Let’s take a little trip down memory lane. The year is 1993. Bill Clinton is president and Monica Lewinsky is unknown. The Boston Red Sox finish in a disappointing but unsurprising fifth place. A bomb explodes in the World Trade Center basement. And in Connecticut, reimbursement rates for dentists treating low-income HUSKY patients are finally raised.
Flash to 2000. In a controversial election, George W. Bush succeeds Clinton. The Red Sox finish in a disappointing but unsurprising second place. The USS Cole is bombed in Yemen. In Connecticut, Medicaid dental reimbursement rates are stagnant. Poor children and families cannot find dentists to treat them.
Things have gotten so bad in 2000 that legal services advocates are forced to sue the state Department of Social Services in federal court for its failure to pay providers enough to attract enough of them to meet the dental care needs of families on Medicaid.
But after five years, no decision has been reached!
As it turns out, that 1993 increase in dental reimbursement rates was the last we would see. No wonder that fewer than 100 of the state’s 2,500 dentists can afford to see significant numbers of Medicaid clients.
In 2001, the court certified the lawsuit against the state as a class action; by 2005 the class numbers 307,048 people, over 200,000 of them children. For the past two years, the Department of Social Services has claimed its solution to the Medicaid dental care crisis was to "carve out" dental care from the general managed care program and run the dental program through an administrative services organization.
But on Jan. 21, DSS announced it was abandoning its plan to carve out dental services — its plan could cost more and result in less access to care. It has no alternative plan.
In 2005, more than a decade since reimbursement rates were last raised, five years since a suit was brought against DSS, nothing has changed.
Dental decay remains the most common chronic disease among Connecticut’s children. Poor oral health causes Connecticut children to lose hundreds of thousands of school days each year. One in four Connecticut children is on Medicaid, but two of three Connecticut children receive no dental care. And DSS continues to exploit the seriously stretched public health providers and the few remaining private providers.
There is an oral health crisis in Connecticut.
Oral disease now has been linked to heart disease, diabetes and preterm, low-birth-weight babies.
The time for excuses has passed.
In one of the wealthiest states in the nation how can we possibly accept there are children with painfully rotting teeth in our classrooms? And grandparents with no teeth at all, unable to eat or speak?
We call on the governor and the state legislature to fulfill their moral and elected responsibilities, end the apologies and delays, and raise dental reimbursement rates. Connecticut’s dentists want the chance to treat our most needy residents. We can give it to them.
Connecticut must follow New Hampshire and other forward-thinking states by developing and funding a comprehensive state oral health plan that moves us toward oral health care forall. Let’s make 2005 the year that we finally do the right thing. Together, we can make all of Connecticut smile!
Robert Slate is executive director of the Connecticut Oral Health Initiative, 175 Main St. Hartford 06106.