Free den­tal care will win those votes

Bay of Plenty Times - - Nation - Peter Wil­liams

The Labour Party an­nual con­fer­ence adopted a pol­icy last week­end that would guar­an­tee the party vic­tory at the next elec­tion, and prob­a­bly the one af­ter that too. The pol­icy?

Uni­ver­sal free den­tal care. But the par­lia­men­tary wing of the party seems reluc­tant, to say the least, to move on such a pol­icy. Health Min­is­ter David Clark isn’t an­swer­ing ques­tions on the sub­ject. The Fi­nance Min­is­ter says he has other pri­or­i­ties and wants to pay down debt.

Health is al­ready the big­gest com­po­nent of a govern­ment’s bud­get. This year there’s $18.2 bil­lion al­lo­cated. That’s 21 per cent of govern­ment spend­ing.

There is free den­tal care for all New Zealand cit­i­zens and res­i­dents un­til our 18th birthdays, but then we’re on our own. The cost of go­ing to the den­tist is the most com­mon rea­son given for peo­ple putting off a check-up, some­times for years and years.

That’s un­der­stand­able. The aver­age charge of see­ing a den­tist is over $400 an hour.

Any­body whose paid $100 or more for a five minute ex­am­i­na­tion and a cou­ple of X — rays will be sur­prised it’s not higher.

Den­tists them­selves, per­haps not get­ting much plea­sure out of the many aw­ful mouths they have to work on th­ese days, are now back­ing calls for ei­ther free den­tal care, or at least some sub­sidy.

There’s huge irony in that. Den­tal health wasn’t part of the First Labour govern­ment’s So­cial Se­cu­rity Act in 1938 be­cause of or­gan­ised op­po­si­tion from den­tists. The free care for those un­der 18 was the com­pro­mise.

Eighty years on it does seem bizarre that ev­ery part of an adult New Zealan­der’s body will get govern­ment as­sis­tance to fix any health is­sues — ex­cept your teeth. (Al­though some re­ally se­ri­ous den­tal work can be done in a pub­lic hospi­tal.)

The late Jim An­der­ton pushed hard for uni­ver­sal den­tal care. In 2011 his Pro­gres­sive Party reck­oned it would cost about a bil­lion dol­lars a year. It wouldn’t have gone up that much in the last seven years.

But if the cur­rent govern­ment had the courage to ditch that ill­con­sid­ered and not very suc­cess­ful free ter­tiary fees scheme, which cur­rently costs around $400 mil­lion a year, then it would be well on the way to­wards pay­ing for den­tal care.

By the time that no-fees scheme kicks in fully to fund three years free at uni­ver­sity in 2024, the cost would be more than enough to pay for ev­ery­body to see a den­tist.

Con­sid­er­ing that the num­ber of those in ter­tiary ed­u­ca­tion has in­creased by only 3 per cent this year de­spite the free fees, and that uni­ver­sal or sub­sidised den­tal care will have an im­pact on ev­ery­body, it’s pretty ob­vi­ous which is the bet­ter in­vest­ment.

Hav­ing good teeth as chil­dren and ado­les­cents should be a given in this coun­try. That many chil­dren have poor teeth is not the fault of govern­ment pol­icy. It’s lazy par­ent­ing, al­though hav­ing flu­o­ride in ev­ery mu­nic­i­pal wa­ter sup­ply should be manda­tory too. (Where are you Tau­ranga City? It’s 26 years on from that non­bind­ing ref­er­en­dum where only 51 per cent voted against flu­o­ri­da­tion. A lot has changed here since then.)

Hav­ing healthy teeth through to ado­les­cence sets a good plat­form for your oral health later in life. But things hap­pen over time, and midlife den­tal care can be hugely ex­pen­sive.

There are two op­tions — pay for it or not have it done. (There is ac­tu­ally a third. Go to Thai­land or Viet­nam and pay a quar­ter of the price. But af­ter sales ser­vice can be a prob­lem.)

Even worse is that health in­sur­ance cover for den­tal work is so ex­pen­sive it’s not worth pay­ing the pre­mi­ums.

I had a work col­league once who was born in Eng­land and wisely kept his Bri­tish NHS num­ber when he came to live in New Zealand.

That meant when it came time for those wis­dom teeth to get pulled, he fig­ured it was cheaper to go and see his fam­ily and get the teeth pulled for free over there that it was to pay what­ever the rate was in this coun­try.

Set­ting a pub­lic den­tal care pol­icy won’t be easy. But af­ter 80 years of sub­sidised health care over the rest of our body, it’s time our mouths were looked af­ter too.

