Letters: Closed panel dental benefits
May 18, 2015
I applaud the ADA in its market research by the Health Policy Institute. They have been a great resource for the membership, and they have been very responsive to my inquiries as a member of the ADA. But we, ADA leaders, are missing the bigger picture — access to care with closed panel insurance — freedom to choose someone from the short list. We need to save the fee-for-service general dentist. Where have all the children gone? The Health Policy Institute states that there are more options for pediatric patients because of embedded pediatric benefits in medical policies.
What is missing from this article is the statement that most of these "embedded pediatric benefits" are restricted by only being allowed to have coverage by in-network dentists. The pediatric dentists seem to be thriving in this environment.
As a practicing fee-for-service general dentist, I am seeing fewer and fewer children. I have always seen children in my 25 years of practice.
Some of this is due to new parents taking their children to pediatric dentists and parents who are forced to use in-network dentists or encouraged by their insurance plan to use in-network dentists. Now, we can't make third-party payers change their benefit books, but the ADA can fight to limit closed panel plans as it relates to access to care.
So we have insurance benefits for children for a small group of in-network dentists; how do closed panel dental benefits help society with access to care? The bottom line is that it doesn't.
The ADA needs to fight to keep these plans open so that patients are free to choose their family dentist and not be herded like cattle into closed panel insurance plans.
I need "my ADA" to step up and protect the ability of the solo general dentist to practice dentistry. Or is this the end of solo general dentist practice?
Victor Gregory, D.M.D.