Is Congress Losing Sight of the Potential Implications to American Health Care?
Sep 13, 2009 - 12:16:49 AM
(HealthNewsDigest.com) - The President asked and answered during his primetime news conference how the proposed health care reform packages will benefit all Americans. While we applaud the basic ideas driving this process, we are concerned that the current House Tri-Committee proposal will cause significant disruptions in families’ self-directed, ancillary healthcare coverage -- dental and vision – potentially causing millions of Americans to go without quality services and care.
In today’s market, 99 percent of all dental and vision benefits are provided separately from medical coverage as “stand-alone plans.” Dental and vision insurance is designed and sold as separate policies by companies that specialize in these benefits. Under the current House Tri-Committee proposal, significant consequences to dental and vision coverage will take place. While we understand that the results may be unintended, they are severe nonetheless.
Covering the oral health care and vision needs of children is an important and worthwhile goal. With 72 percent of all employers offering dental and vision benefits as part of their benefit packages, 132 million Americans are now covered under family dental and vision policies. As can be seen, the private market is meeting a large part of the goal of insuring as many Americans as possible at the lowest cost possible. This number has steadily increased, and the number of Americans with dental coverage has nearly doubled over the past two decades, with similar increases in the vision industry.
Under the House bill, “qualified health plans” will be required to offer children’s oral and vision health services as part of the essential benefits package required in both the Exchange and the private market. Therefore, the 132 million Americans enrolled in family stand-alone dental and vision benefits will be forced to drop their current private coverage and be required to purchase their children’s dental or vision coverage through a medical insurer. While adult coverage in the legislation is still permitted to be sold in the private market, family coverage plans have proven most cost effective.
Eliminating private family vision and dental plans will increase costs and reduce choices for American families. Parents will have less incentive to continue their own dental and vision benefits once they are required to purchase dental and vision coverage for their children through their medical insurer. Parents that choose to maintain their dental and vision coverage will face the complications and added costs of having different family members enrolled in different benefit plans. More confusion does not translate into better care or better health for Americans.
The current proposal could have significant cost consequences for the medical delivery system. Dental and vision benefits play a critical role in improving the health of Americans and reducing the overall cost of chronic disease. With chronic disease representing 75 percent of the total U.S. spending on health care, few know that optometrists and dentists have the ability to detect symptoms of diseases such as diabetes, hypertension and heart disease, much earlier than primary care providers. Moreover, it is well established that Americans with dental and vision coverage are more likely to go to the dentist and optometrist or ophthalmologist for regular preventive care and obtain needed early treatment related to dental or optical conditions, as well as other chronic diseases which can be detected through these regular visits.
Medical plans that can be “qualified health plans” do not, for the most part, have the infrastructure to deliver dental and vision coverage. Under the proposed health care reform plan, to meet the essential and basic requirements of any health insurance offering and, at the same time offer “premium-plus” options, qualified health plans will have two alternatives – either build dental and vision capacity, including quickly establishing relationships with dentists and vision professionals and adding dental and vision providers to their networks, or subcontract their children’s dental and vision coverage. This will result in unnecessary administrative costs for the medical plans and increase dental and vision premiums outside this coverage as family coverage becomes unraveled.
Creating a new infrastructure for the delivery of dental and vision services will slow the implementation of health reform and add to its overall cost. Hundreds of dental and vision benefits plans already exist and are successfully serving millions of Americans’ needs. The proposed legislation should build on successful and proven efforts to efficiently provide dental and vision services.
The dental and vision community is anxious to work with Congress to address our concerns and to ensure that, as we expand medical coverage for Americans, we also build on what works in oral and optical health care.
For further information, click here: National Association of Dental Plans
For further information, click here: Vision Care for Life
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