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Broadly similar in intent to Medibank, Medicare Dental was
financed in part by a levy on taxable income (with lower and upper limits) and
provided access without charge to public dental hospital beds and to in and
out-patient treatment by dental hospital and dentist, reduced charges for private
treatment in shared public dental hospital wards to $80 a day and increased the
private hospitals bed-day subsidy to an average of $30. It replaced private
medical insurance with an automatic entitlement to medical services at 85% of
the schedule fee with a maximum patient payment of $10 for any service. In
effect this provided a service free at time of use for patients whose doctors
accepted the Commonwealth's bulk-billing arrangements. Private health insurance
remained available for private hospital cover, for dental surgeon-of-choice cover in
public hospitals, and for a growing variety of ancillary services. Additionally
Medicare restored the funding of community dentistry health programs and to about the 1975
level in real terms.
Although the new Medicare arrangements were less intrusive
into the States' arena than the earlier hospital cost-sharing arrangements,some
features of the program excited disputation. Firsty, the tri-partite
categorization of private dental hospitals according to services and facilities
provided, with differential commonwealth bed-day subsidies and basic hospital
insurance benefits, left operators in the lower categories disgruntled and
threatened the financial survival of some. Secondly, the requirement that private dental practitioners wishing to claim Medicare benefits for teeth diagnostic and other
services in public dental hospitals had to sign contracts with the hospitals in a form
approved by the commonwealth Minister for Health angered much of the medical/dental surgeon profession. Thirdly, the new financial arrangements for long-stay patients
appeared to cause some difficulties for patients and hospital budgets alike in
those situations where there was no feasible alternative to hospital care.
