by Carol Tekavec, RDH
While it is impossible to accurately predict what the future holds for dental consumers (our patients), we can identify some trends and facts:
- Employees will be paying more toward their health benefits. According to an industry expert at a recent dental meeting, the average monthly contribution by workers for all health benefits was $122 in 1996 and $138 in 2000.
- Government-mandated benefits, such as chiropractic, minimum-stay maternity, and alcohol-abuse treatment (and many others), have increased costs of health insurance by as much as 30 percent.
- A general economic slowdown plus rising premium costs are giving rise to a proliferation of "defined contribution" plans, where an employee has an allowance of funds and makes choices of where to invest. These are replacing "defined benefit" plans, where actual benefits are detailed. Other choices often include vision care, prescription coverage, dental care, long-term nursing care, etc.
- An ADA poll in 2000 showed that a lack of insurance coverage was the top reason for not visiting the dentist.
- In an international marketplace, American companies often face higher costs for employee benefits than foreign companies. If increasing costs continue, benefits may be cut.
- The Health Insurance Association of America prescription drug data shows that costs are likely to increase as much as 18 percent per year for the next several years.
With patients being increasingly more responsible for choosing their benefits, how will dental coverage fare? What chance does dentistry have against prescription drug coverage, one of the most highly publicized and desired coverage choices available? What about long-term care and our generally aging population?
Since dental benefits appear to be so crucial, what might organized dentistry and private dentists do to increase awareness of dental treatments and the desirability of dental benefits?
- Organized dentistry may want to consider extensive education and marketing (advertising) of dental treatments directly to consumers. Pharmaceutical companies have seen a great increase in the demand for their products when marketing has targeted consumers rather than physicians. Patients request drugs by name when visiting their physicians. If consumers were as aware of tooth-colored restorations and periodontal treatments as they are aware of prescription allergy medications, demand for these treatments would increase.
- Organized dentistry and third-party payers have much to gain by working together to stimulate interest in dental care. The traditional adversarial relationship is not conducive to increasing awareness and demand for treatment. Lack of insurance affects the dentist, the patient, and the insurer. If consumers do not choose dental benefits, they will not receive the care they need, which adversely affects their health; dental plans will not be sold as frequently, which adversely affects the dental insurance industry.
The possible elimination or reduction in benefits of dental plans will also affect dentists who have already decided to practice "insurance-free." While patients may have been agreeable to a gradual change from having dental offices file their claims to filing claims on their own, benefits were still helping to cover the bills. If patient benefits are greatly reduced or eliminated, treatment visits will likely decline.
Carol Tekavec, RDH, is the author of a new insurance-coding manual, co-designer of a dental chart, and a national lecturer with the ADA Seminar Series. Contact her at (800) 548-2164 or visit her Web site at www.steppingstonetosuccess.com.