This year we took thirteen Midwestern Arizona students to Washington for National Lobby Day with the American Dental Association (ADA) and the American Student Dental Association (ASDA) from April 8th through April 10th. I’m not sure, but I think we may have brought more students than any other school. As this year’s ASDA political advocacy chair for Midwestern, I really wanted us to have a strong showing at National Lobby Day.
Organized dentistry is something I’m passionate about. There is a common saying in Washington, “if you’re not at the table, you’re on the menu.” The only way our profession can remain at the negotiating table is if we lobby and organize. With 161,000 members and a membership rate exceeding 80%, the ADA is a healthy lobby. What’s more, the American Dental Political Action Committee (ADPAC) provides financial backing to dentists running for Congress and state legislative positions.
Organized Dentistry’s Response to the Opioid Epidemic
This year we tackled the opioid epidemic head on. The ADA is the first association of healthcare professionals to release an official set of guidelines for best prescribing practices related to opioid medications. Lawmakers were very receptive to our recommendations and were ecstatic that dentists are taking the lead on this crisis. We play a larger role in preventing opioid abuse than many realize. While family physicians prescribe roughly 15% of all immediate-release opioids in the United States, dentists prescribe about 12%.
Some of the recommendations the ADA made concerning opioids are as follows:
- Require continuing education for opioid prescribers. How much CE was a point of contention at the meeting, but many dentists seem to think that 2 hours annually is a reasonable requirement.
- Impose prescribing limits that do not exceed seven days for initial pain relief.
- Support prescription drug monitoring programs. Additionally, the ADA would like to help improve the quality, integrity, and interoperability of state prescription drug monitoring programs.
Putting Health Insurers in Check
The ADA and ASDA also collaborated with the American Optometric Association (AOA) this year to pass the Doc Access Act. This bill would prevent insurance companies from offering nominal payments for otherwise non-covered services in order to say that the service is covered.
Often, insurance companies will say they cover a procedure, but then offer only a small reimbursement to the providing dentist. Patients think that their crown will be covered by insurance, but instead receive a bill from the dentist to make up the difference for everything beyond the nominal payment from the insurer. This practice is bad for patients and dentists/optometrists alike.
The Doc Access Act also has provisions to protect dentists and optometrists from retaliation by insurers. It also has a provision that bars insurers from communicating with enrollees in any way that interferes with the doctor-patient relationship. Finally, dentists are not restricted to using only laboratories approved by the insurer.
Making Health Insurers Play Fair
One of the most important bills we have worked hard to squeeze through Congress is the McCarran-Ferguson repeal. Currently, only health insurance companies and Major League Baseball are exempt from federal anti-trust regulations. Dentists can’t discuss their fees without breaking anti-trust laws, but health insurers can.
The McCarran-Ferguson Act was necessary to protect the burgeoning health insurance industry when it was passed decades ago. Today it is outdated and has led to anti-competitive business practices by health insurers. The repeal, called the Competitive Health Insurance Reform Act, passed the House overwhelmingly. We only need a Senator to sponsor the bill and we can finally put this burdensome law to rest.
Alleviating the Student Debt Burden
There were about 500 dental students at National Lobby Day this year. All together we comprised about 8% of all dental students in the country. The biggest issue we addressed on behalf of all 100% of our colleagues was the exorbitant cost of student loans. I talked about the Crippling Cost of Dental School Tuition last year, and I tried to shed light on the question, Why is Dental School so Expensive?
ASDA proposed several strategies that would allow Congress to alleviate the burden of skyrocketing tuition rates for professional students. Below is a list of some of our recommendations:
- Increase the availability of Direct Unsubsidized Loans for dental students.
- Prevent a phase out of Grad PLUS Loan programs. House Republicans proposed tighter limits on federal student loan borrowing and it could have disastrous consequences for professional and graduate degrees.
- Lower interest rates across the board.
- Reinstate eligibility for professional students to access federal Direct Subsidized Stafford Loans.
- Allow students to refinance graduate student loans more than one time. This would allow young professionals to take advantage of lower interest rates when economic conditions improve.
- Extend student loan deferment. As I understand this proposal, it is for students seeking additional specialty training.
- Increase transparency to the loan application process.
- Preserve public service loan forgiveness programs. There are many fears surrounding PSLF, leading many to worry that it will be dismantled entirely. If you want to know more about PSLF, I wrote about it in this article about How to Pay for Dental School.
- Finally, we encourage further education from lenders and institutions to help students make informed decisions about financing their education.
Helping Charities Help People
The last bill we discussed was the Action for Dental Health Act. This bill would allow dental organizations to qualify for oral health grants from Health and Human Services (HHS). Programs like Give Kids a Smile and Mission of Mercy provide millions of dollars in free dental care to tens of thousands of Americans. Give Kids a Smile alone treated 450,000 children at 1,500 events. They have also provided almost $50 million in free dentistry since 2000.
Enjoying our Nation’s Capital
Besides talking to lawmakers, we also have some fun. Our state delegation took us out to dinner at Carmine’s, not far from the White House. Afterward, most of us went to The Dubliner and shared some drinks with plenty of laughs.
We were lucky to be in Washington during the Cherry Blossom Festival. The cherry blossoms were in full bloom throughout the city. their cotton white appearance softening the neoclassical edifices of the stark and imposing federal buildings. I wish that I had more time to take photos, but most of my sightseeing happened after dark due to my tight schedule.
I can’t speak highly enough about my experience with ASDA. Every dental student should be as involved with organized dentistry as they can be, even if it means just paying membership dues. The success of this great profession is a credit to those dentists before us who worked hard to protect their business, their patients, and their livelihood. Now it’s our turn.