Albanese government backbenchers among those pushing to add dental to Medicare despite the health minister saying it’s not a priority
Half-a-century after it was left out of Gough Whitlam’s original Medibank scheme, dental care remains a hole in Australia’s public health insurance system.
Federal governments have offered piecemeal solutions in the decades since to make a trip to the dentist more accessible and affordable.
But none have been prepared to pursue universal access, leaving millions of Australians to choose between dipping into their wallets or skipping treatment.
As the 2025 federal election approaches, Whitlam’s successors in the Albanese government are under growing pressure to at least map out a path to finally add dental to Medicare.
Labor backbenchers are among the advocates pushing the case despite the health minister, Mark Butler, confirming it is not a government priority.
“I think Labor needs to commit to doing a thorough investigation of it and how we would introduce it,” Mike Freelander, a Labor MP and paediatrician, told Guardian Australia.
“My view is coloured by my background. I’m a paediatrician. I see kids with terrible dental care and terrible dental caries (cavities) and dental abscesses.
“Lack of dental care does cause significant pain and suffering, particularly in the paediatric age group, but also in older people.”
The Greens put dental care on the federal election agenda last August, unveiling a policy to expand Medicare coverage to dental services, including regular check-ups and teeth cleans, crowns, orthodontic treatment and oral surgeries.
The scheme would cost $14bn in its first year and $196bn over the decade to 2034-35, according to Parliamentary Budget Office (PBO) costings.
The Greens used its balance-of-power position after the 2010 election to push the then prime minister Julia Gillard to include dental care into Medicare for eligible children.
More than 51m services to 3.5 million children have been delivered since the scheme’s introduction in 2014, although reports have shown the program is used by less than half the eligible population.
With opinion polls pointing to another hung parliament after this year’s election, the Greens leader, Adam Bandt, said expanding the scheme to all Australians would be a top priority in negotiations to support a minority Labor government.
“It’s an unfinished piece of health reform that the country desperately needs,” Bandt said.
“People are putting off going to the dentist because they can’t afford it. That makes people’s health problems worse. In a wealthy country like ours, everyone should be able to go to the dentist.”
But even among supporters of universal dental care, the Greens’ plan has been criticised as impractical and a poor use of taxpayer funding.
Freelander said the Greens’ option was “completely unrealistic”, insisting any model must limit which dental services were subsidised.
The Grattan Institute has advocated for a Medicare-style universal dental scheme that is gradually phased in over a decade, rather than introduced immediately, at a cost of about $5.6bn a year.
The staged model has the backing of Dr Carmen Lawrence, who was health minister under Paul Keating when the commonwealth implemented a dental scheme (which was later wound up) targeted at disadvantaged adults.
“I think doing it in one hit would probably be more than anyone could do politically,” said Lawrence, a former Western Australia premier who now chairs Council on the Ageing WA. “But all the elements are there to do it, focusing on children, on low-income earners, on older citizens, and eventually extending it to everybody.”
The PBO costings of the Greens policy exposed the logistical challenges of universal dental, warning it was “highly uncertain” if there would be enough dentists to meet an expected surge in demand.
Dr Chris Sanzaro, the Australian Dental Association (ADA) president, cited workforce challenges among several reasons for the peak body’s resistance to a Medicare-style scheme.
“We don’t see that a blanket Medicare approach for every Australian is the right way to go, because we know that the funding of that is going to be significantly expensive for the government, and that’s going to open up a bunch of challenges in terms of access to dentists, use of workforce,” he said.
Sanzaro has doubts about a universal scheme being a good use of taxpayer funds.
“It’s a lot of money to provide a limited service to a lot of people. Arguably, some of those people can already afford that service or better.”
The ADA wants the federal government to instead roll out a targeted program for vulnerable groups, similar to the child dental benefits scheme, starting with over-65s and then expanding to Aboriginal and Torres Strait Islander populations and low-income earners.
“We know there’s a lot of people in nursing homes, aged care facilities that have had significant impacts on their general health because of poor dental health,” Sanzaro said.
A seniors dental benefit scheme was a recommendation in both the aged care royal commission and 2023 Senate inquiry into dental care, which heard older Australians were delaying or avoiding treatment due to costs.
The government chose to “note” rather than progress that recommendation in its July 2024 response to the inquiry, a decision the ADA described at the time as a “wasted opportunity”.
The Albanese government also has not accepted the report’s final recommendation, which urged the commonwealth to work with the states and territories on the staged implementation of a universal dental and oral health care scheme.
The stance appears to jar with Labor’s own national platform, which describes oral health as the “missing element of Medicare” and outlines a goal to provide affordable dental services for all Australians, and the views of several Labor backbenchers.
A $2.4bn pledge for free dental for older Australians was also part of Labor’s failed 2019 election pitch.
In his valedictory speech to parliament in November, the retiring Labor MP Brian Mitchell urged the government to put dental into Medicare on its agenda.
“I have no illusions about the expense or the difficulty, but it’s time to commit to starting a process,” Mitchell said.
“Too many people, our people – the old, the sick, the poor – are suffering from poor dental and mental health for us not to turn our attention to it. In the words of the great late JFK, we do these things ‘not because they are easy but because they are hard’.”
In a statement to Guardian Australia, Butler acknowledged the desire for dental to be added to Medicare but reiterated that it was not a priority for the government.
“I’ve tried to be honest with people that the government’s focus right now is strengthening Medicare and rebuilding general practice after a decade of cuts and neglect from the Liberals,” he said.
“I can’t say to people that in the short term there’s going to be any change to dental, but I do recognise in the longer term there’s a lot of ambition for dental to be covered by Medicare.”
The government had started work on a new 10-year national dental plan, which would outline goals to reduce the inequities in oral health across different parts of the population.
The shadow health minister, Anne Ruston, said the Coalition recognised access to affordable dental care was an important issue, particularly at “a time when health costs are skyrocketing”.
Ruston said the opposition wanted Australians to have “timely and affordable access” to healthcare and would announce its health policies ahead of the election, due on or before 17 May.
“The Coalition does not support the Greens’ policy, which would add an additional $45bn in government spending at a time when inflation is already having a serious impact on the cost of healthcare,” she said.
