And as part of that commitment, it commissioned the National Advisory Council on Dental Health to investigate the potential of a universal dental care scheme like Medicare.
The Government released the council's final report on Monday but its findings were largely over-shadowed by the Labor leadership vote.
The council set a long term goal of universal and equitable access to dental care for all Australians.
But with the Government committed to delivering a budget surplus next financial year, it seems unlikely it will have the money to implement such a broad based scheme.
It's a big dilemma for the Government, because it's also promised a substantial investment in dental care in the next budget.
An increasing number of Australians say they're putting off visiting the dentist because of the cost. About one in four Australians has untreated decay and studies show that poor oral health can lead to much bigger health problems.
To discuss that question, I am joined in the studio by Associate Professor Hans Zoellner, the Head of Oral Pathology and Oral Medicine at the University of Sydney and the founding chairman of the Association for the Promotion of Oral Health.
In our Melbourne studio, Associate Professor Matthew Hopcraft from the Melbourne Dental School at the University of Melbourne. He's also the president of the Victorian Branch of the Australian Dental Association.
And on the phone, Professor Philip Clarke, who holds the chair in Health Economics at the Centre for Health Policy, Programs and Economics in the School of Population Health at Melbourne University
Gentlemen, welcome.
Let's start with the council's long term goal of a universal dental care scheme. Hans Zoellner, what's the case for such a broad based scheme?
HANS ZOELLNER: Well, in Australia we have universal health insurance for the rest of health and really the problems that we have in dentistry really boil down to the fact that we have been frozen out of the system. We are not in Medicare.
Our public dental services, rather than - as they do in medicine - delivering high quality for care for people, are too expensive or to difficult to treat in private practice or in private hospitals. When it comes to dentistry, the public dentistry is really poor dentistry for poor people.
So we are completely out of the system. We don't even have internships, we don't have registrar appointments, we don't have conjoint specialist appointments.
They're the problems so putting us into Medicare is one important big step that would make access to services possible for the great bulk of the population and would start to turn things around.
ASHLEY HALL: Matthew Hopcraft, the president of your association was one of the members of the advisory council that handed down this report, and the key recommendation was the pursuit of a universal dental scheme but your association has long been against such a scheme.
What is your objection? Why do you object to it?
MATTHEW HOPCRAFT: Thanks Ashley. Look, the association has long held the view that we should have a targeted scheme.
We know that about 65 per cent of the population are already able to access dental services reasonably well and what we really need is a scheme that looks at targeting towards that 35 per cent of the population who are having difficulties in accessing services.
So we need to put more funding and more investment into that group of people. We don't need a revolution in dental services, we need an evolution in trying to bring along those 35 per cent of the people.
ASHLEY HALL: But if we do have a poor system for poor people is there not a need to expand that so everybody is getting good care?
MATTHEW HOPCRAFT: I think absolutely. We need to expand services for that group of people - that 35 per cent of people - who are disadvantaged and who do have significant difficulties accessing care but that doesn't mean that we necessarily then need to go ahead and provide universal services to the 65 per cent of the people who are accessing or able to access good quality care.
ASHLEY HALL: Private dentists have a vested interest in opposing a universal scheme, don't they? It will put a lid on what they could charge.
MATTHEW HOPCRAFT: Not at all, Ashley. I mean, our members for a long time have been involved in a range of different public schemes.
The original Commonwealth dental health program that run through in the early '90s that our members participated in from their private practices; we have had for a long term involvement in Department of Veterans Affairs, treating patients on a government fee schedule, not on the dentists own fee schedules. And those Department of Veterans Affairs fee schedules tend not to go up at the same rate as the cost of sort of health inflation but members will treat those patients often with no additional cost, no co-payment.
There has been significant use of the Medicare chronic diseases dental scheme by dentists. Again, often not- most dentists bulk-billing and not charging extra gaps so this perception that dentists are only interested in charging lots of money and are not interested in the health of their patients, we dispute that.
ASHLEY HALL: Well, that wasn't the suggestion.
But Philip Clarke, will private dentists lose out under a universal scheme? You look at the comparison between private and public schemes. What will be the effect on the dental profession?
PHILIP CLARKE: I mean, I think depending on the design of the scheme, I think perhaps to sit on the fence in this debate... I think we have got to work out what our objectives are in terms of access and what are the key problems - but then look at the incentive effects of different schemes.
And clearly, potentially, having a universal scheme, potentially is you know inflationary and potentially it also leads to high use - which is a term... Economists use the term moral hazard.
But that may be something that the community is willing to pay for if they want the idea of being able to go- for everyone to sort of have, as it were, equal access in a similar fashion to Medicare.
So I think partly it is about talking to the community because the money for this doesn't fall from the sky, it comes from the community. So engaging with the community to get community objectives of how much we are willing to pay to finance a scheme - and then very carefully thinking through the design issues.
And although I think the sort of current document produced by the International Advisory Council is a very interesting one and contains lots of options, what is very noticeable is there were no economists on the council to think through those issues and what are the problems, and how do you get an optimal scheme - and that is in great contrast with Medicare, the design of Medicare.
ASHLEY HALL: Hans Zoellner, the question I contemplate is to what extent does the exclusion of dental health from Medicare have to do with the notion that oral health is in a sense a personal responsibility, that we can have a lot of control over the preventative side of things and that governments shouldn't bear the cost of people who are lazy or fail to look after themselves.
HANS ZOELLNER: Yeah, that is a historically judgemental view that was- that really came from the early '70s. Back in the '70s when the forerunner of Medicare was being developed there was a sense well dentistry, you can predict what is going to happen. People have got... You know, we knew the lifestyle facts that led to dental disease.
What we didn't know at that time was necessarily the lifestyle factors that led to 25 per cent of cancers and most of adult diabetes, and in fact most of chronic heart disease.
And in fact, in the meantime, the rest of medicine has caught up with us and we have sort of realised well actually, there is a hell of a lot of disease that is entirely due to our lifestyle factors but we haven't turned around and said 'Well let's just let people who are fat with diabetes die'.
You know, if you've got cancer and you're a smoker, just let you rot because you bastard, you were smoking.
We haven't done that and I don't see that we should be now sort of looking back and using this very judgemental, old fashioned view of public health to colour the current debate on whether dentistry should be part of the system.
ASHLEY HALL: I'll stay with you and raise the question of the cost.
The argument against a universal scheme usually centres on how much it will cost to implement, and opponents say that costs will spiral because people who are currently putting off dental care in Australiawill make the most of the new coverage. You have done some work that looks at the various schemes and you say that the scheme would be self-limiting.
Read more from the source: http://www.dentistryiq.com/index/display/news-display/1615666103.html
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