Public Policy Options for Better Dental Health Report of a Study (1980) / Chapter Skim
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Appendix 2. Individual Committee Members' Comments on the Report
Appendix 2. Individual Committee Members' Comments on the Report
Pages 139-152
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From page 139... ...
To exclude preventive services for children and adolescents from the practice of dentistry under a national plan would have unfortunate consequences It would use the power of funding mechanisms to reorient dental practice away from the current emphasis on prevention in which the profession takes justifiable pride. In the presence of a school based preventive program, patients should be provided the choice of receiving preventive services from dentists in the community.
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From page 140... ...
Lawrence Kerr, D.D.S. President, American Dental Association Private Practitioner Harold Hillenbrand, D.D.S Executive Director Emeritus American Dental Association 2-2 *
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From page 141... ...
Professor of Economics and Public Affairs Princeton University Thanks mainly to the untiring efforts of the committee's staff, led by Chester Douglass, and to the patient and able chairing of the committee by Dorothy Rice, this report now stands as a solid contribution to policy analysis in the area of dental care. I concur in the findings of the report and endorse its recommendations as far as they go.
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From page 142... ...
After assuring themselves on the issue of quality, the consumers' essential next question is what impact the new type of manpower will have on the prices of health services. Another way of looking at the matter is to inquire what set of economic lifestyles consumers are willing to support by their use of health services: predominantly the elevated economic lifestyles of physicians and dentists, or relatively more of the less elevated lifestyles of lowerskilled health workers.
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From page 143... ...
This freedom of choice should be offered consumers at least so long as our society refuses to make dental care of homogeneous quality accessible to all citizens, regardless of ability to pay, perhaps through a comprehensive universal dental care program of the type adopted by some nations in Europe. Proposition 7 Current statutory restrictions on task delegation in dental care serve to enforce an economic structure that hampers the ability of market forces to constrain dental care prices and expenditures.
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From page 144... ...
The nine propositions suggest the following recommendations: Recommendation 1 Because the United States is unlikely soon to make adequate dental care available to all Americans through a national dental insurance or dental care plan, policymakers should critically review the existing statutes on licensure in dentistry and explore ways to make added dental services available at lower prices through bolder delegation of tasks from dentists ot non-dentists, especially to expanded-function dental auxiliaries and nurses. Recommendation 2 Because the cost savings from more extensive task delegation in dental care are more likely to flow through to consumers in a highly competitive market structure, every effort should be made to maintain and to heighten competitive pressures in the dental care market.
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From page 145... ...
After a decade of intense empirical research on health care markets, economists have come to the conclusion that for such routine primary care services competitive markets tend to work pretty much as would be predicted by classical economic theory. In the separately available amplification of these remarks, I begin with some exposition of the basic economics of health manpower substitution (Section II)
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From page 146... ...
However, although concurring, I feel that the recommendations are not strong enough. In essence, the data show that the two major dental diseases, caries and periodontal disease, are chronic diseases which affect the vast majority of the population.
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From page 147... ...
But it is not truly unrealistic to have a comprehensive national dental program now, even if composed of a variety of components. The nature of the two major dental diseases cries out for such a coordinated approach.
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From page 148... ...
The research literature which assesses the outcome of oral health status among populations covered by various types of nationally developed dental care delivery systems has not been comprehensively considered in this report. Policy issues raised in the volume, International Dental Care Delivery Systems (eds e J.I.
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From page 149... ...
This literature seems to parallel findings from-the study of the utilization of other ytpes of health services, reinforcing the strong relationship between the child's behavior and that of the mother or relevant "social others." While this literature was discussed in committee deliberation, its failure to be included in the Final Report is reflected in the committee's ultimate recommendations. A school-based preventive program for children which omits significant links to the family ignores one of the most prominent sets of findings emerging from the health services and social science literature of the past fifteen or more years.
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From page 150... ...
I am not against school-based programs, but I feel uncomfortable pulling out from all the possible policy options available only one organizational model existing internationally, ignoring essential and critical links to existing supports in the culture, namely the family and the private sector of dentistry. In the quest for rapid solutions, we may fail, as the New Zealand lesson tries to teach us, to achieve long-term success -- oral health for all which includes adults.
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From page 151... ...
On humanitarian grounds and in the absence of contradictory evidence, it would appear that the provision of emergency dental services would be appropriate. Linking minimal service provision of this sort to the system which delivers care to children also could reinforce the idea of the maintenance of a similar delivery mode for all.
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From page 152... ...
On humanitarian grounds and in the absence of contradictory evidence, it would appear that the provision of emergency dental services would be appropriate. Linking minimal service provision of this sort to the system which delivers care to children also could reinforce the idea of the maintenance of a similar delivery mode for all.
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