apologies i have literally just put some thoughts here onto a response - not well framed in any sense of the word. Just wrote as i thought and it is evident. am sure more will come as i read again and think. thanks for writing this I enjoyed reading it.
thanks Matt - after 20 years as a dentist it is only now that i am appreciating the need to educate myself more on matters such as these. Appreciate the amount of work you put into advocacy and shaping policy.
1. Dentists are rarely consulted (well enough) or with adequate time to put forward a proposal or retort in time for an efficient solution to be mooted.
2. The model of funding available in medicine can not work for dentistry and an indexation freeze would be catastrophic ie surely there has to be some user input of funds into the model such as a copayment. Which then leads to what is an acceptable amount etc. (that’s for another day of course)
3. What aspects of dentistry is covered under medicare needs to be defined clearly. I have loosely seen proposals where “all dentistry is covered” - this is foolish thinking given the spectrum of dental services that are required and provided for in the private sector.
I would disagree with this - we have lots of opportunities to try and influence the policy debate. We know (roughly) when elections are, we have the opportunity to speak to politicians and policy makers, engage with the media and build coalitions with other stakeholders. All of these discussions - particularly about expanding Medicare - have been going on for more than a decade.
Why can't the model for Medicare in medicine work for dentistry? It already does with the Child Dental Benefits Scheme, and in many ways it replicates what we already have with private health insurance - a third party paying a subsidy for a percentage of the treatment cost. Medicare (and CDBS) allow providers to charge their usual and customary fee, so that a gap is ultimately at the discretion of the provider.
With respect to a freeze - indeed it would be a problem - but we are also at the mercy of health funds in that respect. Having good legislation is critical, and holding governments to account is also important. But if there is a freeze, then the gap gets progressively larger until it becomes a political problem - which is what we are seeing now in medicine.
There should certainly be debate about what services are covered - and this was extensively discussed at the recent Senate inquiry and forms part of their report and recommendations.
Fair enough. I assume (incorrectly) that when change doesn’t happen rapidly enough i perceive it as being devoid of opportunities/actual change. I stand corrected and thanks for pointing that out.
The CDBS doesn’t cover the entirety of services needed in children from my (very limited) understanding. It includes a certain amount of funding for a particular set of item numbers.
Yes understand the challenge we have with HF in australian health system
I think we would all like change to happen more rapidly than it does. Our biggest challenge is in convincing politicians and policy makers how important good oral health is (and the importance of access to timely and necessary care) - particularly against all of the other competing interests. Unfortunately it's not a debate we are always successful at.
There are certainly issues with CDBS (for example not covering treatment provided under GA in hospitals), and they have been raised through numerous formal reviews. Hopefully we will see action on that some time soon.
apologies i have literally just put some thoughts here onto a response - not well framed in any sense of the word. Just wrote as i thought and it is evident. am sure more will come as i read again and think. thanks for writing this I enjoyed reading it.
Appreciate you taking the time to read and comment, and I think the more we talk about these things and hear a range of views, the better.
thanks Matt - after 20 years as a dentist it is only now that i am appreciating the need to educate myself more on matters such as these. Appreciate the amount of work you put into advocacy and shaping policy.
1. Dentists are rarely consulted (well enough) or with adequate time to put forward a proposal or retort in time for an efficient solution to be mooted.
2. The model of funding available in medicine can not work for dentistry and an indexation freeze would be catastrophic ie surely there has to be some user input of funds into the model such as a copayment. Which then leads to what is an acceptable amount etc. (that’s for another day of course)
3. What aspects of dentistry is covered under medicare needs to be defined clearly. I have loosely seen proposals where “all dentistry is covered” - this is foolish thinking given the spectrum of dental services that are required and provided for in the private sector.
I would disagree with this - we have lots of opportunities to try and influence the policy debate. We know (roughly) when elections are, we have the opportunity to speak to politicians and policy makers, engage with the media and build coalitions with other stakeholders. All of these discussions - particularly about expanding Medicare - have been going on for more than a decade.
Why can't the model for Medicare in medicine work for dentistry? It already does with the Child Dental Benefits Scheme, and in many ways it replicates what we already have with private health insurance - a third party paying a subsidy for a percentage of the treatment cost. Medicare (and CDBS) allow providers to charge their usual and customary fee, so that a gap is ultimately at the discretion of the provider.
With respect to a freeze - indeed it would be a problem - but we are also at the mercy of health funds in that respect. Having good legislation is critical, and holding governments to account is also important. But if there is a freeze, then the gap gets progressively larger until it becomes a political problem - which is what we are seeing now in medicine.
There should certainly be debate about what services are covered - and this was extensively discussed at the recent Senate inquiry and forms part of their report and recommendations.
Fair enough. I assume (incorrectly) that when change doesn’t happen rapidly enough i perceive it as being devoid of opportunities/actual change. I stand corrected and thanks for pointing that out.
The CDBS doesn’t cover the entirety of services needed in children from my (very limited) understanding. It includes a certain amount of funding for a particular set of item numbers.
Yes understand the challenge we have with HF in australian health system
I think we would all like change to happen more rapidly than it does. Our biggest challenge is in convincing politicians and policy makers how important good oral health is (and the importance of access to timely and necessary care) - particularly against all of the other competing interests. Unfortunately it's not a debate we are always successful at.
There are certainly issues with CDBS (for example not covering treatment provided under GA in hospitals), and they have been raised through numerous formal reviews. Hopefully we will see action on that some time soon.