JERM model of care: an in-principle model for dental health policy

Oral diseases are the most prevalent conditions in the community. Their economic burden is high and their impact on quality of life is profound. There is an increasing body of evidence indicating that oral diseases have wider implications beyond the confines of the mouth. The importance of oral health has not been unnoticed by the government. The Commonwealth (Federal) government under the Howard-led Coalition in 2004 had broken tradition by placing dentistry in its universal health insurance scheme, Medicare. Known as the Chronic Disease Dental Scheme (CDDS), the program aimed to manage patients with chronic conditions as part of the Enhanced Primary Care initiative. This scheme was a landmark policy for several reasons. Besides being the first major dental policy under Medicare, the program proved to be the most expensive and controversial. Unfortunately, cost containment and problems with service provision led to its cessation in 2012 by the Gillard Labor Government. Despite being seen as a failure, the CDDS provided a unique opportunity to assess national policy in practice. By analysing the policy-relevant effects of the CDDS, important lessons can be learnt for policy development. This paper discusses these lessons and has formulated a set of principles recommended for effective oral health policy. The JERM model represents the principles of a justified, economical and research-based model of care.