Lobbyists Make Sure Proper Dental Care Doesn’t Happen In The USA. Is It The Same In Australia?
One of the most well known speeches in the world was delivered on 19 November, 1863 by President Abraham Lincoln. It took two minutes.
This from a man with intense dental anxiety after a tooth extraction left him with a broken jaw.
Memorised by school children, The Gettysburg Address is as familiar to Americans as, “Look! Up in the sky! Is it a bird? Is it a plane?…”
In reverence to the casualties of one of the bloodiest battles of the American Civil War, it speaks of liberty, equality and freedom like the Man of Steel espoused “truth, justice and the American way”. (Before the last was changed in 2021 to “a better tomorrow”. Frankly neither doing much for “truth” and “justice”.)
Though Lincoln was not praised at the time in the way he is now, the brevity of his speech gives resounding power to the statements it contains; its essence being that if democracy won’t work in America, it won’t work anywhere.
A hundred-and-fifteen years later, Frank Sinatra took more than twice the time Lincoln did to implant the merits of New York, New York where if you can make it there, you’ll make it anywhere.
It’s as famous a message as the Gettysburg Address, if not more so. The idea of things working, working out, and working well because it’s America, a place formed and fuelled by Americans, seems to be a favoured nowhere/everywhere theme.
The cultural narrative is Lincoln on the train to that Pennsylvania military cemetery, scrawling his speech on the back of an envelope. It has the incidental genius aspect we really like: where from little things big things grow.
Just ask Paul Kelly.
It’s a story, a version, that we humans adore.
We like it so much it’s universally attributed to favoured things where something accidental, something incidental, changes everything. It’s an account of which we will never tire.
Lincoln never did scribble on that envelope.
He’d spent almost two weeks constructing that speech.
As an unconfident impromptu orator who always refused invitations to speak off-the-cuff, the likely maker of this myth would’ve been Harriet Beecher Stowe. Since the rumour of this event came from her three years later, it seems she couldn’t keep her imagination simply to the likes of Uncle Tom’s Cabin.
Always, we seek the soupçon of some divine inheritance that’s on indefinite hold for the meek. These stories are definitive, inarguable evidence that eudaimonia awaits those in the humble pursuit of authenticity and virtuous growth.
Because always, each and every time that cosmic conveyer belt moves, it is us getting closer to that prime prosperity position.
The continued transfer of the quaint translation is the temporary tattoo that gives cred while knocking the crass edge off anything remotely egocentric and assured. It’s a softener for any hint of hedonism, where motivation was purely because it felt good. It’s a vaseline-coated view that slips us into believing something happened because an external, ethereal hand felt it so righteous and necessary.
The good of the greater good is greater.
We did the same with J.K. Rowling. Well before her perfect porcelain veneers.
The single mother on welfare, seeking warm refuge in an Edinburg café from an unheated, mouse infested flat to write Harry Potter is too delicious a journey of triumph over adversity to not want.
It was the British press, rather than Veritaserum that revealed the truth.
Although Joanne Rowling (she gave herself the ‘K’) was indeed a single mother briefly on the dole after the collapse of her marriage, the café belonged to her brother-in-law and any suggestion that she lived in relative poverty is to detract from her middle-class upbringing. She would have regularly seen her dentist and had a professional clean.
What J.K. Rowling achieved is an historical literary marvel. Why we choose to wrap that in smoke and mirrors is equally endearing and insane – both of which are the workings of the human psyche that makes no claim on logic.
Like the little logic in American politics.
For every almost 750,000 citizens the House of Representatives has one congressperson.
That makes the US not only internationally a crazy undemocratic outlier, it’s also very different to the no more than 50,000 the Founding Fathers wanted. Given that the future is always difficult to predict that’s kind of okay – but it makes it different to what Americans want, and very, very different to what they need.
Any political system needs to be legitimate to be stable and that stability comes from people feeling that it’s fundamentally fair and transparent.
That’s the scrawl on the back of the envelope.
US elections are utterly warped by geography and gerrymandering.
The not-quite 625,000 people of Vermont have as much power as 20 million New Yorkers. The ultimate authority is the Supreme Court, where justices are politically appointed, have life tenure, and parties look for idealogues. It has so vastly overextended its own power that the court is absolutely arrogant in flaunting its corruption.
