Dental Tribune India Issue

Dentaltribune|July-September, 2010 news & Opinion 3 Dr Ronald L. Tankersley The health-care reform bill re- cently approved by the US Con- gress aims to improve access to health care for over 30 million Americans. However, dental groups say that the legislation significantly neglects oral health. Dental Tribune Group Editor Daniel Zimmermann spoke with Dr Ronald L. Tankersley, President of the American Dental Association, about the historic decision and its effect on dentistry in the US. Daniel Zimmermann: The American Dental Association did not support the health-care reform bill recently approved by Congress. Could you explain the rationale for your decision? Dr Ronald L. Tankersley: As America’s leading advocate for oral health, our decision was pri- marily based on the oral-health provisions of the bill. We could not support the health-care re- form legislation because it does not include provisions to mean- ingfully improve access to dental care for millions of American children, adults and elderly by properly funding Medicaid dental services. You say that the reform does not do enough to assure that low- income families receive adequ- ate oral health care. On the other hand, millions of people will fin- ally be able to buy health insur- ance regardless of their social status or pre-existing medical conditions. While countless other groups can weigh in on the health-care reform’s overall merits & flaws, people look to the ADA for a determination of its effect on oral health care. And when the government is willing to spend close to a trillion dollars over the next ten years, but not spend a dime on improving access to Medicaid dental services for those most in need, somebody has to raise an objection. If we didn’t do that now, how could we expect lawmakers to take our concerns seriously in the future? That was the basis of our decision. You have also rejected the idea of workforce pilot programmes. Could you tell us the reason for this? The ADA’s opposition to the alternative dental models pilot programme was limited and based upon our long-held belief that certain surgical procedures must be performed only by lice- nsed dentists. The big losers of this reform are going to be the insurance com- panies. What effect do you think the reform will have on the dental profession itself? Although the ADA could not support the final legislation, we did recognise that it contained many worthwhile provisions pertaining to oral health. These included increased funding for public-health infrastructure (in- cluding Centers for Disease Control and Prevention progra- mmes), additional funding for school-based health-centre faci- lities and Federally Qualified Health Centers. We also recog- nised increased Title VII grant programme opportunities for general, paediatric or public- health dentists and funding for the National Health Services Corps loan repayment progra- mmes. These provisions, which the ADA supported and lobbied for, will have a measurable, beneficial effect on dentistry and dental patients. In your opinion, what should be changed in the reform bill to make it feasible for dentists and advance patient care? When it comes to improving access to oral health care, our message remains: fund Medi- caid, the Children’s Health Insu- rance Program and other dental public health programs suffi- ciently. These programmes are only capable of fulfilling their roles if they receive adequate funding. Many states spend less than 0.5 per cent of their Medicaid dollars on dental care—an astonishingly low rate, considering the impor- tance of oral health to overall health. Further, poor dental reimbursement rates paid to dentists mean that many of them can’t participate in Medicaid, which is one of the reasons that many states fail to provide oral health care for even half of their eligible children. The federal government can and must do more to ensure states are able to come up with their share of these benefits. Republicans and other interest groups have announced that they will oppose the reform bill. Where will you position yourself once the law has come into effect? The ADA will continue to lobby for improvements to Medicaid dental benefits and will be watc- hing closely as federal agencies implement provisions of the law. We want to ensure that the provisions we support are car- ried out correctly, and will work to change the provisions we oppose. Thank you very much for the interview. DT “HC reform legislation … does not include provisions to meaningfully improve access to dental care” An interview with Dr Ronald L. Tankersley, President of the ADA