Powerful Group Fights to Keep Others From Lucrative Practice as It Prepares for High-Court Ruling
In election years, low-profile industry lobbies get a chance to be major political players. This time, it’s the dentists’ turn.
Though overshadowed by health-care behemoths such as the American Medical Association, dentists boasted the largest single health-care political-action committee, ADPAC, in 2008, according to the nonpartisan campaign-watchdog site OpenSecrets.org. The American Dental Association PAC gave more than $2 million to federal candidates and parties in that election.
They boasted the largest single health-care PAC in 2008, gave nearly $13 million to state and local politicians in 2010, raising the question: What do dentists want? Alicia Mundy has details on The News Hub. Photo: Reuters.
For the 2010 races, the ADA’s chapters gave nearly $13 million to state and local politicians, according to the National Institute on Money in State Politics, a nonpartisan campaign-research group. This year, the ADA and its 157,000 members are on track to dole out millions in federal and state contributions, making it a heavy hitter on the Washington political scene.
The flood of dentist money raises a question.
What do they want?
Dentists want a repeal of parts of President Barack Obama’s health-care law. For one thing, they want to preserve their monopoly on fixing cavities and are battling to prevent other health-care providers from doing “drill and fill” or setting up their own teeth-cleaning practices.
A Supreme Court decision expected next week on the health-care law could provide a new platform for America’s dentists and a wide range of interested parties. The health-care sector that leapt into the fray during the battle over the president’s bill hasn’t quit. Doctor-owned hospitals, medical-device makers and specialty physicians such as anesthesiologists are among those fighting parts of the law, contributing millions of dollars to dozens of medical-industry PACS.
Critics of the dental industry want other providers, such as trained dental hygienists and therapists, to offer basic cavity treatment as well. They contend it is the best way to expand oral health care to poor or remote areas of the country and nursing homes. Only Alaska and Minnesota currently allow midlevel dental-care providers.
“Access problems are very real and widespread,” and the cost of hospital emergency-room visits for dental crises is rising, said Shelly Gehshan of the Pew Children’s Dental Campaign. Dental therapists have “worked effectively for decades” in Great Britain and New Zealand and are “providing safe, competent care” in Alaska, she said.
Dentists say only fully qualified practitioners should be pulling your teeth. They have aligned themselves this year with a number of efforts in Congress to repeal portions of the health-care law. One part they dislike in particular promotes the use of trained dental therapists, dental-care providers who aren’t dentists.
Whether the court voids all, none or part of the law, members of Congress say, they plan to respond with a new round of legislation—creating opportunities for lobbying groups to push their positions into law.
Some ADA members track dentists who treat senators and representatives. It isn’t unusual for politicians to get an earful, as well as a mouthful, while in the chair, according to officials of several large state ADA chapters.
Sen. Bernie Sanders (I., Vt.) hoped to duck the ADA when he arranged a Senate hearing this year to discuss improving access to affordable dental care, including using more nondentists. The committee planned the session largely in secret to avoid a showdown. Within days, its cover was blown.
“Have you nailed down a date?” a top ADA lobbyist wrote in a Jan. 31 email to a Sanders aide. “Will others be invited to testify? Is there anything in particular the Committee seeks to highlight? I’ll look forward to hearing from you.” The aide, surprised by the leak, emailed a federal official, “It’s very strange that he would know all of this information.”
“We pay people to find out information,” said an ADA lobbyist. “That’s their job.”
Organized dentistry flexed its muscles in 1965 to keep dentists out of the Medicare system, one reason dentistry has become a lucrative profession, with dentists able to charge whatever the market will bear. The ADA’s lobbying team bulked up in 2007, when dentists found themselves on the defensive after the death of 12-year-old boy in the Washington, D.C., suburbs from an untreated tooth infection. The story became national news, prompting calls for more and cheaper dental-care providers.
The ADA is powering up again this year, sending out what it calls its “dogs of war”—dentists who lobby to “keep well-intentioned fools from doing stupid things” to dentistry, according to a recent ADA newsletter.
In early May, about 400 dentists gathered in Washington for the annual ADA Lobby Day, armed with talking points and maps of congressional offices on Capitol Hill. Many dentists carried black folders emblazoned with the word ADPAC in large white letters.
“You hold it forward under your arm, letters up,” said one attendee. Some folders contained checks for campaign events.
One attendee, Dr. Ricardo Kimbers of Baltimore, joined the ADA 29 years ago.
“My father was a dentist,” said Dr. Kimbers, who owns a small practice. Dr. Kimbers, one of the relatively few African-American dentists, said that he wants to see an expansion of dental care in low-income areas, but that for safety reasons he also backs the ADA position against midlevel providers.
“If they want to drill cavities, they should become dentists,” he said.
Although the dental-industry PAC has been more or less bipartisan in its giving over the past decade, ADPAC’s federal money in this election is tilting Republican. ADA President William Calnon, who practices in western New York, said the ADA is giving more money to Republicans this year because “there are more of them in Congress” and they “have a good track record embracing ideas we support.”
During the debate over the health-care bill, the ADA allied itself with consumer-advocacy groups and hygienists and, despite objections from budget hawks, persuaded Congress to add coverage for basic dental care for all children to the bill. But it also blocked a provision that would have covered nondentist providers on most Indian reservations.
One provision the ADA fought, a demonstration program on midlevel dental-health providers, did make it into the bill. Funding for the program is now stalled in Congress, blocked by one of the industry’s biggest supporters.
“I have not been a supporter of the midlevel provider as a solution to the access issue,” said Rep. Mike Simpson of Idaho, a senior Republican on the appropriations committee—and a dentist.