Back when Kevin was an MP rather than a PM, he made inconvenient election promise that might be interpreted to mean he would fix the health system. So (being keen to be seen to be a man of his word), after he got the gig, he formed a Commission to ask health experts to gather submissions from anyone who cares and come up with recommendations on how to fix the health system.
The Commission duly performed as expected and (a year and half later) came up with sleep inducing statement of stuff-we-already-knew (in 123 parts). Unfortunately (and rather inconveniently) the Commission also suggested an actual structural change. They wanted to add basic dentistry to Medicare. Even more unfortunately, the Commission (clearly getting carried away with its own importance) suggested raising taxes to pay for the actual structural change.
Kev knew the media would eventually read the report and discover the tax-bomb. So he cut them off at the pass by announcing plans to have a ‘conversation’ (yep, another one) with the Australian people before anyone did anything. The plan was to punt the issue well beyond the next election. The nit-picky media (you know who you are) chose to focus on tax rise rather than all the excellent stuff-we-already-knew (obviously being manipulated by opposition’s friends in high places), causing a bit of a pickle for our hero…
No, this isn’t the plot for an episode of The Hollowmen. It’s very (and, all too sadly) real. But stepping aside from the political reality (that gradual change will most likely occur in due season), it’s worth looking at some of the concentrated wisdom of the health hierarchy so painstakingly collected throughout the report.
An overwhelming theme is that prevention is better than cure. So it’s a bit odd that the single biggest cost in the whole thing (and the only item with a specific funding proposal) is actually 100% cure and 0% prevention. The National Health and Hospitals Reform Commission want to spend $3.6 billion per year on basic dental services. The money will come from a 50% increase in the Medicare levy paid by every ‘working family’.
Dental services are primarily consumed fixing damage done by tooth decay. And the cause of tooth decay is established beyond any shadow of a doubt. There aren’t many occasions when Nestle, Coca-Cola and the World Health Organisation find themselves in complete agreement on a health issue, but this is one of them. Tooth decay is caused by the consumption of sugar.
Preventing a disease is rarely as easy or as obvious as halting the consumption of a single consumer substance. It’s even rarer to have everybody (even the people who make a fortune from selling it) agree that it does in fact cause the disease. The only other example I can think of is tobacco (yes, Big Tobacco did eventually agree). All of which makes me wonder why the medical and political responses to lung cancer and tooth decay are so very different.
We actively try to prevent people commencing consumption of tobacco. If they are foolish enough to do it anyway, we tax them into submission instead. The taxes raised vastly exceed the health costs of treatment and go to benefiting the whole community. Imagine our response to tobacco if it was the same as the proposed response to sugar. We’d be handing our kids a ciggy, resigning ourselves to the inevitability of them eventually needing extensive treatment for lung diseases and jacking the medicare levy up to cover the costs.
Since everyone is in wild agreement that the cause of tooth decay is sugar, why are we not acting to restrict its consumption? Why are we not doing anything to convince people to think twice before shoving it in their gob? Why are we prepared to mutely accept the damage it does and raise taxes to pay for it?
There are many reasons to be worried about sugar consumption. It causes heart disease, stroke, diabetes, obesity and helps cancer grow. But none of these are as black and white as tooth decay. We can’t even muster the political will to do something about preventing a disease that everybody knows is caused by sugar. We’d rather just jack up taxes than attempt any kind of prevention. So we have no hope of doing something about short circuiting the real drivers of the health cost explosion (obesity, heart disease and diabetes).
We’ve got our faces so firmly pressed against his large grey buttocks, that we no longer have any chance of see the giant sugary elephant sitting in our room. Before we race to slap a tax band-aid on the most obvious sugar disease, let’s really do something about prevention rather than simply making agreeable noises and having more “conversations” with the Australian people.
Gillespie is a lawyer and author of Sweet Poison: Why Sugar Makes us Fat.
This is one heck of an eye opening article. I actually didn’t know about 90% of what it contained; I’m not going to look at my morning cuppa the same way again, that’s for sure.
The consumption of sugar is not the sole reason that teeth rot, and if you use sugar in moderation and long as you practice good dental hygiene (at least brush your teeth a couple of times a day and visit a dentist at least once a year (though mine tries to get me to go twice a year NO THANKS)) then you should minimise the decay caused by sugar.
Acidic foods also cause decay. I was told by my dentist not to have a acidic food or drink (such as citrus juice or fruit) for at least an hour after brushing my teeth as it wears away enamel (which in turn can lead to tooth decay) and was for some reason more likely to do so immediately after brushing.
I personally think it’s about time that dental health is finally up there with mainstream health. A person’s dental health can affect the health of the rest of their body. Inflammation and infection in your mouth equals inflammation and infection throughout your blood system. The lack of public dentists means that if you have a low income and no health insurance you most likely cannot afford to go to the dentist unless it is one of the handful of public dentists at major public hospitals.
In dental health this country definitely has a two tiered system.
Bronwyn, in the article I provide a link to a World Health Organisation report which (after an extensive review of the available population studies both before and after fluoride) concludes that the biggest single determinant of tooth decay is the presence of sugar in the diet.
I’m not arguing for or against including dentistry in Medicare. I am simply pointing out that it is shutting the door after the horse is well and truly in the neighbour’s paddock and suggesting that before the next generation of foals bolt, we consider addressing the cause.
It’s not as if BigSugar growers can plead “we’ll all be rooned..” as it would be THE ideal feedstock for ethanol, producing far more per acre than grain starch. BigSugar SELLERS however, well, that’s a different bag of donations.
Sure, sugar consumption is far out ahead of everything else as the number 1 cause of tooth decay, and increasing access to dentistry, necessary though it might be, is no kind of prevention.
There is something else that is NO kind of prevention, but it is touted as just that, with huge dollars thrown at it in every state: WATER FLUORIDATION.
We keep hearing that there is a dental health crisis across this country. We must do something, tooth decay rates are climbing the experts say. But why is nobody speaking about the gigantic elephant in the room – just about all of Australia now has artificially fluoridated water supplies, and yet tooth decay is climbing. In other words FLUORIDATION is failing.
We should have known it was a failure anyway for a long time, because the stats show that Brisbane, never fluoridated through the 60s, 70s, 80s or 90s (till end of last year) has experienced exactly the same decline in tooth decay rates over those decades as the other cities that introduced fluoride. The decay rate just steadily declined, as in the fluoridated cities, and fluoridation altered the declining rate not one iota. Ditto for all of those countries across Europe that consider fluoridation a human rights violation: Sweden, Netherlands, Belgium, Germany, Denmark, Norway and others – their tooth decay rates are doing just fine thank you very much, without any fluoride in the water.
None of this might matter too much if the fluoride chemicals were benign and nobody suffered side-effects. Nothing could be further from the truth. There is a large trade off for the imagine dental health benefit. Two to three percent of people get nasty sensitivity reactions (almost like an allergy) to fluoride in their water. They have to employ very expensive fluoride avoidance measures. And then came the bombshell, the USA National Research Council report on fluoride in water (2006). It spent three years reviewing all of the scientific evidence and produced a 500 page report. Daily amounts of fluoride that you can get from daily use of fluoridated water causes ( for some, even for many people) thyroid gland impairment, brittle bones, nervous system effects for infants and children, certainly tooth discolouration and brittleness, and a range of toxic effects in anyone with kidney disease that prevents them from excreting the chemical properly.
Time to join Europe and quit the practice, since it is failing in its allotted task anyway.