Public Policy Options for Better Dental Health Report of a Study (1980) / Chapter Skim
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Benefit Priorities and Their Estimated Costs
Benefit Priorities and Their Estimated Costs
Pages 93-108
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From page 93... ...
The data to facilitate financially unbiased estimates of national dental needs were collected in the 1971-74 Realth and Nutrition Examination Survey and have been discussed earlier in this report. Plan Priorities for Coverage of Dental Care Priority One has as its goal the reduction of the incidence and prevalence of dental disease in later life by instituting coverage of preventive services for children and adolescents.
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From page 94... ...
The major question about the effectiveness of prevention for adults is the degree to which preventive services reduce periodontal diseases. The evidence is not clear.
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From page 95... ...
Expenditures are based on fees charged in private dental offices. For FY 1980 an attempt is made to compare the projected expenditures based on needs with expenditures expected if the current financing mechanisms continue.
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From page 97... ...
On the other hand, the extent of the quality assurance mechanisms in a national program have not been defined; an elaborate system to prevent the overutilization of dental services would be costly. Allowing for a moderately expensive quality assurance system, and assuming that a national program may not be able to achieve optimal efficiency in its administration, an administrative and quality control overhead of 10 percent seems reasonable.
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From page 98... ...
Health education/plaque control c) Sealants: 4 per child at ages 6 and 12 PRIORITY TWO - Comprehensive services ( excluding prevention)
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From page 99... ...
Endodontic treatmen t Pulp capping, vital pulpotomy, and root canal therapy h) Treating handicapping malocclusions Diagnosis and treatment planning Initial appliances, fixed plus 18 months treatment PRIORITY THREE - Prevention services for adults a)
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From page 100... ...
Further, the impact will be dissipated if utilization rates are low, such as 45 to 55 percent, and reduction in need for comprehensive services may not be realized without behavioral changes on the part of the covered population. Some of the services in Priorities Two and Four cover a backlog of unmet needs that will not recur.
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From page 101... ...
¢ z o ¢ z An c: a: cn a)
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From page 102... ...
allowed approximate estimates to be derived for the yearly incidence of new needs for partial dentures and bridges. Expenditures for treating these new needs were derived assuming estimated incidence rates applied to the projected population for each of the years 1980-84, and that the utilization rate would be 45 percent.
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From page 103... ...
One is the delivery of preventive care to children in a school-based program by salaried dental hygienists as recommended in Chapter 1. The services in Priority One, which involve screening and prophylaxis (including fluoride application, plaque control, and dental health education)
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From page 104... ...
PROJECTED EXPENDITURES FOR DENTISTS' SERVICES UNDER CURRENT DENTAL CARE SYSTEMS COMPARED WITH EXPENDITURES UNDER NATIONAL HEALTH INSURANCE FY, 1980 Under Current Systems ( in millions ) Cover ed by t he Fo ur Plans When Delivery is Based on Need in millions ~ Total*
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From page 105... ...
Need-based Projections Table 42 is a comparison of FY 1980 projected expenditures based on need and projections based on the demand experience of the California Dental Service (CDS)
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From page 106... ...
In any event, the greater of the two projections for individual services may give an upper limit for anticipated expenditures for dental services under national health insurance, although the needbased estimates would appear to provide a valid basis for comparing expenditures projected by other methods. Table 42.
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From page 107... ...
The most costly part of the comprehensive proposed program is Priority Four, comprehensive services for adults, estimated at $14.3 billion. Based on the demand experience of the California Dental Service Corporation, projections of total expenditures of the four plans amount to almost $23 billion.
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