Fixing the Broken Dental Medicaid Program

The dental Medicaid program is beyond requiring a tune-up. The dental Medicaid program is wallowing in full-blown failure mode.

Dismal fee schedule rates have squeezed out most ethical and skilled clinicians, except those who provide care as a charity or community service. Governmental price fixing has failed miserably. Many providers on the list of managed care organizations (MCOs) read like a rogues’ gallery within the dental profession. Patients and parents are not only frustrated by the troubling level of care they receive, but shortcuts in dental sedation have led to alarming rates of morbidity and mortality. The media reports case after case of civil and criminal legal actions for alleged dental Medicaid fraud.

Here’s exactly what needs to be established:

1. We need to attract (not coerce) talented and ethical dental providers to the mainstream of care for dental Medicaid. Our disadvantaged citizens deserve no less.

2. We must assure taxpayers that their tax dollars are utilized responsibly and not targeted on “welfare for the rich.” That means minimal expenditures for MCOs, which manage dental Medicaid for the states; serious due diligence with oversight of taxpayer expenditures; and a halt to the largess the private equity industry currently enjoys in its position as beneficial owner of so-called dental Medicaid mills.

3. We must empower Medicaid recipients and their parents to make positive healthcare decisions in their own self-interests. The present arrogant, paternalistic attitude of government and big business knowing best has failed. True consumer transparency and empowerment is vastly superior to our entrenched model of crony capitalism.

4. The failed model of continuously throwing additional taxpayer dollars at the dental Medicaid problem represents flushing good money down a toilet. Seemingly, that’s the best that policymakers in Washington, corporate dentistry, and organized dentistry can come up with. That disturbing policy only serves special interests and not taxpayers or our disadvantaged citizens. Don’t take their bait/refrain of “What about the poor children?” The entire model of dental Medicaid requires a total restructuring.

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