The Consumers Health Forum is largely welcoming of the dental announcement, although noting some of the obstacles ahead, including that over 80% of Australia’s dentists work in private practice.
The Doctors Reform Society is making similar “this is welcome BUT…” noises, with its statement saying the announcement “lacks any vision or strategy to achieve comprehensive universal access dental care for Australians,” and noting the plan’s dependence upon already-stretched state-run public dental services.
Meanwhile, Croakey has been waiting for some time now to see if any health groups will engage with the campaign to increase Newstart allowances.
As Dr Tessa Boyd-Caine, the Deputy CEO of the Australian Council of Social Service, argues below, it’s an important health issue when income support payments are so low that they entrench poverty.
Increase Newstart to improve health for all
Dr Tessa Boyd-Caine writes:
In February this year, the National Advisory Council on Dental Health reported that Australia had 60,251 potentially preventable hospitalisations for dental conditions in 2009-10. This was the fourth most common cause, constituting almost 9%, of all potentially preventable hospitalisations.
People who have difficulty accessing dental care are most likely to present to hospital with potentially preventable dental conditions; and it is lower income households with poor visiting patterns that are most at risk of poor oral health. As the Dental Council concluded, differences in income impact more significantly on dental treatment pathways than the initial experience of decay itself.
Despite Australia’s relative wealth and a universal health system under Medicare, almost 40% of people in Australia go without access to timely dental care because of the cost. Similarly, almost 40% of low income households have untreated decay compared to less than half that number in high income households.
The Government’s commitment this week to a national dental scheme will be a critical step towards improving the dental health of the nation. But, important as it is, universal access to dental services will not change the material deprivation of the many people who miss out on basic health services because they simply can’t make ends meet.
Many of these people are living on the unemployment benefit (Newstart), Youth or other Allowances intended to support people as they look for work or undertake their studies.
Yet, at $35 a day, Australia provides the lowest level of income support to people who are unemployed than any other country in the OECD. That’s why ACOSS has been campaigning for a $50/week increase to Australia’s unemployment benefit (Newstart) and other Allowances in this week’s Federal Budget.
These Allowances have not increased in real terms in 20 years. A single adult on the Newstart Allowance survives on $245 per week, which is not enough to make ends meet, let alone cover the cost of transport to job interviews. Recipients of these Allowances are not eligible for other income supplements that pensioners can access, such as the Utilities Allowance. It’s not only the unemployed, as people living on Youth Allowance while they study and widows receive the same payment levels.
The payment is so low it acts as a disincentive to work, propelling into poverty the people who rely on them while they look for work. That’s why ACOSS’ call to increase these Allowances has been supported by a broad cross-section of interests including the Henry Tax Panel, the OECD, the Business Council of Australia and economists like Judith Sloan who advised John Howard as Prime Minister.
Increasing Newstart and other Allowances is a health issue as much as it is good economic policy. People relying on these Allowance payments have just $14 in their weekly budget to spend on health, after rent, utilities and food expenses. They rarely have private health insurance. They are eligible for health care cards, but this enables them to receive concessional medicine prices only.
It’s not surprising that SANE Australia has found significant numbers of people forego filling a prescription in order to meet basic costs such as food for their families. GPs who bulk bill are increasingly hard to find; and specialist services are next to impossible to access, other than via admission to a hospital emergency department.
The impact of mental illness among income support recipients is another key area of concern. Every year ACOSS surveys community services nationally to find out the biggest issues facing their clients, the vast majority of whom rely on these Allowances to support themselves and their families.
Last year, non-health services reported that poor mental health was the single biggest challenge faced by their clients. The impact of untreated mental illness is a major burden on individuals and their families: people who cannot afford to access treatment or fill their prescriptions are less likely to secure and maintain affordable housing; to provide a stable home for their children through schooling; or to balance family pressures with the job-seeker activities required of them by Government to receive their Allowance in the first place.
But it has equally significant implications for health and other services, including those called on to provide support when mental illness becomes acute. Limiting income support payments to inadequate levels simply undermines recipients’ capacity to minimise their risk of serious mental illness through maintaining secure accommodation and employment, balancing household bills and health costs, and keeping connected to family and community.
As the campaign gathers momentum, we have seen the consensus strengthen across the Australian community, beyond the social service organisations that work every day with people experiencing poverty, to a far broader societal recognition that these payments cannot continue at such low levels.
It’s important that health groups and medical professionals join their voices to the call to increase these payments. As long as Australia continues to pay the lowest rate of unemployment in the OECD, we cannot hope to improve the health status of our country overall.
Closing the gap, supporting community-based primary care, and relieving the burden of unnecessary hospitalisations will not be enough if we don’t also ensure that everyone in Australia can access a living wage. $35 a day is just not enough.
• Dr Tessa Boyd-Caine is Deputy CEO of the Australian Council of Social Service and was a member of the National Advisory Council on Dental Health.