It makes me mad. While we have money to put people on painful, inhumane, expensive respirators and other machines to prolong the end of their lives, we can’t seem to find the money for preventive health care for children. So I was delighted to hear that the local nonprofit agency The Effort was going to open a pediatric dental clinic in Oak Park. It’s a cool, kid-friendly dental clinic with toys, murals and video distractions.
Apparently, good dental health plays an important role in our success in life. Dental problems are one of the main reasons children miss school. This clinic will provide much-needed dental services for hundreds of low-income kids.
The Effort’s Oak Park clinic is supported by a grant from the First 5 Sacramento Commission. The commission receives around $16 million a year from a 1998 tobacco tax imposed by California voters. Nearly $3 million has been allocated to support five pediatric dental clinics in our region. Later on this year, there will be clinics opening in Rancho Cordova and south Sacramento.
At the opening ceremony, I asked Debra Payne from the First 5 Commission about the state of dental care for low-income families in Sacramento. It turns out that this clinic is a bright spot in a rather bleak situation. Because she didn’t have five hours to answer my question, she suggested I read the commission study. This report compares Sacramento’s managed-care dental program with fee-for-service programs that exist elsewhere in the state.
In 1994, Sacramento moved away from the traditional method of paying dentists for “actual services provided” to a method where qualified Denti-Cal patients were sent to one of five managed-care plans. Under the managed-care system, the provider is paid the same amount per patient whether they provide many dental services or no services. Obviously, companies could make more profit if they took the money but provided fewer or no services. According to this report, that’s essentially what’s been happening.
Compared to the rest of the state, Sacramento’s low-income patients have been getting substandard dental care. Only around 20 percent of the 117,000 children receiving Denti-Cal in Sacramento were receiving services, compared to 41 percent statewide. The study uncovered a host of other problems. To add insult to injury, this program not only provided less care, but it did not save any money, which was why we switched in the first place.
The First 5 Commission has a list of recommendations. These new clinics are part of the solution, but we need to take the managed-care system and give it a root canal. One does not need to be a brain surgeon to know that giving 117,000 Sacramento kids good dental care will prevent a whole lot of future problems.