Tuesday, May 24, 2011

Medicaid Study: Dentists Hesitate to Treat Children on Medicaid?

Dentists are hesitant to see children on Medicaid for an emergency dental appointment?

Dentists were less willing to see kids who needed an emergency appointment if they were covered by Medicaid than if they had private insurance in a new study based in Cook County, Illinois.

Even dental practices that were enrolled in the state's Medicaid and Children's Health Insurance Program were more willing to treat a kid with private insurance than one enrolled in the state's plan for low-income families according to the findings, which are published in Pediatrics.

"I believe it comes down to financial incentives and administrative burden," Nancy Maserejian, a researcher at New England Research Institutes in Watertown, Massachusetts told Reuters Health in an email.

"The amount of money dental practices get paid to do the same procedure is a lot less when Medicaid is reimbursing them," added Maserejian, who has studied access to dental care but was not involved in the current study.

It's very possible that for people on Medicaid, access to dentists varies widely on a state-by-state basis, researchers say, since each state has its own system of paying dentists for different procedures and its own reimbursement rates.
Well, Medicaid or called Denti-Cal in California is different in each state. Some states pay dentists better than others and some have less burdensome rules. In California if you are over the age of 21, most routine dental services are no longer paid.

But, what do you expect?

America continues to be a capitalist country and money paid for dental services rendered is the "invisible hand."
In economics, the invisible hand, also known as invisible hand of the market, is the term economists use to describe the self-regulating nature of the marketplace. This is a metaphor first coined by the economist Adam Smith in The Theory of Moral Sentiments, and used a total of three times in his writings. For Smith, the invisible hand was created by the conjunction of the forces of self-interest, competition, and supply and demand, which he noted as being capable of allocating resources in society
So, why is dentistry any different?

Most dental offices are small private businesses and if there is self-interest of the market to see these patients, then they do it. If not, then the patients will have to wait.

In this case, many of the offices that were contacted were not even enrolled in the Illinois Medicaid program, so the prospect of them being paid at all, may have been much lower. Again, the invisible hand at play. Dental offices are not constructed to operate at a financial loss.
Amy Martin, who has studied access to dental care at the University of South Carolina's Arnold School of Public Health, said that although access to care is a problem in many places, these results may not generalize to other parts of the country.

Cook County -- which includes the city of Chicago -- is an especially wealthy area with lots of residents covered by insurance, she said, meaning that dentists can get by just fine only treating patients with private insurance.

"There's little market motivation in Cook County to accept new patients who have Medicaid, while that might not be the case in a poor, rural county that depends on Medicaid patients to stay in business, Martin, who was not involved with the new research, told Reuters Health.
I think the hidden agenda with this piece was to demonize the big, bad rich dentists in not seeing poor patients on Medicaid. Please, don't get me started on that B.S..

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