By the time you read this edition
of the Capital Star, we might know more about HB 3200, but then again perhaps
not since Congress is in summer recess for all of August. This thousand plus page bill is the proposed
government health plan. The question is, how would this affect dentists? The general consensus is that no one has read
the bill!
I looked on the Dentaltown
website, http://www.dentaltown.com./
to see if anyone was talking about this and found a thread entitled “Are
Dentists Included in the 1000 Plus Pages of National Health Insurance proposal
being voted on in the House?” There is lively discussion about the bill and the
dental implications.
I downloaded the pdf of the bill
and did a search for anything dental.
http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h3200ih.txt.pdf
What I found is a provision to subsidize training for dental professionals to
serve “underserved and vulnerable populations”. SEC. 799C. FUNDING THROUGH PUBLIC
HEALTH INVESTMENT FUND specifies
appropriations year- by- year until 2019 for just over $3 billion for this
initiative. As near as I can tell, the present form of the bill does not
specifically recommend any changes to the current delivery model of dentistry
in the US.
Others offering their opinions on
Dentaltown feel that since dental plans are piggy backed onto patients medical
plans, when employers...large or small... shop for their package of benefits,
more companies and employees will switch to a government plan and the incidence
of patients with dental insurance will greatly diminish. Some see this as not a
bad thing. One post offers the opinion
that, “it doesn’t matter if a person has benefits or not because only the
patients that are motivated are the ones that enjoy regular preventive care”.
He continues to make the point that a significant portion of those that now
have coverage let their benefits go to waste due to non-utilization and the
less that have insurance will eliminate waste in the system.
Another opinion is that, “a
certain percentage of our patients will just stay away from our offices due to
the financial considerations of having to pay for their routine preventive care
out of their very highly taxed pockets”.
One Florida dentist stated that,
“one thing is certain... I will absolutely close my doors the day government
tells me I must see entitlement patients. I'll walk away that day and let
everything go into default. I promise”.
Sounds dramatic and some might actually walk away from patient care, but
the reality is that most of us need to work and have bills and obligations just
like others. We are not all rich doctors as perceived by politicians and
patients.
Many feel that it will be
difficult to fund an extensive overhaul of the healthcare system. One “Townie” (what regulars on Dentaltown
call themselves) states that, “the plan cannot be sustained financially
without taxing the middle class. It is going to be apparent to them (the
middle class) soon and they will turn on themselves. It is already
happening. I'd like to suggest that Dentistry offers a good example for the
medical health care reform problem. Every day, dentists and patients have
meaningful discussions about the care that is going to be given and received,
the actual cost and who is going to pay for it. This is something that
is completely lacking in medical care since doctors and patients are so
far removed from the cost and payment issue. There is no incentive for doctors
and patients to really care that much about how much the treatment is going to
cost.... ergo, costs spiral out of control.”
Included in HB 3200 is a section
delineating employer requirements. Essentially, one may choose to offer
coverage, contribute toward coverage, or contribute in lieu of coverage for
employees and their dependents. The way I read it, this only applies to
businesses with an annual payroll of more than $400,000. There is also a
mention of a tax on individuals without “acceptable” health care coverage of
2.5% of adjusted gross income.
Certainly, there will be many
changes by the time the House passes it and more when the Senate version is
presented. Then the final bill will come out of a conference committee. If the
profession of dentistry is not being consulted for its input, why not? We as
health care professionals are affected in many ways by whatever happens since
we are in a unique position of being care providers, small business owners, and
employers. The way we deliver care or what we charge is likely to change, as
business owners, we will be expected to pay taxes to support the program, and
as employers, we are expected to provide “acceptable” health care coverage to
our employees and their dependents.
The general consensus at this point is that
little is known about what this bill actually contains. I’ve looked at pieces
of it and the language, references, and subsections are bewildering to say the
least. You have the link so you can go look at HR 3200 and be better informed.
Stay tuned- your future depends on it!
Officers 2009-2010
Dr. Eric Hollander, President
Dr. Jeffery Brunson, Pres-Elect
Dr. Tom Wicheta, Secretary
Dr. Misty James, Treasurer
Dr. Jackie Vo, Member-At-Large
Dr. Stan LaCroix, Past President
Dr. Kavin Kelp, Editor
Dr. David Reeves, Webmaster
Nancy Nisbett, Executive Director
