To understand the industry's view of healthcare legislation, it's
important to understand a few facts about dental benefits, based on
years of actuarial and administrative experience in the dental benefits
Five points underlie our "dental perspective" on proposed legislation:
- Dental health is an integral part of overall health, and
dental benefits are an integral part of dental health. Oral health has
improved dramatically over the last three decades due largely to better
access to affordable dental care.
- Better access to affordable dental care is primarily due to
the tremendous growth of both employer-and government-sponsored dental
programs. Such programs -- including UCR, HMO and PPO dental delivery
models -- are already cost-efficient, consumer-oriented and effectively
administered under current regulations.
- Despite the success of dental benefits in promoting oral
health, there are still many Californians who lack coverage because
their employers do not offer it. Many Californians only recently
obtained such benefits due to the recent availability of lower cost,
dental HMO and PPO programs and enrollee-paid voluntary programs.
- Legislative proposals that significantly increase the cost to
administer dental programs have the unintended effect of reducing the
number of Californians with dental coverage, thereby limiting access to
affordable dental care and diminishing oral health throughout the state.
- Free market forces properly dictate the fee and
reimbursement arrangements negotiated under various delivery models
between dental carriers and dental professionals. Dental carriers must
be encouraged -- not hindered -- in their efforts to define and enforce
their fee arrangements and dental policies to ensure necessary and
appropriate care is delivered in accordance with group contracts and
high professional standards.