Lana Hart is a Christchurch-based writer, facilitator and tutor.
OPINION: Evidence continues to mount in favor of better access to dental care in New Zealand.
Last week’s news felt like deja vu; For years we have heard stories of thousands of children having their teeth surgically removed due to cavities and adults suffering for years from the pain, rather than having to pay for dental care.
But this time around, there were new features in these disturbing stories involving the use of pliers to pull out sore teeth, addictions to drugs and alcohol due to chronic dental pain, and statistics indicating that 40% of Kiwis cannot afford dental care. care at all.
And, there are new voices in the dental care discourse, with Auckland City Mission joining the Association of Salaried Medical Specialists in backing the latest in a long line of grim reports, Tooth be Told.
* Election 2020: DHB cuts go ahead in bid to end ‘postcode lottery’, says Chris Hipkins
* The State Can Afford Free Dental Care, So Let’s Go
* Tax sugary drinks to fund dental care
* Canterbury children record high levels of tooth decay
* Poverty causes ‘third world’ dental problems, says Hamilton dentist
Although every government insists that the cost of universal or subsidized dental care is unaffordable, there is renewed energy to at least do more than stick with a largely privatized system of adult dental care. But is that enough to finally make policy changes to our country’s rotten dental record?
Tackling our dental care crisis has so much to do that you would have thought politicians would have done so long ago: it affects everyone with teeth in the country, it has strong ties to many other government-funded areas like health and poverty, and its influential stakeholders consistently speak out and provide solid financial and health evidence of the need for change.
There are many theories about why certain issues get political action and why others don’t. One is John Kingdon’s classic policy window theory, which identifies three streams of activity that must be present for a policy change to occur.
Kingdon says a window of opportunity opens when an issue is high on the public agenda, when a solution is politically feasible, and when there is a political environment conducive to policy change. If these factors do not match – for example, the solution is not feasible or if the political climate focuses on more pressing objectives – then the issue will drop off the political agenda.
There is no doubt that the public sees dental care as high on the country’s agenda. A recent poll found that more than 83% of Kiwis support subsidized adult dental care. Two years ago, a poll reported that two-thirds of voting Kiwis supported free dentistry.
Solutions to the problem show that they are also feasible, such as funding through a sugar tax, phasing in cheaper interventions such as adult care up to age 26 years, or the ability to deduct dental expenses from gross annual income on tax returns. Flip to the back page of any of the dozens of reports on this topic and you’ll find substantive, affordable, and achievable recommendations that have never been implemented by the government of the day.
The third factor in Kingdon’s model is whether the policy environment is right. High inflation and a struggling healthcare system are not making it easier to tackle the dental care crisis, but they are also reinforcing the need to treat dental problems with lower cost preventative care and healthcare facilities using their limited resources to remove tumors, not teeth.
What is missing is that the major political parties prioritize dental care policy. Despite the Labor Party promising to introduce free universal dental care in 2018, it only managed to triple the amount of its dental subsidies for low-income families this year, continuing to ignore the fact that affordable dental care is a chronic problem for a majority of New Zealanders, not just those eligible for Work and Income grants.
National Party policy focuses only on children, but contains at least preventive measures like toothbrushes and dental education in schools.
The Greens and NZ First want free dental care extended to more groups such as students and the elderly – perhaps NZ First will be able in next year’s election to slip its dental policy in policy negotiations, as the party did in the 2005 trust-and-supply agreement for the SuperGold card policy.
Meanwhile, ACT is crafting policies on everything from anklets to ground zero public service, but remains silent on how it would fix this mess. Show us your cards, ACT!
As the dental crisis grows and more pliers are used to deal with it, we need voters to pressure their political parties to strengthen their commitment to dental care policy.
Our window of opportunity is right now. An election year is just weeks away. It’s time for the building energy to deal with New Zealand’s continuing dental crisis to make dental care a part of next year’s election.
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