by JoAnn R. Gurenlian, RDH, PhD
Have you been reading or listening to the news these past few months about the air traffic controllers who fall asleep during their shifts? Scary thought, isn't it? For those of us who are frequent flyers, it does cause us to wonder about the chances we are taking in the air.
I think the same can be said for health-care workers on the ground. With the recent legislative changes as part of health-care reform, will we be found to have been asleep at the health-care controls?
Take, for example, the situation with physicians. They have years of education to become specialized in their fields and look forward to a lifelong career in medicine. They assume that the powers that be in government will make good decisions, partnering with them to improve the health of the public. Talk about a dangerous assumption.
The reality is that our government, insurance companies, and economists, who are making decisions about health-care arrangements for the people of the United States, have anything but their interest at heart. The bottom line here is economics, and all of us are going to pay the price for the consequences of their decisions.
Currently, the American Medical Association (AMA) members find themselves in a quandary, because the new economic model being promoted is to create agencies known as Accountable Care Organizations. These groups are accountable to the federal government and are designed to oversee medical procedures and treatment – not to support quality medical care, but to support economic efficiency. These organizations will be manned by physicians who will receive incentives for denying medical testing and treatment, in an effort to keep costs down. Current physicians and recent graduates of medical schools are wondering how this happened. When did this concept get approved? How did they miss this during all the health-care reform discussions? Didn't the government relations division of the AMA catch this?
Part of the problem is the overwhelming number of pages of new regulations issued related to implementing health-care reform. According to Congressman Fleming's health-care repeal update, there have been 6,578 pages of new regulations issued through March 14, 2011. Who is reading that information and staying on top of it? And who is overseeing these regulations on behalf of the public?
The other part of the problem is that physicians don't have time to practice politics while they are busy practicing medicine. They want someone else to do that work. In remaining passive with legislation, they have found themselves not only out of the driver's seat, but out of the car as well!
Now you might be thinking, OK, too bad for physicians. At least we don't have to worry about that in oral health care. Remember what I said earlier about making dangerous assumptions? If this is happening in medicine, do you really think oral health care is going to fly under the radar? Trust me, we are heading in the same direction as medicine.
When I received notice from the ADHA that the federal government is planning to cut the Alternative Dental Hygiene Care Provider Demonstration Grants, I could see the handwriting on the wall. Let's cut programs that will support innovative models for improving access to oral health care. That should help improve the oral health condition of the United States. More than 60 organizations support this initiative, but our country is in financial straits, and things have to be sacrificed. And so it begins – a cut here, a cut there, and we won't need to work hard to figure out how the oral health of the public got worse instead of better.
If you are just learning about this situation, or have not had a chance yet to talk to your federal legislators, now would be a good time to break out of the "let someone else take care of this" mold and start being heard. Contact your senators and congresspersons. Ask them to support funding of the Alternative Dental Health Care Provider Demonstration Grants (Section 340 G 1 of the Public Health Service Act).
While you are at it, start getting involved with your constituent and national professional associations. Ask the hard questions:
- How is oral health care changing?
- What don't we know that is in those 6,000-plus pages of new health-care regulations?
- How is dentistry and dental hygiene different in the past year?
- How can we improve the oral health of the public instead of watching it get worse?
I don't want us to find ourselves in the same position as the physicians ... waking up in a few years asking, How did this happen?
JoAnn R. Gurenlian, RDH, PhD, is president of Gurenlian & Associates, and provides consulting services and continuing-education programs to health-care providers. She is a graduate program faculty at Idaho State University, adjunct faculty at Burlington County College and Montgomery County College, and president-elect of the International Federation of Dental Hygienists.
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