A.I. HAMILTON (WINTER 1978), ADA POLICY ON NATIONAL HEALTH INSURANCE: IS IT CONSISTENT?, OPERATIVE DENTISTRY, VOL3(1) PP. 1
ADA Policy on National Health Insurance: Is It Consistent?
The American Dental Association is generally committed to maintaining private practice as the mode of providing dental service for the American people. Ordinarily the Association voices objection to government schemes for introducing socialized dentistry, but one has the uneasy feeling that someday we shall be told that socialized dentistry—or national health insurance as it is euphemistically called—is an idea whose time has come and that we had better participate so that we may have some control over the direction the system takes. This is like telling the man on the scaffold to put the rope around his neck because the rope will keep his feet from hitting the ground and thus prevent breaking his legs.
A suspicion we are being led the wrong way arises when we note the Association’s reaction to plans for national health insurance that contain no provision for dental treatment. Rather than rejoicing at the government’s unexpected sagacity, the American Dental Association takes umbrage at what it considers to be a slight to dentistry, on the premise that oral health is an integral part of total health and should be included in any health scheme that is truly comprehensive. It happened with Medicaid. If socialized dentistry would provide better treatment, the action of the American Dental Association could be applauded—but such is not so.
Dentistry in the United States is not without faults but it provides a service comparable to the world’s best and much better than that provided in most countries. The best way to improve our service is to improve the quality of restorative dentistry. Such an improvement, however, would not occur under national health insurance. On the contrary, quality would decline. And how unfortunate for the patients!
Rather than waste its resources in trying to ensure a place for dentistry in national health insurance, the American Dental Association could benefit patients by doing all it can to improve the quality of restorative dentistry. Among other measures the Association could help substantially by according a place among the specialties of dentistry to operative dentistry (the only major branch of dentistry without specialty status) and so encourage young graduates to embrace operative dentistry as a career, and by more comprehensive testing and monitoring of dental products. If the government neglects to include dentistry in a national health plan, so much the better. Be thankful.
A IAN HAMILTON
University of Washington
School of Dentistry SM-56 Seattle, WA 98195, USA