Tuesday, May 27, 2014

Advocacy in Dentistry - ADA Storms Capitol Hill - Washington, DC

United States Capitol at Sunrise

I was honored to be part of a delegation that went to Washington DC to provide dental care advocacy on behalf of the Colorado Dental Association and the American Dental Association.  We had a chance to meet with most of our Colorado legislators in person and if they were unable to meet with us personally, they had their health care staff expert meet with us.

This year we had three issues to bring forth.  The first was a reform on student loans hoping to get a reduction in interest and an increased tax deduction.  This is for everyone with student loans, not just dentists.  An interesting stat - Americans collectively owe $1.1 trillion dollars in student loans, much of it subsidized by the government.  It is quickly approaching the amount of money that we owe China ($1.4 trillion).   Congressman Paul Gozar, DDS (R-AZ) calls this a bandaid, a good start - but not a comprehensive solution.  The cost to go to college/graduate school must evolve as it is unsustainable.  Dentistry is the costliest of the professions to train and it is not unheard of for a dental student to finish with a $500,000 student loan debt.  This is a 30 year mortgage, not a student loan.

The second issue we discussed was an ask for grant money to help start initiatives that will serve those in need.  These grants will help states with initiatives such as "Give Kids a Smile", "Missions of Mercy" and community coordinators that will help people find a dentist via emergency room referrals, nursing homes, schools, etc.  The legislators asked where is the money going to come from.  We call this designated grant money an investment, not a cost.

For example, in Colorado - we have an event called Colorado Mission of Mercy (COMOM). COMOM is a 2 day event where dental professionals set up a temporary dental clinic in a big way.  Over a thousand patients are treated for free over the course of the event.  All of us bring our own dental tools and supplies and treat what is needed.  The cost to put on a COMOM is $160,000.  The amount of dentistry given to the community over a $1,000,000. This is money that won't have to come from government benefits such as medicaid.  The next COMOM is in October in Henderson, CO.

The third issue was a letter initiated by Rep. Paul Gosar, DDS (R-AZ) that we want our legislators to join in and sign.  This letter asked the Center for Medicaid and Medicare services to improve the fairness and transparency of Medicaid recovery auditors and their review process.  We believe that audits of medicaid providers should be done to catch providers trying to beat the system, but not on those that are doing their best to serve those in the community in need.

Currently, in some states, the process is "guilty until proven innocent" with very little opportunity for the provider to have any recourse to defend him/herself. It is difficult for dentists to want to join up to become medicaid providers when these type of audits are in place.

We also had a variety of speakers give us the current state of the political climate in Washington.  There is less than 40 legislative days left in session and due to stalemate political party posturing, they predict that very little legislation of any significance will get done.  Sad that this is the case.....

One of the best speakers was Rep. Peter Roskam (R-IL).  He was preaching to the choir when he said that the Affordable Care Act cannot put a price tag on caring for our patients.  He predicts that the "commoditization of health care" is going to drive down the opportunity for us to truly care about our patients.  I am doing everything in my practice to not let this happen.  I hope my colleagues will too.

A big revelation was how important our political action committees (PAC's) are.  Both ADPAC (national) and CODPAC (Colorado) raise funds to advocate to keep dentistry a profession of relevance.  This year alone, these PAC's have allowed us to spend time with our legislators to explain our needs so we can provide the best dentistry and services to our communities that we serve.