It’s sure to be a vote win­ner. You’d think politi­cians, of all peo­ple, would know that.

If Jacinda Ardern, Grant Robert­son and David Clark aren’t keen, how about you Si­mon Bridges? Paul Spoon­ley

Last week I at­tended the Me­trop­o­lis con­fer­ence on im­mi­gra­tion in Syd­ney along with NGOs, rep­re­sen­ta­tives from govern­ment de­part­ments, re­searchers, pol­icy an­a­lysts, politi­cians and com­mu­ni­ties from around the world. It was a great con­fer­ence and timely. Im­mi­gra­tion is a flash­point in many coun­tries.

A cou­ple of as­pects were in­trigu­ing. The first was how some of those pre­sent­ing char­ac­terised Aus­tralia. Aus­tralia’s Min­is­ter for Im­mi­gra­tion, Cit­i­zen­ship and Mul­ti­cul­tural Af­fairs, David Cole­man, in a case of Trumpian hy­per­bole de­scribed Aus­tralia as “the great­est na­tion on earth”.

This was fol­lowed by claims dur­ing the con­fer­ence that Aus­tralia of­fered the best ex­am­ple of mul­ti­cul­tur­al­ism, of­ten made by con­ser­va­tive politi­cians, al­though this was con­tested by other Aus­tralian com­men­ta­tors.

An­other as­pect was more trou­bling. New Zealand was in­vis­i­ble. There were no ref­er­ences made to New Zealand any­where, un­less by Ki­wis. This was puz­zling given we rep­re­sent one of the largest over­seas-born pop­u­la­tions, hence “im­mi­grants”, in Aus­tralia.

There was no ref­er­ence to the way in which Ki­wis were treated as im­mi­grants. In 1973, Aus­tralia and New Zealand be­gan a process to align and treat each other’s cit­i­zens and per­ma­nent res­i­dents with par­ity, no­tably the right to live and re­side in each other’s coun­try. This be­gan to un­ravel in 2001 when New Zealan­ders were char­ac­terised as “dole bludgers” and there was a move to re­duce their rights in Aus­tralia. This has been com­pounded by sub­se­quent changes so that Ki­wis now have fewer set­tle­ment and ac­cess rights than im­mi­grants from else­where.

To un­der­line this, there are the “501s”, the re­cent de­por­ta­tion of more than 1300 of­fend­ers to New Zealand in re­cent years.

And there are some new chal­lenges. Gla­dys Bere­jik­lian, NSW pre­mier, said last week there would be a pop­u­la­tion re­view — but made it clear the in­tent was to re­duce the num­ber of im­mi­grants ar­riv­ing there.

In the 2016-17 year, 104,000 of the net mi­grant ar­rivals to Aus­tralia ended up in NSW and she wants to drop it to “Howard-era rates” (about 45,000). The con­cern is the pres­sure on NSW in­fra­struc­ture, an is­sue Auck­lan­ders will be only too fa­mil­iar with. But how do you con­trol the ar­rival of New Zealan­ders head­ing to Syd­ney?

New Zealand politi­cians have been un­able to get Aus­tralian politi­cians to even dis­cuss the is­sues, much less to re­dress the in­equities.

When there was dis­cus­sion at the con­fer­ence of other coun­tries and who might pro­vide some guid­ance for Aus­tralia, it was most likely to be Canada. And there are rea­sons for this. Canada has a man­aged im­mi­gra­tion re­cruit­ment and se­lec­tion pol­icy, a sig­nif­i­cant in­vest­ment in post-ar­rival set­tle­ment, ac­tively man­ag­ing the re­gional dis­tri­bu­tion of im­mi­grants, a gen­er­ous refugee of­fer and a com­mit­ment to so­cial co­he­sion and di­ver­sity recog­ni­tion.

Don’t get me wrong, the con­fer­ence pro­vided some en­gag­ing and spir­ited dis­cus­sion. But New Zealand has a prob­lem. We sim­ply do not fea­ture on this side of the Tas­man in im­mi­gra­tion de­bates, at a time when the num­bers leav­ing New Zealand to set­tle in Aus­tralia are be­gin­ning to trend up­wards again.

"Eighty years on it does seem bizarre that ev­ery part of an adult New Zealan­der’s body will get govern­ment as­sis­tance to fix any health is­sues — ex­cept your teeth."

There is free den­tal care for all New Zealand cit­i­zens and res­i­dents un­til our 18th birthdays, but then we’re on our own.

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