Newsletter article - 1996

FIRST OPTION FOR DENTAL INSURANCE

Regular readers of our newsletters will know that we have campaigned for a long time to have our patients maintain their traditional relationships with our office by retaining their "fee for service" dental plans. We have educated them that some of the newer varieties of insurance such as HMO's and PPO's have certain drawbacks to them which include:

1. Inability to choose from any dentist or specialist, but rather, only go to a dentist whose name is on the company's list of "preferred providers."

2. A significant drop in the quality of care which our patients have come to expect.

3. Long waits for treatment due to the needs of these providers to treat more patients at lower fees to maintain their incomes, and to ration their care.

We recently treated a new patient to our practice who was referred by her father. She had a tremendous cavity in a molar, which required root canal therapy. On her health history she stated that she always went to the dentist every six months. When she was asked why the dentist didn't' treat the tooth years ago, she said, "He always would ask if the tooth bothered me, and I would say, "Sometimes". His response was "Try and put up with it!""

A recent article in the American Dental Association News highlighted the experiences of a four-dentist group in Bordentown which had experimented with adding "managed-care" for its patients. They found that they could not afford to treat patients at the fee levels dictated by the HMO's. They met with executives of the company to see whether there was any way to become more profitable, whose responses all centered around dropping the level of quality. Instead, the Bordentown dentists dropped the HMO.

Anyone watching TV nowadays knows how much money companies like US Healthcare and HMO Blue are paying for advertising. The insurance companies are making money, and shortchanging their enrollees and their healthcare providers. Managed Care often turns into nothing more than Managed Neglect.

As a consequence of the perceived need for a truly quality-oriented managed care entity in the state of New Jersey, doctors in the state have organized FIRST OPTION. It is a healthcare plan which combines the best aspects of fee-for-service and managed care, and hopes to be a beneficial option for all three corners of the healthcare triangle (providers, patients, and company). As a staff member at West Jersey Hospital, Dr. Markus has been given the option of joining this organization.

We often are asked by patients to help them sort through all their insurance options to help them determine which dental insurance policy is best for them. Before you make a decision for yourself based on what your out-of-pocket contribution is, please consult with us to determine how much more you stand to lose by choosing a plan which cares more about the quality of their television advertisements, and, not a whit about the quality of treatment.

If you are aware that your employer is "shopping" for dental insurance, please feel free to contact us. We will be happy the have someone from the American Dental Association counsel them to make the right decisions.