Janis Oshensky Lobbies Congress – Not Dentists

Show Me the Math

By Darrell K. Pruitt; DDSpruitt 

I have noted here far too many times how it disappoints me that Delta Dental Plans Association vice president Janis Oshensky repeatedly chooses to turn to politicians rather than discuss Delta Dental’s arguably egregious and harmful policies with me, a dentist. I intend to put a stop to such disrespect one PR expert at a time if necessary.

Long ago I warned Oshensky that if she didn’t talk to me, she should probably just shut up in order to preserve what’s left of her Internet reputation. Since by posting her Letter to the Editor on POLITICO.com today, she obviously ignored my advice, this highly critical comment will reliably join three others of mine on her first page soon enough. Her employer is sacrificing her like a pawn.

The following comment is the one I posted on POLITICO.com in response to Oshensky’s letter. It might just help the vice president to finally come to a decision on this issue one way or the other. Either way, marketplace conversation like this cannot help but lead to safer air for the community … My pleasure.

http://www.politico.com/news/stories/0709/24873.html

Dear POLITICO.com Editor:

This comment and subsequent invitation to Janis Oshensky is in response to the Delta Dental Plans Association vice president’s July 14, 2009 letter to you. Her letter is the most recent message she successfully sent Congress using a political news Website. Even though Ms. Oshensky holds the position of VP of dental relations as well as public policy, she has avoided answering this dentist’s questions about Delta Dental’s policies for months. If Ms. Oshensky is willing to do so, I would love for her to join me in discussion of Delta Dental’s taxation subsidy right here on POLITICO.com so that our lawmakers can witness a more balanced view of the issues.

Hello – It’s Me

Hello. My name is D. Kellus; Pruitt DDS, and I’m a practicing dentist in Fort Worth, Texas. It is my professional opinion that my patients are harmed by the policies of managed care dental plans like that sold by DDPA because there is no accountability to their clients or dentists. There is barely any accountability to those who select and pay for Delta’s products – dental patients’ naive bosses.

Like virtually every US citizen, your readers probably couldn’t care less about the dental industry. It is precisely because dentistry has been uninteresting for decades that make the microcosm of health care incredibly interesting to me. Let me uncover for your appreciation the event horizon in dental history. You could learn about more than just dentistry.

If left to natural forces of human nature, what happens to value when there is no accountability? For example, what do the 1975 East German Trabant and the 1979 Ford Pinto have in common? By popular vote, those products not only represent the two worst automobiles ever made, but the state shielded both manufacturers from accountability to consumers. Poor quality happens.

Oshensky argues against the taxation of managed care dental benefits like those sold to employers by Delta Dental. Let me offer that if Delta’s product were taxed like income, its value would quickly dive below the market threshold that attracts purchasers’ consideration.

Allow Me to Show-You the Math

Recently, Delta Dental of Michigan lost the accounts of thousands of GM retirees when their group dental benefits were cut in bankruptcy negotiations with UAW. Suddenly, Delta found itself forced to market their product to individuals who for once have the choice to keep their money. Faced with true competition for healthcare dollars, Delta leaders desperately cobbled together individual policies for the retirees who want to continue with their coverage. Even though Delta did everything possible to lower the cost of their coverage, the cheapest of the plans they offered still runs about $30 per person per month, and covers only 50% of everything, including preventive. So for premiums of $360 per year plus half the preferred providers’ 20% to 30% discounted fees, is this a bargain for Michigan retirees?

Free Markets 

In my free-market, fee-for-service practice, if a patient comes in for two cleanings and routine x-rays during a year, 100% of my bill is $208. This is the market price in my neighborhood that is continually challenged by lively competition with other dentists for new patients who may not even have dental benefits. Those customers pay in full at the time of visit, just like most people whose bosses purchased Delta Dental Plans.

Value Comparisons

So let’s compare value of Delta Dental’s product with cash. If I were a Delta Dental preferred provider, my fee of $208, less Delta’s 25% discount would be $156. Never mind that my wife has problems with my 70% cut in pay, let’s move on. 

The patient’s half of the $156 I earned is $78. $360 + $78 = $438. So for one uneventful year of discounted dental services with a dentist chosen from a list of names, a patient can expect to spend more than twice as much than if they paid the free-market price at the point of service.

Assessment

Not only is that hardly a bargain, but it is my opinion that managed care dentistry is dentistry by the lowest bidder with no quality control. That should be enough meat to get this conversation rolling. Now it’s your turn Ms. Oshensky. I think you have to admit that you’ve got holes to mend in the dental relations part of your job.

Conclusion

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3 Responses

  1. Hello,

    How much does dental school cost in the USA? How might I best go forward? Any information is much appreciated. Thank you very much.

    Sincerely,
    Janet

    Like

  2. Janet,

    Just use your internet search engine of choice, to visit your dental school of choice, for all related information. Of course, any ME-P reader is free to opine, as well. Good luck!

    Ann
    Ann Miller; RN, MHA
    [Executive Director]

    Like

  3. Stepping Stones to Success founder Carol Tekavec, RDH, posted an article on PennWell blogs discussing Delta Dental’s fee-capping plan that was run out of Rhode Island a month ago. I thought she was too polite in her criticism, so I posted this comment following her article.

    http://community.pennwelldentalgroup.com/profiles/blogs/did-you-know-insurance

    Nice article, Carol. Perhaps it was too nice.

