You don't know what you've got till it's gone?

 

Don't it always seem to go that you don't know what you got 'til it's gone. These words from the Joni Mitchell song "big yellow taxi" may prove prophetic if Congress passes the new proposed expansion of the new Medicare bill to include dental. If this bill is passed and not carefully thought out it could cause a problem for many elderly patients, who may expect a continued high standard of dental care. If this bill is passed, many dentists may choose not to participate, retire or sell their practices to more business oriented corporate entities. 

Many private dental office have significant fixed overhead expenses that are often exceeding 70% of their collections and if dentistry is added to our medicare benefits, the deeply discounted fees that medicare may allow will discourage many dentists from participating.  If they choose to participate, they may change their operating procedures, in order to greatly increase the number of patients seen. Either way this may not be the type of personalize dental care that Medicare recipients currently enjoy. 

For less affluent seniors this legislation might possibly actually improve their access to dental care, but it certainly won't be an improvement for their more affluent peers. That is why many dentists advocate making dental benefits available to those who really will benefit and need it, but not to all those over 65 since many do not really need this type of government assistance or interference with their regular care.

When I speak with my elderly patients, most are happy with the type of care they receive at our office. They like that they can call and speak with Ida my office manager about any concerns, without being placed on an endless hold and can get appointments with us usually the same week that they call. If they need to speak to me, I will talk to them the same day they call . 

Many of our seniors are frustrated with the changes to our medical care system that tend to distance them from their physicians. Speaking to their doctor, without an appointment, can be difficult and their physicians are often employees of hospital based practices that are managed by for profit hospitals. If the new proposal to include dentistry in standard medicare part B, this may push dentistry further in this direction since it will become even harder for single dental practitioners to maintain their own private dental office.