The Medicare Chronic Disease Dental Scheme: Historical, Scientific, Socio-political Origins

While evidence and expert opinion are the foundations of effective policy, the politics, economics, and timing of a proposal can affect outcome. Australian government involvement in the planning, funding and delivery of dental services has been minimal and inconsistent. Many believe that the hybrid dispersal model of shared constitutional power has intermittently led to poor administration of national health policy. Throughout the decade-long prelude to the introduction of the Chronic Disease Dental Scheme, a landmark health policy in Australia, Parliamentarians moved responsibility for public dental services of disadvantaged Australians into an impasse between the Federal, State, and Territorial Governments. Developments throughout the era confirm the influence of administrative intrigue, centralized authority, competing priorities, funding pressures, political strategy, public opinion, scientific evidence and the timing of a proposal on the formulation and implementation of oral health policy. Synchronized inter-governmental collaboration was also absent. Moreover, the impasse and its resolution immediately before a national election demonstrate the bipolar roles of centralized political authority and political resolve in either obstructing or implementing policy. The historical, scientific, and socio-political contexts undermining the preamble to the Chronic Disease Dental Scheme lend weight to concerns about the hybrid dispersal model of constitutional power.