ADA says hold insurers accountable

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ADA President Dr Karin Alexander
ADA President Dr Karin Alexander

The Australian Dental Association (ADA) last week gave testimony on the main factors that influence Australians’ out of pocket dental costs to the Senate Committee Community Affairs Committee.

President of the ADA, Dr Karin Alexander, who gave evidence to the Committee, said:

“The latest data that ordinary Australians contribute $7.4 billion towards their dental care shows that the majority are able to access dental care. However, much of this spend is in private health insurance premiums and the out of pocket costs created by the gap between customary fees charged by dentists and the rebates paid by private health insurers.

“Many blame the dentist but the ADA’s annual fee surveys show that average dentists’ fees for the last five years are below health CPI and average private health insurance premium increases. There has been little legislative or policy action to compel private health insurers to provide an adequate level of rebate for dental services”.

The ADA also raised concerns that while Commonwealth government dental schemes do provide some targeted access to dental care, their rebates are inadequately short when compared to average dental fees. For example, dentists are repeatedly out of pocket when providing services to veterans and so the continued willingness of dentists to perform services under these conditions is being strained.

Dr Alexander continued: “The Department of Veterans Affairs’ (DVA) dental scheme rebates in recent years are on average 20 per cent short of the dentist’s average fees for common procedures, and the trend is increasing. Considering that the ATO’s benchmarking surveys show that 70 per cent of dentists’ revenue goes straight towards the costs to run their practices, we’re reaching a situation where the government is making dentists operate at below cost. While veterans are entitled to receive assistance with accessing care, for the government to expect dentists to provide dental care at a loss is blatantly unfair. This situation is especially concerning because government dental schemes base their rebate schedule on the DVA scheme.

“Government schemes must be improved to reflect the actual costs and range of dental treatment Australians need, and private health insurers should be compelled to ensure that their rebates adequately reduce patients’ out of pocket costs, rather than allow them to shift the blame to healthcare providers”.

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