Better Access to Dental Care
The cost of seeing the dentist is beyond the means of thousands of New Zealanders - especially those on fixed incomes. A bill of $400 or more to get a sore tooth fixed? They can’t do it.
The Progressive Party intends to put dental care within reach of everyone too.
It’s not hard to find someone with a scary story about the cost of dental care.
- Elderly New Zealanders who have had good teeth all their lives and suddenly find they need comprehensive dental treatment when their incomes are fixed and they are least able to pay for it.
- Families faced with difficult choices between having the treatment they need – and the cost of paying for it.
Acceptable dental care is beyond the means of many New Zealanders.
The situation now
Some coverage is provided for children. All school children in New Zealand are entitled to free basic dental treatment. Subsidised care is unavailable for some orthodontic requirements.
After age 18, very little publicly-provided care is available. Most adults have to pay the full cost of treatment or go without.
Hospitals can provide services that relieve pain and extract teeth. Services are heavily restricted – mainly only for people, such as psychiatric patients and long term beneficiaries. Patients have to queue for subsidised care at 5 o’clock in the morning.
Beyond those minimal services, there is nothing unless you can pay for it.
Dental surgery can be cripplingly expensive and beyond the means of many families. Improved dental care needs to be much more than a trip to the dentist for a check up. The cost of that alone can be beyond the means of many low income families.
But the real cost hits when a person needs more attention – a filling or the replacement of the tooth altogether.
Policy
Dental care should be brought into New Zealand’s health system.
The Progressive Party want to see a programme that steadily introduces more affordable, accessible dental care.
We would like to see a policy phased in over the next five years - similar to the roll-out of cheaper doctors visits. Those population groups in greatest need would get assistance first.
We will work with industry and researchers to develop the mechanism that will best improve access to dental care.
The objectives of the funding mechanism will be:
- Cheaper access for patients.
- Minimising the expense to taxpayers.
- Ensuring dental care professionals (from dental therapists, to dentists, to surgeons and orthodontists) have incentives to enter and stay in the profession, providing the care needed.
We are working closely with the profession, and with others in the health system who have a stake and expertise to develop a scheme that best makes our objectives.
Examples of options
Subsidy
This would work in a similar way to subsidised doctors’ visits. Some doctors provide free, or nearly free, consultations paid for by the subsidy from the government. Other doctors charge a top-up fee.
At first, subsidy levels could increase according to need, so that full subsidies were made available to those least able to afford care they need. As the scheme was rolled out, the level of subsidy would increase for others, so that the cost of dental care began to come down for everyone.
Dental therapists program
Remember your visit to the school dental clinic? Dental professionals who were not full dentists, took care of you teeth. It wasn’t perfect, but it was better than nothing.Community dental facilities, funded by government, supervised by professionals, could be part of an improved care programme.
Insurance
One characteristic of dental care is that your need tends to vary at different times in your life. Young people, and older people tend to have higher demand than working age people.The actuarial predictability of people’s demand for dental care lends itself to an insurance scheme. New Zealanders could pay in, with the government providing subsidies according to your ability to pay, and the insurance provider setting rules about eligibility and coverage. ACC is already well equipped to do this.
Costing
The cost of more affordable dental care depends on how much more affordable and accessible.
A checkup with scale and polish, with one filling can cost $180. For half the population, paying half the cost of the visit would cost the government $180 million. Some patients would need more care. With a subsidised programme, more cost-effective options could be provided.
Comprehensive improvements need to be phased in because the spare capacity to immediately provide comprehensive care doesn’t exist.