Hand the kids a ciggy

Back when Kevin was an MP rather than a PM, he made an inconvenient election promise that might be interpreted to mean he would fix the health system. So (being keen to be seen to be a man of his word), after he got the gig, he formed a Commission. The Commission was to gather submissions from anyone who cares and come up with recommendations on how to fix the health system.

The Commission duly performed as expected and (a year and half later) came up with sleep inducing statement of stuff-we-already-knew (in 123 parts). Unfortunately (and rather inconveniently) the Commission also suggested an actual structural change. They wanted to add basic dentistry to Medicare. Even more unfortunately, the Commission (clearly getting carried away with its own importance) suggested raising taxes to pay for the actual structural change.

Kev knew the media would eventually read the report and discover the tax-bomb. So he cut them off at the pass by announcing plans to have a ‘conversation’ (yep, another one) with the Australian people before anyone did anything. The plan was to punt the issue well beyond the next election. The nit-picky media (you know who you are) chose to focus on the tax rise rather than all the excellent stuff-we-already-knew (obviously being manipulated by the opposition’s friends in high places), causing a bit of a pickle for our hero …

No, this isn’t the plot for an episode of The Hollowmen. It’s very (and, all too sadly) real. But stepping aside from the political reality (that gradual change will most likely occur in due season), its worth looking at some of the concentrated wisdom of the health hierarchy so painstakingly collected throughout the report.

An overwhelming theme is that prevention is better than cure. So it’s a bit odd that the single biggest cost in the whole thing (and the only item with a specific funding proposal) is actually 100% cure and 0% prevention. The National Health and Hospitals Reform Commission want to spend $3.6 billion per year on basic dental services. The money will come from a 50% increase in the Medicare levy paid by every ‘working family’.

Dental services are primarily consumed fixing damage done by tooth decay. And the cause of tooth decay is established beyond any shadow of a doubt. There aren’t many occasions when Nestle, Coca-Cola and the World Health Organisation find themselves in complete agreement on a health issue, but this is one of them. Tooth decay is caused by the consumption of sugar.

Preventing a disease is rarely as easy or as obvious as halting the consumption of a single consumer substance. It’s even rarer to have everybody (even the people who make a fortune from selling it) agree that it does in fact cause the disease. The only other example I can think of is tobacco (yes, Big Tobacco did eventually agree). All of which makes me wonder why the medical and political responses to lung cancer and tooth decay are so very different.

We actively try to prevent people commencing consumption of tobacco. If they are foolish enough to do it anyway, we tax them into submission instead. The taxes raised vastly exceed the health costs of treatment and go to benefiting the whole community. Imagine our response to tobacco if it was the same as the proposed response to sugar. We’d be handing our kids a ciggy, resigning ourselves to the inevitability of them eventually needing extensive treatment for lung diseases and jacking the medicare levy up to cover the costs.

Since everyone is in wild agreement that the cause of tooth decay is sugar, why are we not acting to restrict its consumption? Why are we not doing anything to convince people to think twice before shoving it in their gob? Why are we prepared to mutely accept the damage it does and raise taxes to pay for it?

There are many reasons to be worried about sugar consumption. It causes heart disease, stroke, diabetes, obesity and helps cancer grow. But none of these are as black and white as tooth decay. We can’t even muster the political will to do something about preventing a disease that everybody knows is caused by sugar. We’d rather just jack up taxes than attempt any kind of prevention. So we have no hope of doing something about short circuiting the real drivers of the health cost explosion (obesity, heart disease and diabetes).

We’ve got our faces so firmly pressed against his large grey buttocks, that we no longer have any chance of seeing the giant sugary elephant sitting in the room. Before we race to slap a tax band-aid on the most obvious sugar disease, let’s really do something about prevention rather than simply making agreeable noises and having more ‘conversations’ with the Australian people.

Also published in Crikey.