Ya just gotta hate the dentist …

Tanya Plibersek clearly does.

On one thing she is right. The Chronic Diseases Dental Scheme, thrown together in the last days of the Howard Government, is poorly designed, and poorly targeted.

The Labor Government have been trying to close down the scheme since they were elected but until recently the Greens have resisted. The main problem has been the cost … about a billion a year.

The gatekeepers for the scheme are the general medical practitioners. The standard of sufficiently chronically sick is a bit of a loose one. Some patients admitted to the scheme have had no significant illness at all. Sadly most of the healthy poor have been excluded.

In order to save costs a very tight approach has been applied to the regulations. A couple of very useful tools for the bureaucracy have been the requirement for a quote for treatment and a report to the medical practitioner being made before treatment commences. Failure to comply is met with a demand for refund of the rebate. That may not seem so bad but consider this, a verbal quote that all treatment will be at rebate only is not considered adequate and heaven only knows what the medical GP makes of the letter that says “Thanks for referring Mrs. Jones. I will be doing two fillings, one extraction and a scale and clean”. If the dentist is found to be in breach they will have done the work at their own expense and been fined their full match fee. In many practices the established principals will have full books and new patients are directed to the new assistant. The scheme has generated quite a few new patients and a few young dentists have been bankrupted for no crime greater than failing to comply with one or both of these rules.

A private members bill aimed at moderating the punishment for providing first class dental treatment but second class paperwork was voted down by Labor and the Green Adam Bandt.

The scheme could be made to scrub up very nicely. All it would take would be some consultation with the Australian Dental Association and a little redrafting of the rules, but clearly the Labor-Green Alliance aren’t looking for any goodwill from the dentists.

Ms. Plibersek’s strident complaints of massive rorts, over-servicing and poor quality treatment are not supported by the evidence and serve only as an excuse to close the scheme.

You will be quick to notice that the savings come soon and legislation for the new more expensive scheme will be passed before the next election. The benefits and the burden on the taxpayer come later. How much of the cost will in fact be foisted onto the states?

When asked where the money will come from Ms. Gillard said the “announcement today is about a large saving” because of the closure of the CDDS. On the other hand Ms Plibersek’s office  stated that the axeing of the CDDS could not be counted as a budget saving because the scheme had not been factored into the budget because of  the government’s intentions to axe it.

The two conflicting points of view are entirely consistent … with Labor’s usual performance, we’re lucky really, that dentists aren’t being compelled to work in converted school halls filling teeth with recycled pink batts.


How much … ?

From the Australian

…Liberal MP Andrew Laming … estimated the cost of the carbon tax on hospitals at between $1044 and $2400 a bed this financial year. …

Tanya Plibersek doesn’t believe it …

A spokesman for federal Health Minister described Dr Laming’s analysis as deceitful. “The Commonwealth Treasury and Department of Health and Ageing estimate that the impact of the carbon price will only be 0.3 per cent on hospital costs,” he said. “This is equivalent to only 1c for every $3 spent on hospitals.

Sinclair Davidson at Catallaxy Files does the maths for us …

In 2009-10, an estimated $46.3 billion—about 3.6% of Australia’s gross domestic product or about $2,180 per person—was spent on Australia’s hospitals

So a quick back of the envelope (on dated data):
1/300 = 0.00333, then multiply that by 46.3 billion = 154.3 million. With about 85,000 beds across Australia that works out to $1815 per hospital bed on average – more or less what Andrew Laming estimates it to be.

So it looks like the carbon tax will be adding $154.3 million dollars to the health budget without any contribution to improved health outcomes.