Monday, December 2, 2019

It’s Time For Health Insurance To Pay For Dental Care

 


The article quoted today could be a very slippery slope.  While I agree that dental care needs to be covered better by health insurance, I’m not sure that including it as *part* of health insurance is a good idea.  One of the biggest complaints is that the $1000-1500 deductible on today’s dental policies are the same maximum amount that was covered in the 1960s… and of course the costs of that treatment are no where near what they were back them.  The problem becomes that reimbursement of healthcare by insurance in the medical model is not what it should be either.  I don’t know that I want my treatment mixed in with all of the other aspects of the healthcare system.  How about just increasing the yearly maximums to what they would be adjusted for inflation?

Be that as it may, author Peter Ubel has a good point in his article.  You can read it in its entirety here.

Last time I checked, the mouth was still part of the human body. If I remember correctly, when people experience mouth problems, they ache just as much (often more) than if they experienced problems elsewhere in their bodies. So why do we still treat care of the mouth differently than other types of medical care? Why will my health insurer reimburse the cost of my annual physical but not the price of an annual dental check-up?

The insanity has to stop.

I am ranting on this topic today in part because of a study in the United Kingdom that demonstrates the tight connection between oral health and more general health. This study was focused on people with diabetes who also suffered from periodontitis—for what us non-dentists call “gum disease.” The researchers randomized people to usual care versus intensive periodontal treatment. Those receiving the more intensive dental care not only had better oral health at the end of study, they also had better diabetes control, as measured by a blood test called the A1C; the higher your blood sugar, the greater your A1C. A year into the trial:

Control patients:                                            A1C = 8.3%
People receiving intensive dental care:        A1C = 7.8%

Good dental care is part of good medical care. Because of a historical accident involving power struggles between physicians and dentists, health care insurance in the United States has not typically included dental care. That is a mistake. People deserve robust coverage for all their basic medical needs, including oral health.

Right now, it is easy for a physician to increase the dose of diabetes medications for their patients and expect decent insurance coverage for those treatments. But we could reduce the need for those expensive medicines if we just gave people better dental care. It is insane to pay to treat people’s diabetes while refusing to pay for dental care that will reduce the severity of that illness.

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