Not only has the Supreme Court made it legal for billionaires to spend as much money as they want on elections, but court records show one billionaire property developer managed to buy himself two decades of unique and intimate access to one of the most powerful people in the US and therefore one of the most powerful people in the world.
In short, the court has hijacked American democracy.
Where the undemocratic becomes inequitable and dangerous is when the core competition is between two political parties. That’s what brings disunity to the entire country – the US doesn’t see itself as big states and small states – it sees itself as red states and blue states.
It’s created an unstable equilibrium with agendas and outcomes that don’t legitimately serve the majority. The struggle for good oral health in America is a chronic symptom of the complex, insular system of oral health care that makes George Washington’s wooden teeth look true, and rather good.
Lawmakers repeatedly show that the American Dental Association (ADA) and America’s Health Insurance Plans (AHIP) have much more power than all of their constituents. Public health policy is strongly influenced and controlled by lobbyists of commercial activities when Members of Congress continue to ignore what every American says they want most out of the Build Back Better Act: adding dental coverage to Medicare.
Many times the ADA has killed bills to expand access to dental care.
For the past sixty years the dental lobby’s staunch opposition to dental coverage for more than just the poorest Medicaid recipients, is that Medicare’s reimbursement would be less than satisfactory to the dentists.
Like J.K. Rowling’s pre-Potter destitution, along with the mawing of insurance companies US dentists are crying poor. Their average salary is $US176,000.
Insurance allies the ADA in battling Medicare dental coverage because of the concern is the bottom line impact, rather than the oral health of seniors.
The most aggressive lobbying comes from two industry-funded groups: AHIP and the Better Medicare Alliance. It represents insurers’ profitable Medicare Advantage plans – many of which include dental benefits.
All this gnashing of teeth while millions and millions of Americans over the age of 65 are in desperate need of dental care. One-in-six is over the age of 65. Many would be relieved to have proper access to having their tooth decay treated, periodontal disease avoided or managed, and All On Four implants as an option.
Organised dentistry is also standing in the way of a proven solution that would cost taxpayers nothing. Similar to nurse practitioner and physician assistant programs, lawmakers and advocates in several states have proposed adding dental therapists (trained to do more than a hygienist but less than a dentist) to dentist-led teams.
But the ADA and its state affiliates have lobbied and sued so that dental therapists are unable to practice other than in particular states with Indigenous populations. It has that crass edge crying out for a temporary tattoo.
It appears that not only does the US have a problem with democracy, it has a problem with dentists having a problem with differentiating the worth of their income, and the value of good oral health for anyone not earning anywhere near a hundred-and-seventy-six grand a year.
At least ten states identify as having a shortage of qualified dentists. Those they have, want to have their cake and eat it too; unlike many of the nation’s population, they have the teeth to do it.
Literally and figuratively.
In Australia, the Whitlam government wanted to include dental in the precursor to Medicare (Medibank) in 1974.
It had been hard yakka negotiating with doctors, and at the time, the government was basically was spent. That it was sacked not too long after means we’ll never know what the end of the story could have been other than the one that was, with Kerr’s cur and nothing saving the Governor-General.
Fifty years have passed and God didn’t save the Queen or the public dental system either. There have been times that Dental Health Services Victoria spent taxpayer’s money on lobbyists rather than treating people on low incomes.
Federal Labor claims that it remains committed to its “long-term” (read never) goal of expanding Medicare to dental health services while conveniently and repeatedly omitting a specified time frame.
The Coalition argues that oral health is a key part of primary care, and is extending its agreement with the states to (inadequately) fund public dental for another (paltry) year.
What part of “key part” it doesn’t understand, is key to understanding why it’s doing nothing worthwhile.
The Greens is the only party with parliamentary representation promising universal dental care. It took a $77.6 billion pledge over 10 years to the 2022 federal election which is the most positive thing yet. But if you’re never going to get elected, it’s easier to make grander promises.
There is a culture of “mateship” between the government, big business and powerful private interest groups. more than half of all Australian lobbyists having previously worked for the major political parties, or as federal or state public servants.
One-in-four are former staff of backbenchers, parliamentary secretaries or ministers.
Is dental care lobbying the same in Australia as it is in the States?
When five decades have passed, and advisors to state mining ministers now lobby for miners, one time health minister advisors move over to Big Pharma, and ex chiefs of staff currently represent the gambling industry, you can bet it is.
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