Former Deputy Chief Medical Officer Pans Greens Party Push for Universal Dental Care

A dentist works on a patient in Nashville, Tenn during a clinic visit on Sept. 7, 2023. (The Canadian Press/AP-George Walker IV)

Former deputy chief medical officer, Dr. Nick Coatsworth, has pushed back on a Greens proposal to absorb dental care into Medicare so all Australians can go to the dentist for free.

Australia’s universal healthcare system Medicare provides free or subsidised doctor visits and emergency care, but generally doesn’t cover trips to the dentist.

Queensland Greens member for Griffith Max Chandler-Mather pushed free dental care in a post on X amid debate in federal parliament about tax cuts.

Mr. Chandler-Mather believes that even those earning more than $200,000 would support free dental care.

“What would you choose? 1) Bring dental into Medicare so everyone can go to the dentist for free or 2) Spend $84 billion giving ppl earning over $200k a $4,500 a year tax cut? Labor chose tax cuts for politicians and billionaires. I reckon the public would prefer free dental,” Mr. Chandler-Mather said.

“Having a doorknocked a lot in Qld I can say without a shadow of a doubt that even ppl earning over $200k choose dental into Medicare. Labor’s changes to stage three tax cuts will still see the budget deprived of over $300 billion and makes things like free dental even harder to win.”

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But Dr. Coatsworth responded to the Greens proposal with concerns about absorbing dental care into Medicare.

He said “only a rare genius” could think that using the Medicare model for a universal dental program was a good idea.

“Or someone who simply doesn’t understand health funding. If we end up with government-funded dental care please let’s not repeat the same mistakes of the past 40 years. A different model, based on preventive care, and that avoids incentives to over-service,” he said.

Universal Dental Plan Would Cost $12 Billion

The parliamentary budget office provided costings for universal dental care in a paper released in November.

This followed a Senate inquiry, led by the Greens, which Health Minister Mark Butler is due to respond to this year. The total cost of a universal scheme for Australians would be nearly $12 billion (US$7.8 billion) a year.

The report considered multiple ways dental services could be provided to Australians if the Medicare system is expanded (pdf).

One option is universal coverage of dental services. This would provide rebates of 100 percent for all Medicare card holders for all items that are listed in the Child Dental Benefits Schedule.

The rebate could be either capped at $1,095 over two years and subject to indexation, or totally uncapped.

Other options explored included means-tested coverage, seniors dental care and funding preventative care only.

Coatsworth Delves Deeper Into Universal Dental Care

In another post to X, Dr. Coatsworth explored the idea of universal dental care further, raising concerns that service costs would go up if government funded dental care.

“What does a preventive model for universal dental care look like? Free check up’s and basic interventions through to 18 years of age only? We need in built caps on the cost of the program from the start,” Dr. Coatsworth said.

“How do we prevent fraud and over-servicing from providers? As soon as the government funds it, service costs will go up. Ever thought about whether you need the X-rays of your teeth? (hint—you don’t)”

He also asked the question of whether a completely different funding model could be used, such as a super-like personal account for dental services where government funding is indexed to income (higher the income, the less government contribution).

“But ultimately the money is yours to spend as you will on dental care. Not someone else’s. Let’s create some incentives to have better dental health,” Dr. Coatsworth said.

The Greens launched a policy to bring dental into Medicare in 2022. The policy states that dental care is expensive and too many people are unable to afford to see a dentist.

“The Greens will invest $77.6 billion over the decade to provide free dental care to everyone who is eligible for Medicare, ensuring everyone can visit the dentist when they need to, ” the policy states.

Australia does offer public dental clinics at the state level for residents with a concession card, however the wait lists are often lengthy. Eligible children also receive child benefit benefits of up to $1,095 over two years if their family receives an Australian government payment.

What Happens Overseas?

In the UK, the National Health Service (NHS) provides clinically necessary dental care that keeps the mouth, teeth and gums healthy and free of pain.

The New Zealand government provides dental care for those under 18, along with help for people with low income or disability, illness or injury.

In France, the government reimburses some dental appointments and dental care treatments up to 70%, while those with prostheses top-up insurance can receive a limited range of implants, crowns, bridges and dentures for free. 

In the United States, dental care is generally self funded or provided through insurance plans. Medicare health insurance for people over 65 does not cover most standard dental care or dentures.

Australia’s public funded universal health care insurance scheme Medicare was introduced just over 40 years ago, on Feb. 1, 1984.