By Joanne Bladd
Healthcare funding is one of the most fiercely fought-over slices of the government budget, ask any health minister.
Healthcare funding is one of the most hotly fought-over slices of the government budget. Ask any health minister, and he or she will tell you that medicine is essentially a numbers game - the question of who gets paid for what and why, is determined by the number of patients who need the service.
So it's strange that when it comes to receiving funding, dentistry is still the poor relation. There are few parts of the body where problems crop up as regularly as in the mouth.
You may go your whole life without needing the services of a neurosurgeon, but it's a rarity to find a middle-aged adult who has never had a filling, or sweated through a root canal procedure. Yet these procedures are still seen - even by the ministers holding the purse strings - as a luxury and not a necessity.
This perception is of real concern as Dubai's Health Authority thrashes out the details of mandatory insurance. Market talk suggests that dentistry is unlikely to get a mention on the basic plan, leaving residents (or those that can afford to) to fund their own care.
Public sector dentists will tell you the bulk of their patients only attend (and usually when pain forces them) because their care is paid for by the government's soon-to-be-phased-out subsidy scheme. Once that's stripped away, patients will respond in exactly the way you would expect - they'll stop coming.
The ripple effect of this will also hit upcoming dental graduates. If Dubai only has a token public sector service, local graduates will either be fighting for a tiny pool of places, or need to jump straight into private practice. The emirate is already scrabbling for dentists, and the smaller the number in practice, the higher the prices, as a glance at existing pricelists will show.
Dubai's Health Authority is not expected to force insurers to shell out for breathtakingly comprehensive treatment plans. Nobody is asking for high-end cosmetic work to be.
But as evidence stacks up to show the impact of oral health on wider systemic health, the case for some level of coverage is getting stronger. Insurance isn't a ‘one size fits all' solution, but it is a step along the path to offering a reasonable level of dentistry to more than the elite few.
To add to your comments about what health care treatments are covered and what is not covered by the mandatory insurance scheme. This statement is taken directly off the Daman website on services not covered: "Health Services and associated expenses for the surgical treatment and non-surgical, medical treatment of obesity (including morbid obesity), and any other weight control programs, services, or supplies. (Extracted from: Daman General Exclusions Abu Dhabi Plan) How can this insurance program not include any nutrition intervention to 33% of the population that is overweight or obese? Or do you just treat the diabetes and ignore the obesity? Or just treat the cardiovascular disease but not the obesity? A team of trained medical professionals is required to treat the obesity epidemic but even nutrition intervention by a dietitian could significantly reduce healthcare costs, this is backed by loads of research. The cost of not providing any nutrition therapy to tackle this epidemic will be in the millions. Time to re-think the long term health strategy of this plan and include medical nutrition therapy as part of a proactive and reactive intervention. Valerie Houghton, Registered Dietitian