PUBLIC SERVICE LOBBY GROUP DENTAL ANALYSIS INCORRECT (DENTAL RORT LEAVES GAP IN BUDGET)

The Association for the Promotion of Oral Health – APOH (Contact Chairman: H Zoellner 0403 785 783) said today that a Lobby Group for State Health bureaucracies published misleadingly Incorrect statistics to undermine dental medicare.

“People Needing Medicare to Pay for Health Preserving Dental Services Have Had Entitlement to $2,125 Dental Medicare Rebate Per Year Since November 2007” says Chairman H. Zoellner.

Since November 2007, people with life threatening chronic conditions including diabetes, congenital and valvular heart defects, head and neck cancer, bleeding disorders, immune compromise, organ transplants and mental health problems, have been entitled to $2,150 of Medicare for private dentistry per year.

“The Australian Health and Hospitals Association (AHHA) is a Lobby Group for State Public Services and Has Been Given Incentive to Undermine Dental Medicare by Health Minister Roxon”..said Zoellner.

The AHHA website states “Our core business is to represent and support Australia’s public healthcare sector”, comprising mainly state health services.

Federal Health Minister Roxon has attempted to axe dental Medicare, but has been blocked twice in the Senate. To enlist support from State bureaucracies, Minister Roxon has made an earlier promise of $290M Federal funding for State public dental services contingent on axing dental Medicare.

This has provided the AHHA and other representatives of state dental services, with an incentive to undermine dental Medicare, because Medicare only funds treatment in private dental surgeries.

This contrasts with our association (APOH), which has no vested interest and only promotes dental health.

We Recently Published Analysis Showing Good Use of Dental Medicare Funds in Relieving Pain, Saving Teeth, Delivering Fillings and Providing Dentures

Our detailed analysis demonstrates dental Medicare patients have a back-log of untreated dental disease (about 3 treatments for pain, extractions or surgical procedures per patient), and that Medicare spending is generally sensible). There is, nonetheless, too much crown and bridgework being performed, representing 7.7% of treatments per patient and about 20% of the total dental Medicare cost. We expected something closer to 3%.

The Public Service Lobby Group – AHHA- Today Published Incorrect and Misleading Statistics Discrediting Dental Medicare.

The Sydney Morning Herald today quoted AHHA analysis saying crown and bridge work accounts for 40% of dental Medicare costs. They insult patients who are getting on average 3.7 treatments for pain or extractions, suggesting their treatment is mainly cosmetic. Further, “a dentist who did not wish to be named”, accused the private dentists delivering service to dental Medicare patients, of “rorting”.

APOH Chairman Hans Zoellner responds:

“Unlike the ‘dentist who did not wished to be named’, APOH has no need to hide a shoddy and misleading analysis behind an alias – our figures stand up to critical analysis, and only reflect the facts. I am happy to be named, and our Association stands by its analysis”

“The figures published by the AHHA are grossly incorrect, inflating crown and bridge services by 100%.”

“The only people guaranteed to benefit from diverting Medicare funding to state public services, are the state bureaucracies the AHHA represents”

“Pouring Federal money into state dental services is like running a tap through a sponge, something comes out the bottom but heaven knows what’s been lost in the middle”.

“The AHHA has not made details of its inaccurate analysis available for public scrutiny. ” “The extent of their inaccuracy is easily confirmed by checking the Medicare website. We invite anybody to look at our figures, and compare them with the raw data which is publicly available”.

APOH is an independent think-tank and advocacy group for improved dental services comprised of a wide

representation of stake-holders and experts. APOH can best be contacted via the Chairman:

A/Prof Hans Zoellner: hzoellne@mail.usyd.edu.au, Mobile 0403 785 783

State Government Lobby Group Analysis Incorrect

The number of Enhanced Primary Care dental Medicare services provided from November 2007 to September 2008 according to type of service across Australian states, as well as the number of such services per patient expressed on a per-tooth or per-denture basis (Indicated in Italics in Brackets). Also shown in italics, are the number of direct-simple restorations and total services, relative to indirect- complex restorations (crowns, bridges, inlays, implants).

