San Jose Mercury News Editorial: “Obama promise could falter on eye, dental care”

Yesterday, the San Jose Mercury News ran an editorial on the potential impacts that healthcare reform could have on vision and dental benefits. Give it a read below. Got an opinion on this? Share it by leaving us a comment!

SJ Mercury News Editorial: Obama promise could falter on eye, dental care

A major health care reform promise by President Barack Obama is in danger of going down the drain without so much as a whimper from the White House.

Obama has said repeatedly that the government “is not going to make you change plans or your doctor under health reform.” But unless he or the Senate forces a change in legislation the House passed earlier this month, the parents of 40 million to 50 million children throughout the United States will see a disruption in the way their dental and vision benefits are administered — with little or no cost-benefit to the federal government.

A relatively obscure provision of the House bill would not impact adults, but it would force parents to buy children’s dental and vision insurance from medical insurers. That would mean the nearly 300,000 children in Santa Clara County who are insured through specialty carriers such as Delta Dental or VSP would have to switch to a medical carrier that may or may not permit their children to see their own dentist or eye doctor.

That may be good news for medical insurers looking to add revenues to beef up their bottom lines, or for a government hoping to simplify the insurance process. But it’s of no clear benefit to parents who use these services. General insurers haven’t done as good a job with dental and vision care, perhaps because the specialty carriers have done so well at filling the need.

The bill unveiled Wednesday by Senate Majority Leader Harry Reid, D-Nev., is better than the House plan, thanks to an amendment backed by Sen. Debbie Stabenow, D-Mich. The Senate bill allows families greater choice in the selection of dental plans, but it still would force parents to purchase vision care for their children from a medical carrier.

Stabenow has been pushing Reid to include an amendment that would allow families greater choice in the selection of plans. Obama needs to help her give Reid and the House a hard shove to ensure they end up with a good plan.

Quality dental and vision care is on par with general medical care in securing the overall health of children. An estimated one in 20 preschoolers and one in four school-age children have vision problems that, if left untreated, will impair their ability to perform in the classroom.

And it’s not just a matter of vision. Thorough eye exams by qualified doctors are one of the best ways to detect the onset of diabetes, a growing problem for American youths and a major contributor to skyrocketing health care costs.

Dental care is the most common unmet need for children. A 2004-05 study by the Dental Health Foundation found that almost two-thirds of California children have some form of dental disease by the time they’re in third grade. Nationwide, it’s estimated that children miss nearly 2 million school days every year because of dental problems.

It’s hard enough for parents to make sure their children get this care from the providers they’re comfortable with. Health care reform shouldn’t make it harder. Obama must intercede in the health care negotiations and fulfill his promise to Americans that “if you’re happy with your plan and your doctor, you stick with it.”

One Response

  1. Some thoughts that may lessen concerns or anxiety.

    1. Several years ago in California, the PERS (Public Employees Retirement System, the entity that negotiates health care plans and premiums for all active and retired California State employees) group requested or negotiated the separation of vision care medical care negotiations.

    2. Thus become the “carve outs” where vision care entities had to independently negotiate with PERS. The benefit is the greater latitude that vision care entities could use to negotiate with PERS.

    3. Separately, there are HMO (mainly non-staff models) that will subcontract with vision care entities to offer vision care to their members. The HMOs know that their expertise lies in medical care and not vision care and have not ventured by themselves into this market.

    4. In summary, a reverse or “carve-in” process might occur where medical plans will subcontract with vision plans to offer vision benefits. The total sum might not be noticeable or obvious to the average subscriber or beneficiary but may impact the choices or the latitude of company procedures that can be delivered to vision care patients.

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