PHA says health funds best placed to deliver access to dental care

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Private Healthcare Australia has used its submission to a Senate inquiry to restate the position of private health insurers as the major funding source of dental services.

Over 14.5 million Australians, 55 per cent of the population, have extras covering dental. Dental is the largest area of expenditure by private health insurance under extras cover, representing around 55 per cent of benefits.

Private Healthcare Australia CEO Dr Rachel David said, “Private health insurance is currently the most effective funding mechanism for dental services in Australia. Health funds use contracted billing arrangements with dental practitioners to sustainably pay higher rebates for treatment in exchange for no or known out-of-pocket costs.”

Out-of-pocket costs for dental services provided through health funds have been static from 2010-11 to 2021-22.

The association said this contrasts sharply with government-run programs.

Services covered by the Medicare Benefits Scheme have experienced sharp increases in out-of-pocket expenses from 2010-11 to 2021- 22, including general practice (up 63 per cent), medical specialists (up 98 per cent), and allied health (up 95 per cent).

Private health insurers pay over $3 billion each year in benefits for dental.

Benefits paid by private health insurers have also increased as a share of all spending on dental services, from 14.4 per cent in 2009-10 to 20.2 per cent in 2020-21.

“The Private Health Insurance Rebate is a key factor in supporting Australians' access to dental services. The vast majority of health fund members are not rich – 42 per cent have a taxable income of $50,000 per year or less, and for 10 per cent of these the aged pension is their only income,” said Dr David.

“Increasing the rebate for people on very low incomes, particularly as cost of living pressures escalate, is a more effective and fairer use of resources than the introduction of a universal subsidy for dental. Including dental care in Medicare is not an equitable solution as the wealthy would receive exactly the same rebate from Medicare as people living below the poverty line, those who are homeless, and Australians living in areas where access to care is severely limited.

“The Albanese Government has recognised the principles of Medicare require greater support for the more vulnerable across the community through targeted measures in the 2023-24 Federal Budget to improve access to primary care. The inclusion of dentistry to Medicare would simply subsidise the wealthy and exacerbate the existing workforce distribution problems.

“In addition, Commonwealth-funded dental schemes have been plagued with criticisms including that services are restricted, incentives to dentists to participate are inadequate, over-servicing and potential fraud.

“Health funds support a more targeted approach to assist the vulnerable and have the expertise to deliver a future Commonwealth-funded scheme that avoids the challenges faced by previous government dental programs,” added Dr David.