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Meeting with policymakers

Dental students, dentists: Debt affects job prospects, families, communities

April 10, 2017

By Kimber Solana


Making their voices heard: From left, Tufts University dental student Evanthia Vranas, New York University dental student Katie Rothas,  Southern Illinois University dental student Margaree Lachowiez and Dr. Barbara L. Mousel, Illinois State Dental Society president-elect, smile for a photo inside the congressional office of Rep. Peter Roskam, R-Ill. following a meeting with the representative’s staff during the 2017 ADA Dentist and Student Lobby Day.
Washington — Sitting across from a legislative assistant of Rep. Peter Roskam, R-Ill., dental student Margaree Lachowiez revealed how much debt she already has from dental school — $117,000 in two years.
    
"I'm projected to be just below the average debt of about $262,000 by the time I graduate," said Ms. Lachowiez, of Southern Illinios University School of Dental Medicine. "And that's not nearly the amount some of my colleagues take out."

Joining Ms. Lachowiez, Tufts University dental student Evanthia Vranas, of Naperville, Illinois, said her family would spend about $340,000 for her dental education. And sitting between them, New York University dental student Katie Rothas will graduate spending close to a half a million dollars.
    
"I didn't get in to any schools in Illinois," said Ms. Rothas, of Chicago. "I had to go where I got in to pursue dentistry, which was New York University — one of the most expensive dental schools in the country and in one of the most expensive cities to live in."
    
To help ease the burden, Ms. Rothas said her parents had to take out from their retirement fund to pay for her living expenses. The tuition of about $86,000 year, however, will come from loans.
    
"They tell me, 'You better be making a lot of money because we'll be living for a while,'" Ms. Rothas said, smiling.
    
But in seriousness, this level of debt ultimately affects graduating dental students' decisions on where to practice, job prospects and, ultimately their communities and the residents of their home state, said Dr. Barbara L. Mousel, president-elect of the Illinois State Dental Society.

The four Illinois residents' visit in Rep. Roskam's office was just one of 400 meetings on March 28 as close to 1,000 dentists and dental students visited their representatives' and senators' offices on Capitol Hill for the ADA Dentist and Student Lobby Day.

Their goal during the March 26-28 effort was to speak out on three issues important to the oral health profession and patients: repeal of the McCarran-Ferguson antitrust exemption, health care reform and student debt issues.


Lobby Day 2017: From left, Dr. Ricardo Kimbers, University of Maryland dental students Steve Feldman and Kyle Norwood, Dr. George Shepley, dental students Lucy Johnson and Alexandra Fitzgerald, Rep. Jamie Raskin, D-Md., Dr. Ed Morris, Boston University dental student Mohit Garg and University of Maryland dental student Aaron Tadayon pose for a group photo after meeting with Rep. Raskin during the 2017 ADA Dentist and Student Lobby Day. Close to 1,000 dentists and dental students visited about 400 congressional offices on Capitol during the event. Photo by Alexandria Fitzgerald/American Student Dental Association
The event occurred just two days after the American Health Care Act — the proposed bill to replace the Affordable Care Act — was withdrawn after it didn't garner enough support in the House. Knowing health care reform will remain a political issue for years to come, attendees sought to ensure policymakers' support continued access to oral health services when considering reforms to Medicaid and the ACA.

Lobby Day also came just four days after the House of Representatives on March 22 voted 416-7 in favor of repealing the McCarran-Ferguson antitrust exemption for health insurance companies by passing H.R. 372, the Competitive Health Insurance Reform Act of 2017. Dr. Mousel and the students thanked Rep. Roskam's staff for the representative's support and vote. The legislation now goes to the Senate.

However, student loans dominated the conversations as dental students, and many of the experienced attendees, advocated for more loan repayment programs, refinancing opportunities and lower interest rates on loans.

"When we met with dentists while preparing to lobby, most of them haven't paid off their student loans," said Ms. Vranas, a first-year dental student. "And they've been out of dental school from 10 to 30 years."

The group's meeting in Rep. Roskam's office lasted no more than 20 minutes.

But for the students and Dr. Mousel, it was enough to be able to share their personal stories and concerns to their elected representative.

"I thought his [Rep. Roskam's] staff person was knowledgeable on the issues and it was good to meet in a quiet atmosphere," Dr. Mousel said. "And the three students with me made very important points."


Student debt: Rep. Tom O’Halleran, D-Ariz., left, speak with A.T. Still University dental student Andy Larkin and Midwestern University College of Dental Medicine-Arizona dental student Jeremiah Gossett regarding student loans during the 2017 ADA Dentist and Student Lobby Day. Photo by Jeremiah Gossett/American Student Dental Association
For Ms. Rothas, she pursued dentistry because she wanted to help the underserved in the Hispanic population, with the goal of working in a federally qualified health care clinic.

"No matter your socioeconomic status, race or where you live, everyone deserves a healthy and happy mouth and a beautiful smile," she said. "Having this debt is a huge barrier on what you want to do with the profession versus what you end up doing."

Illinois ranks last in Medicaid reimbursement rates, Dr. Mousel said during the meeting.

"Even if they want to treat the underserved population, low reimbursement rates make that nearly impossible because of debt," she said.

Before they left, they gave Rep. Roskam's staff worksheets outlining the three issues they came to discuss, thanked them for their time, and it was on to the next meeting.

The three dental students walked north across the Capitol to the Senate office buildings to meet with the staff of Sen. Tammy Duckworth, D-Ill. They were joined by another dozen dental students and practicing dentists.

This was the first year that the ADA held its annual advocacy conference — formerly called the Washington Leadership Conference — with the American Student Dental Association's lobbying event.

Dr. Mousel, who has lobbied on Capitol Hill for the past four years, thought the energy level was much higher this year, thanks to the interactions between the dental students and dentists.

"Joining the ADA event this year sort of gave us a bit more gravity," added Ms. Lachowiez, who attended ASDA's lobbying event last year. "Dental students and dentists from different stages in life were able to speak about the same piece of legislation. We hope that made a big impact."

The three dental students and Dr. Mousel said they hope other students and dentists join them next year — not only to help learn more about the legislative process but also to help legislators better understand a proposed legislation's impact on their constituents.

"Nothing changes overnight," said Ms. Vranas. "But as voters, we have the ability and power to promote change that affect our future."

Next year's ADA Dentist and Student Lobby Day will be held April 8-10, 2018. For more information on the event, visit ADA.org/LobbyDay.