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Tuesday
May102011

« Communicate With Your Patients - Mark L. DiRe DDS »

The uprising in our dental community regarding WDS is warranted. In my opinion the solutions are doomed to failure. Our best solution, I believe is our patients. We all need to be square with our patients about the upcoming risks to both of us. We all have patients who are employees, managers and decision makers with companies throughout Washington State. They need to hear from us!

Dentists have been supportive advocates of dental plans written by WDS for the simple reason that the essence of the company was to encourage and support dental health while supporting the concepts of freedom of choice and the economics of private practice. WDS has abandoned this commitment to both of us.

Dental insurance is an employee benefit that is under fire. Employee centric companies have seen their generous commitment to a health care package undermined by economic pressures and run away medical premium costs. We understand. Small businesses like dentistry have all been impacted (we must pay the medical premiums too!). Employees (patients) have been impacted. We understand; and have held the line on increases in fees. This in turn has impacted our employee’s income and our investments in patient care. The cost of doing business does not go down. We understand that too.

Effective health care is a result of commitment. Patients take responsibility for their health by seeking professional services and following through on recommended care. Providers take responsibility to provide an ethical assessment, a sound care plan and high quality treatment. So what commitment is needed from the insurance carrier? We all know that this very question has been under intense debate and scrutiny from all quarters. The insurance industry pleads poverty while they post obscene profits. They demand double digit increases in premiums while decreasing benefits. They shroud coverage in cloaks of verbiage and spinning numbers. Their commitment is obvious.

What has changed? WDS is no longer offering their best plan to employers! Their PREMIER plan was the plan WDS and the best companies in the Northwest were proud to offer to their employees. It is THE alternative to Networked PPO plans. In the State of Washington 90% of the dentists are providing members under the WDS PREMIER PLAN, but only a small percentage are providers under their PPO plans . So with the clout of a big insurer, they are forcing us either into the PPO plans or out of their network. Their choice is to abandon their founding principles, abandon the dental community that has supported them financially and philosophically, and abandon the employee patients who counted on them to offer real health care over profits.

Why are they doing this? Making obscene profits is easy with dental insurance. The entire plan consists of limits and exclusions to care. The risks are limited the usage is predictably low and the language is confusing. The perfect storm for profits! Why do you think that all of the medical insurers are now offering dental plans? The only variable is provider fees. Individual Dentists in the state of Washington have consistently acted responsibly by maintaining fees close to the rate of inflation (3-5%) for decades. An ongoing survey of actual provider fees was used to determine benefits for services for the PREMIRE PLANS. Their PPO plans will cut legitimate fees, reducing them to fees charged in 1999! This creates more profits and only a slightly lower premium to employers. Double digit Premium Inflation is a result of irresponsible fee inflation by Medical service corporations hospitals, large medical groups and insurance companies. Responsible dental fees are not responsible for increases in dental insurance premiums to employers.

Preferred Provider Organizations (PPO networks) are commonplace. They are designed to restrict access to care, freedom of choice, treatment and fees. You encounter them everywhere in medicine. Insurance companies control the patient pools which allows them to control the flow of treatment and money. Providers can choose to lose money or lose patients. The large medical corporations make up losses by overcharging other patients. Fees for services have become a meaningless dance between those that have power (patient pools and money) and the powerless (individuals without insurance). Dentistry is now going through the same dance. The problem here is that we are not large wealthy corporations. The small business dental office is ill-equipped to dance with the wealthy powerful insurance companies.

This is not about dental fees being out of line, this is all about taking advantage. The CEO of WDS said on King 5 News that dentists need to be more efficient. He makes $1.5 million a year! Haven’t we all had enough of these pompous corporate CEO’s spouting sacrifice and efficiency while walking away with Millions of dollars? This all about large companies using fear (loss of jobs or loss of benefits) in the local economic market to shift the economic burden from them to individuals and small businesses. This is about taking advantage of a health delivery system that is working for the participants and abandoning it.

We genuinely care for each and every patient. Their health is important to us. That is why we are in this profession. We do our best to offer the best care we can. But we cannot continue to spend more than we earn (we are not government). Washington Dental Service is not beholding to us or our patients, they only answer to the people who write their checks.

Patients can make the difference! If they voice their concerns about freedom of choice, access and exclusions to care to their fellow employees, benefits managers, and company executives, they can make the difference. The existing PREMIER PLAN allows employers, patients and dentists, freedom of choice and a fair assessment of responsible fees for dental services.

-Mark L. DiRe DDS
Bellevue, WA