Association for the Promotion of Oral Health and head of oral pathology and oral medicine at Sydney

University, said Denticare did not go far enough and would not help people with poor oral health by refusing to cover necessary treatments.

Associate Professor Zoellner yesterday added another concern that Denticare would fuel fee inflation by promising to pay 85per cent of private

dentists’ charges. “If you just pay 85 per cent of whatever the dentist charges … fees will be completely uncontrollable. The other possibility is if

they say: ‘We will tell you what you can charge, and refund 85 per cent of that’, then some practices will close down and others will refuse to

become involved. If the result is that the only way people can access subsidised dental care is through the public system, then the public system

will collapse.”

Professor Zoellner called for Denticare to be scrapped and replaced by a phased expansion of Medicare to cover a much more comprehensive range

of dental services, rather than the limited selection of basic treatments envisaged under Denticare.

He said not only would this be fairer—by avoiding the two-tier Denticare proposal—it would also expose dentistry to Medicare’s inherent competitive

pressures that had successfully reined in doctors’ fee increases for more than 20 years.

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