Shortage Of Massachusetts Dentists Willing To Provide Care After Dental Benefits Extended

08 Aug 2008   

Massachusetts faces challenges in providing access to dental care for low-income residents because only 17% of dentists in the state are willing to accept new patients who have state-subsidized dental coverage, the Boston Globe reports. As part of the state's health insurance law, dental benefits were restored to about 540,000 low-income adults who had lost nearly all dental coverage in 2002. The law also expanded eligibility in state-sponsored health plans, which allowed an additional 140,000 adults to enroll in Medicaid, called MassHealth in the state, or the newly created Commonwealth Care.

Since 2006, more than 200,000 adults covered at least in part by the state sought dental care. State data show that the number of Medicaid beneficiaries who saw a dentist more than doubled in the first year after the law took effect, from about 15% of adults to 35%. According to health advocates, thousands more are expected to seek care in the coming months as community health centers and other groups launch an education campaign about the need for preventive care for children and adults.

The percentage of dentists who accepted people enrolled in subsidized health plans increased from 10% to 17% in 2006 when the state allowed dentists to limit the number of low-income patients they treated. However, Catherine Hayes, a professor at Tufts University School of Dental Medicine, said that a fifth of that 17% has stopped accepting new beneficiaries. Karen Rafeld, Massachusetts Dental Society's associate director, said the dental society has had a difficult time encouraging more dentists to join because "it's still a bureaucratic nightmare."

Dentists say it is unfeasible for them to accept many low-income patients because the state reimbursement rate for treating adults is half of what private insurers typically pay. In addition, dentists criticize payment delays and the "burdensome paperwork" needed to join the program, the Globe reports. Rafeld said that until the state raises the rates and fixes the process, it will be difficult to recruit more dentists to the program.

Kerin O'Toole, spokesperson for Massachusetts League of Community Health Centers, said that without more dentists providing preventive care, "we risk treating people with more expensive and serious health issues" (Lazar, Boston Globe, 8/7).

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Article URL: http://www.medicalnewstoday.com/articles/117673.php

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Comment:

Interesting thing about a 'universal health care' situation showing its ugly side:  At least in terms of dental treatment, if you aren't already healthy you may not get treatment, or as good a treatment as the one before you who took better care or the teeth.  I do not consider what is happening in Massachusettes as any sort of anomoly, instead, it bears witness to a similar mentality of dentists in the UK, who are refusing to treat patients with advanced dental problems ( See 'Dentists refuse to treat bad teeth,' May 27, 2007 article from the UK's Sunday Times ).  Their logic being that they get paid the same per patient whether they do thirty minute's worth of work or two hour's worth.  Frankly, I don't blame them, and this is the situaton we are going to find if the U.S. if we keep pushing for a universal health care entitlement program. California is no different, by the way, according to one caller who can't find a dentist willing to take her 19-year-old under that state's health care program.

This country is flat-broke and we are digging ourselves deeper into debt every day - there simply is no money available for such a program ( Read this short article about the deception the current Congress and Bush Administraton is laying out for YOU about our country's indebtedness... ) and I really don't think the answer is more available private insurance either.  I believe that between federal, state and local governments, the pharmeceuticals and private insurance corporations you have the pure root cause of astronomical health care costs beyond the reach of the average Joe and the decline in the quality of health care in the United States.  Your doctors are, in large part, bound by the tenets of those who hold the purse strings. On the other hand, and often is the case, the professions know how to work the system and the extent of your treatment may well depend on your insurance payout.  So we have gone full circle.

I spoke with two doctors since setting up this article on the OraMedia site.  Each told me that they much preferred working with the patient who took a personal interest in their health in such a way that they would willingly make the necessary responsible changes in their own lifestyles to prevent the unhealthy conditions from reoccurring or worsening.  Both told me that, in the vast majority cases, it would be the cash-paying patent - someone who considered the doctor's time and knowledge more valuable because their hard-earned money was coming directly out of their pockets for the services - who would be most likely to make that effort.  The 'entitled' patients were always less likely to assume that personal responsiblity.  That's just an observation relayed by two professionals, so please hold the flaming email.

This web site is about dental self sufficiency, or self reliance.  I don't know if that is ever really 100% acheivable, but it is much more acheivable when people learn and understand the science and methodology of the proper care and maintenance of the oral cavity, and a lot less expensive as many are finding, I might add.  With this in mind, I think that as a country, our money is better spent through general education (high school grads who have a minimum of real 12th grade educations) and better health education, going beyond the proper use of a condom.  After all, it's YOUR time, YOUR money and YOUR health and NO ONE can do a better job of those commodities like YOU.

Tom