2008. Patient numbers are derived from the number of examinations, while care has been taken to only include item numbers providing data on a per-tooth or per-denture patient basis. The average dental Medicare patient has 3.7 extractions or other treatments for pain, while most patients obtain dentures for which they are eligible once every 8 years. Most patients receive between 2 and 3 preventive services, and 14% of patients have endodontic treatment.

Direct-simple restorations such as amalgams and composites constitute the majority of restorative services (2.26 per patient), while patients an average 0.77 indirect-complex restorations such as crowns, bridges or implants, suggestive excessive use in some jurisdictions. Notably, regardless of comparatively high incidence of indirect -complex restorations, there are from 11.2 to 93 more other procedures performed on a per tooth or denture basis, dependent on state jurisdiction. Overall, data indicate a reasonable use of public Medicare funds for delivery of dental services, but also confirm a need to establish regulation for indirect restorations. APOH suggests immediate engagement of established DVA mechanisms.

DENTAL RORT LEAVES GAP IN BUDGET

Louise Hall

December 2, 2008

DENTISTS and their patients are abusing Medicare Dental to get unnecessary, excess or aesthetic work done on their teeth while the neediest patients miss out, health groups say.

The scheme, introduced in the dying days of the Howard government, was designed to provide up to $4250 in private dental work such as extractions, fillings, and dentures for the chronically ill with poor oral health who could not afford to pay.

But some dentists admit a significant proportion is being spent on treatment that improves appearance, such as crowns, implants, bridges, straightening and capping teeth, but has little or no effect on the patient’s overall health.

One Sydney dentist who did not wish to be named told the Herald some “greedy” dentists were encouraging their patients to take advantage of the largely unregulated handout.

“Patients who are technically eligible because they have a chronic illness come in with their referral and then request aesthetic work, and because there’s no auditing or monitoring of what procedures are done, dentists are churning it out and getting a few thousand dollars a day out of the scheme.”

The Australian Healthcare and Hospitals Association and the National Rural Health Alliance said their analysis of Medicare data showed up to 40 per cent of the funding had been spent on excessively invasive or unnecessary procedures, or crowns and implants that had a more aesthetic function, or for which there were cheaper alternatives.

“We’ve found dentists are offering their patients expensive work like crowns or bridges when they could use a cheaper method and treat nine or 10 people for the same cost and an equal medical outcome,” said the association’s policy manager, Cydde Miller.

An unexpectedly high uptake of the taxpayer-funded scheme has caused a cost blowout that threatens to undermine the Rudd Government’s budget unless it can persuade the Senate to axe the program.

More than 1.73 million services have been performed at a cost of $192 million in the first 12 months, which is more than one-third of the original allocation for the entire four-year program.

But its intended target – indigenous people, the disadvantaged and those in rural and remote areas with complex health needs – have largely missed out, the health groups say.

Almost 75 per cent of procedures were in NSW, with smaller states virtually missing out. Ms Miller said NSW metropolitan dentists tended to be corporatised and well-informed about the benefits their patients could take advantage of.

The Minister for Health, Nicola Roxon, said Labor’s promised Commonwealth Dental Health Program, providing $290 million over three years to states and territories to clear public dental waiting lists, was on hold as the Government could not afford to fund both schemes.

“Under the current program, pensioners suffering from a simple toothache can’t get help – but if those pensioners were multimillionaires instead, with chronic diseases, they would have no trouble,” she said.

The president of the Australian Dental Association, John Matthews, said the scheme should be restricted to the financially disadvantaged. All work should have to get prior approval, similar to the process used by the Department of Veterans Affairs to filter out cosmetic or exorbitant work.

This story was found at: http://www.smh.com.au/articles/2008/12/01/1227979933057.html                     and submitted by: H Zoellner   

The Association for the Promotion of Oral Health – APOH (Contact Chairman: H Zoellner 0403 785 783)

 Coober Pedy Regional Times