Dental in Medicare: I'll Believe It When I'm Sitting in the Chair

There’s a story doing the rounds again about dental finally getting folded into Medicare, and I’ve noticed the same thing happens every time: a flicker of hope, a lot of “believe it when I see it,” and then quietly, nothing. My father-in-law used to say the same thing about the East Coast fast rail every federal election for about twenty years. Some promises age like wine. This one’s been ageing like milk.

I get why people are cautious. Dental has been the missing tooth in Medicare (sorry) since Whitlam’s time, and every few years a government dangles it in front of us like it’s a genuinely new idea. It isn’t. It’s been debated inside Labor for decades. The Greens have pushed it as a headline policy for years too, and whatever you think of them, they’re not wrong that fixing someone’s teeth shouldn’t depend on their postcode or their private health extras cover.

What struck me reading through the discussion wasn’t the politics, though, it was the dentists. Turns out one of the biggest hurdles isn’t funding or bureaucracy, it’s that a chunk of the profession doesn’t want to be on Medicare at all. Fair enough, in a sense, nobody wants a pay cut, and dentistry involves years of training and real surgical skill. But there’s something a bit grim about a profession collectively deciding that public rates are beneath them while people are pulling their own teeth out with pliers because they can’t afford a check-up. I don’t know how you square that circle. Probably some mix of better rebates and genuine workforce planning, more dentists trained, more of them in the regions, because someone driving five hours to see a dentist is not a fringe complaint, it’s most of rural Australia.

We had a stretch a few years back where my daughter needed braces and a couple of extractions, and even with decent extras cover the gap payments were still enough to make me wince harder than she did. We’re a two-income household with no real financial stress, and it still stung. I think about the people for whom that gap isn’t an inconvenience, it’s the difference between getting treatment and just living with the pain. That’s not a fringe problem in a country as wealthy as this one.

The bit of the discussion that actually annoyed me was the accounting. Someone pointed out that the Stage 3 tax cuts cost about the same each year as fully funding dental in Medicare would. I don’t know the exact figures well enough to swear by them, but the shape of the argument tracks with everything I’ve seen about negative gearing, CGT discounts, and how gently we tax resource exports compared to, say, Norway. We’re not short of money in this country. We’re short of political appetite to ask the people who could easily afford to contribute more, to contribute more. That’s not a radical take, it’s just arithmetic with a spine.

I don’t think dental in Medicare happens because a government suddenly develops one. It happens because enough people keep saying it out loud that ignoring it becomes more politically costly than doing it. That’s a slow, unglamorous process, and it’s not guaranteed to work. But rationed hope, deployed sparingly, has a decent track record too. Ask anyone who remembers when bulk billing GPs seemed similarly doomed.