    I also followed the Rhode Island fee-capping story, as well as reported about it here on PennWell blogs.

    http://community.pennwelldentalgroup.com/profiles/blogs/delta-dental-suffers-hits-on

    I recognize the dental benefits company in Rhode Island whose name you didn’t mention. It is Delta Dental. It used to bother me to mention names as well. But I got over it.

    I hope it wasn’t out of respect for the institution that you avoided naming Delta Dental. If so, let me assure you that your respect is widely misplaced. Delta is simply a sleazy discount dental broker that flatters itself by calling itself an “insurance company.” The misnomer is a slick PR upcode meant to confuse busy employers who quickly purchase Delta’s products for employees, without the benefit of a clue.

    Trust me. DDPA CEO Kim E. Volk has proven that she holds no respect for us or our patients. In turn, I have nothing but contempt for her and her company. She is reminded of my opinion every time she, or anyone in Congress, googles her name because my article “Kim E. Volk and dentists to discuss Delta – sooner or later” is her number 1 hit.

    http://community.pennwelldentalgroup.com/forum/topics/kim-e-volk-and-dentists-to

    I think that little piece of work shows that I am doing my part to clean up the community rather than merely complaining about the garbage in the streets.

    If we continue to reward Volk’s selfish ambition by treating her like she is above reproach, how can we ever hope to run unethical people like her out of OUR dental industry?

    I interpret the Hippocratic Oath to mean that I am obliged to protect my patients any way possible. If that means becoming nasty with bureaucrats who would harm them for profit, so be it. That makes it all the more fun, actually.

    I recently read that United Concordia is attempting the same trick. (Doesn’t that make you wonder what happened to the Sherman Anti-trust Act?) An article was posted on the ADA News Online this week in which hard-hitting ADA reporter Arlene Furlong exposes UCCI’s own attempt to limit what a dentist charges for even non-covered procedures. It is titled “United Concordia caps rates nationally for PPO.”

    http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=3685

    Let me describe why these tricks are not fair to PPO dentists who may already be struggling to keep from going bankrupt because of United Concordia clients’ 30% discounts on the procedures the plan covers. If a large percentage of a dentist’s practice are UCCI patients, the dentist cannot afford to break his or her contract with UCCI without going broke in a hurry. And if the dentist is not permitted to raise his or her fees to cover the expenses of running a dental practice, who in this triangle of misplaced allegiances unknowingly suffers? Is it the dentist, United Concordia or the patient? Hint: Ethics aren’t free.

    I know it is painful to think about, for honorable dentists as well as patients, but if a patient is told by a dentist that a tooth needs a filling, how is he or she to know for sure without visiting another dentist? It is a real hassle for a patient to get a second opinion for many reasons, and nobody can verify the need for a small filling without the patient sitting in a dental chair. This builds into the triangle a significant barrier to accountability. Unaccountability allows managed care patients to be hurt when preferred providers are squeezed between overhead and fee caps by United Concordia and Delta Dental.

    Let’s not kid ourselves about the price of ethics. If a dentist finds him or herself trapped, managed care patients will reliably suffer the most – long before the dentist moves out of the area or declares bankruptcy. Yet the innocent and naive employee who is “given” a provider list as part of an employment package is always the least informed about their dentist’s business arrangement with the discount dentistry broker. Virtually none of them are told that United Concordia’s 30% discounted fees mean a 70% pay cut for their dentists. If employees pay is cut 70%, what naturally happens to the quality of the work?

    For the safety of dental patients nationwide, we must drive dishonest businesses like Delta Dental and United Concordia out of our neighborhood. If we each encourage our Congressmen and women to repeal the McCarran-Ferguson Act of 1945, the FTC will put a quick halt to this crap through enforcement of the Sherman Act. Otherwise it will be a state-by-state battle, and I’ll have to tear into bozo CEOs and vice presidents again and again. That’s OK too. I just found two fresh targets in Furlong’s article named Karen Whitesel and Jon Seltenheim.

    Regardless whether we halt collusion between UCCI and Delta using anti-trust laws, we must never resist holding sleazy business leaders like Kim E. Volk personally accountable to their clients, because nobody else will take a stand on their behalf. Only dentists and staff care for dental patients. All others only want their money.

    D. Kellus Pruitt; DDS

    Now, excuse me while I take care of some unfinished business: You must answer to me, Kim E. Volk. If you haven’t done a vanity search recently, three out of ten hits on your first page are my comments, and I haven’t tinkered with your reputation in more than a month. If you stay silent, eventually your whole first page will consist of my invitations, and they will only get nastier. You’re not nearly as special as you think.

    As for the two poor slobs from United Concordia who allowed themselves to be quoted in Furlong’s article, corporate vice-president Karen A Whitesel and senior vice president Jon Seltenheim, I’m going to start tinkering with your Internet brand within hours. You should never again bring your disrespect of my profession onto the Internet because I will do everything I can to ruin you using nothing more than transparency.

    Darrell K. Pruitt; DDS

    Like

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