Why isn’t dental care covered by health insurance?


Good dental health is crucial, honey. Sad teeth and gums can directly cause serious health problems like heart disease. But good dental health is also a marker of status because, for some reason, it is not covered by health insurance. Basically, only people earning six-figure salaries can afford to keep their chompers in good shape.

If you can’t (or really don’t want to) hand over $250 every six months to have your teeth cleaned, your oral health will likely deteriorate. And the longer you leave it, the more problems you’ll have and a bigger bill on the trail.

Limitations like cost plague low-income people, First Nations people, immunocompromised people and those who live in remote areas, while the wealthy navigate the assumption that clean, white teeth and pink gums are a evidence.

So seriously, why isn’t dental care covered by Medicare?

Let’s explain.

Medicare was introduced by the Labor Prime Minister Gough Whitlam in the 1970s. Back then it was called Medibank.

Whitlam originally wanted dental care included, but it was all a huge financial and logistical investment. It took months of negotiating with doctors and surgeons and apparently it was just too difficult to throw dentists into the mix.

Whitlam also didn’t want to go too hard too soon. The government wanted to get the project started and make sure it worked before increasing spending. So he compromised and left out dental care.

Whitlam was dismissed in 1975 and the issue was shelved like lunch yesterday.

The exclusion of dental care from public health care has been discussed ever since, but no government has ever been damned to change it. Too expensive, too much work and people are already used to this system so why bother?

So what dental care is covered by Medicare today?

Concession cardholders can access free basic care such as checkups and fillings. Other more specific treatments or examinations are also covered if they are required before another major treatment or surgery.

For example: dental services required for radiotherapy for certain jaw diseases such as oral cancer are paid for. Or before patients receive a kidney transplant, they need an oral examination. And obviously, if you break your jaw, it will be covered by Medicare in a public hospital. But extracting your wisdom teeth won’t. It’s a mess.

There are also wholesale billing dental x-ray facilities, so ask your dentist to recommend one if they’re trying to make you cough!

But otherwise, your teeth are on their own.

And it’s NOT GOOD.

Around 30% of Australians go without regular dental care due to the cost barrier. A 2020 report found that only half of Australian adults had been to the dentist in the past 12 months. As someone in their twenties, I’d say the overwhelming majority of my friends put it off by at least a year.

The number of adults with untreated tooth decay increased from 25.5% in 2018 to 32.1% in 2020.

And those seeking treatment are stymied by massive waiting lists for public (i.e. free) dental care. The average wait time for a free dental appointment in Victoria in 2020 was 18 months. The NT was the worst in 2018 with an average wait time of 26 months. People could potentially lose half of their teeth while waiting to sit down.

So what is being done to fix this problem?

Pretty much screw it all up.

So far, only the Greens have promised universal access to free dental care, which would cost $7.6 billion a year.

The Labor Party, the party that literally created Medicare, hasn’t said a word about it despite constantly talking about the quality of Medicare throughout this election campaign.

In short, the dentist will continue to get more and more expensive every year until a federal government finally pays the cost to make it cheaper for us. But it doesn’t look like that’s happening anytime soon.

With that, go to the dentist if you can afford it!

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