Lana Hart is a Christchurch-based author, broadcaster and tutor.
OPINION: The evidence for better access to dental care in New Zealand continues to grow.
Last week’s news felt like déjá vu; For years we have heard stories of thousands of children having their teeth surgically removed due to tooth decay and adults suffering years of pain rather than having to pay for dental work.
But this time there were some new features disturbing stories about using pliers to remove painful teeth yourselfof drug and alcohol addiction due to chronic toothache and statistical reporting 40% of Kiwis cannot afford dental care at all.
And there are some fresh voices in the dental care discourse, with the Auckland City Mission joining the Association of Salaried Medical Specialists in supporting the latest in a long line of somber reports, Tooth be said.
* Election 2020: DHB cuts to end ‘postcode lottery’, says Chris Hipkins
* The state can afford free dental care, so let’s do it
* Tax sugary drinks to fund dental care
* Children in Canterbury have high levels of tooth decay
* Poverty causes dental problems in the “Third World,” says Hamilton dentist
Though every government insists that the cost of universal or subsidized dental care is prohibitive, there is new energy to at least do more than cling to a largely privatized adult dental care system. But is that enough to finally bring about political change in our country’s rotten dentistry?
Tackling our dental care crisis has so many reasons you would have thought politicians did so long ago: it is relevant to everyone with teeth in the country, It has close ties to other government-funded areas such as health and povertyand its influential stakeholders speak out consistently, providing strong financial and health evidence of the need for change.
There are many theories as to why some issues take political action and why others don’t. one is John Kingdon’s classic policy windows theoryidentifies the three streams of activity that must be in place for policy change to take place.
Kingdon says an opportunity opens when an issue is high on the public’s agenda, when a solution is politically feasible and when there is a favorable political environment for policy change. If these factors don’t add up – for example, the solution is unattainable or the political climate shifts towards more pressing goals – then the issue will disappear from the political agenda.
There is little doubt that the public sees dental care as important to the country’s agenda. A recent poll found that more than 83% of Kiwis supported subsidized adult dental care. A survey two years ago revealed two-thirds of the voting Kiwis supported free dentistry.
The problem solutions show that they are also feasible, such as the financing through a sugar taxgradually introducing less costly interventions such as adult care up to age 26 or the incorporation of the capacity to do so claim dental expenses against gross annual income on tax returns. Flip to the back of any of the dozens of reports on the subject and you’ll find substantive, affordable, and actionable recommendations never acted upon by the government of the day.
The third factor in Kingdon’s model is whether the political environment is right. High inflation and a struggling healthcare system make it difficult to respond to the dental care crisis, but they also increase the need to address dental problems with preventative, cheaper care and healthcare facilities that use their limited resources to remove tumors, not teeth.
What is missing is a prioritization of dental care policy by the major political parties. Despite Labor pledging to introduce free universal dental care in 2018This year it has only managed to triple the size of its dental grants for low-income families and continues to fail to address the fact that affordable dental care is a chronic problem for the majority of New Zealanders, not just those who Entitlement to work and income have grants.
The Greens and NZ First want free dental care to be extended to more groups such as students and the elderly – perhaps by next year’s elections NZ First will be able to channel its dental policy into political negotiations, as the party did in 2005 in the trust has done. and SuperGold Card Policy Supply Agreement.
In the meantime, ACT pumps out policies on everything from ankle bracelets to zero-based civil service, but is silent on how it would fix this mess. Show us your cards, ACT!
As the dental crisis deepens and more forceps are used to address it, we need voters to pressure their political parties to increase their commitment to dental care policies.
Our window of opportunity is right now. An election year is only a few weeks away. It’s about time that building energy to tackle New Zealand’s ongoing dental crisis compels dental care to become part of next year’s election.