The Free Press, Mankato, MN

March 5, 2013

My View: Cavities off the charts without accountability

By Margaret Flor
My View

MANKATO — I appreciate the recent article in The Free Press, “Tooth decay in state children growing worse,” regarding the $148 million spent from 2007-2010 in emergency department charges in Minnesota for preventable, non-traumatic conditions that could have been treated in a dental office.

Do you know how many dental exams could be done with $149 million in wasted emergency visits? Divide it by $250, that equals 596,000 children who could have received care.

The state insurance plans puts more value in dental emergency room visits than providing correct reimbursements to the dental provider. At the present time, the reimbursement from the state does not even cover the costs of infection control, OSHA mandates, employee mandates, federal mandates of electronic record keeping that a dental office has to expense before even seeing these children.

There was an office in Southern Minnesota called Main Street Dental of Blooming Prairie and its mission was to take care of the poor population. They had over 25,000 visits a year. They closed in January 2012 because the reimbursements were only 25 percent of the fees charged for dental care from the state of Minnesota insurance contracts. If the state insurance companies that won the contracts would reimburse at least 75 percent of the fees the dental provider charges, I guarantee that there would be more dental providers able to afford to take care of these children.

What was the dental emergency room visit payment made to the hospital? I guarantee it was more than the reimbursement that the dental provider gets for a dental health exam. The other interesting piece to this complicated puzzle is that the insurance companies that win the bid to manage the insurance for the poor do not have to be audited by law. Last year, UCare insurance company, out of the goodness of their heart, gave $30 million back to the state of Minnesota after a whistle blower made it aware to our elected officials that insurance companies that won the state contracts were profiting from these state contracts. 120,000 children in Minnesota could have seen their dentist with those dollars.

Just these dollar figures from dental emergency room visits and money returned back to the state of Minnesota by UCare would have been able to take care of 716,000 children’s dental visits.

There is more than one insurance company that wins the state contract to manage health care dollars for the poor. With the combination of dental emergency room visits, UCare returning money back to the state and other insurance companies involved in caring for the poor, there is enough tax dollars available for the poor to care for their dental health.

What is concerning is that the insurance companies that win the bid to manage these health care tax dollars do not have to be audited. You can thank our elected officials and lobbyist that passed a law years ago that prohibits an audit to occur for the insurance companies that win the bid. However, all health-care providers in the state of Minnesota are consistently being audited by Minnesota Department of Revenue to make sure that they are making the correct 2 percent provider health-care tax payment.

The insurance company that wins the state insurance bid doesn’t have to be audited but the health care provider does?

The state of Minnesota is making sure it is collecting the money but it doesn’t account for the money that is spent. Meanwhile, the children and our poor people of Minnesota suffer. Our elected officials don’t value dental health and they don’t believe auditing the insurance companies is important. If they did care, then there would be care.

Accountability for tax dollars and the dental team is not the only answer to solve this dental disease. Parents need mandatory nutritional education so they can properly care for their children. Two dental visits a year is not going to change habits at home. It only will be a Band-Aid to the out-of-control lifestyles.

If government benefits are received, then they will need to participate in daily healthy nutritional activity. Until everyone is accountable, cavities will be off the charts and the dental disease will never be managed.

Margaret Flor is administrator of Prairie Dental Arts in Waseca.