‘The third-party payer rule will not help the dental patient very much,’ writes Frieda Gijbels (N-VA). ‘The dentist’s threshold must be lowered.’
Minister of Health Frank Vandenbroucke announces that he wants to do something about the affordability of dental care. He mentions the introduction of the third-party payer rule (meaning that as a patient you only pay the patient contribution) and the repayment of crowns and implants. But I don’t think that’s the right way to go. Dental care needs to be thoroughly reformed.
The threshold of the dentist is high in this country. And that often has to do with the costs that dental care entails. dental care (I actually prefer to call it oral care, because dentists take care of more than just the teeth in the mouth) is indeed expensive in this country. That is because in Belgium we have to pay about 57% of the costs of dental care out of our own pocket. That is much more than in say the Netherlands and Germany.
And that is because the rate that the government puts on the various treatments no longer corresponds to the cost price of modern dental care techniques. Many dentists therefore do not adhere to the official rate, because that is simply not feasible. Some dental care is not reimbursed at all. And it’s not just about luxury care, such as teeth whitening (which is not always a luxury treatment, just think of teeth that discolor after they have been denervated). But then it also concerns the treatment of, for example, gingivitis. This is not refunded if you are 55 years or older. While such infection is associated with cardiovascular disease and dementia.
Specific dental care is becoming more expensive, because techniques evolve and because more and more can simply be done. And because a growing group of dentists no longer adhere to the “official” rates, a third-party payer rule (in which the patient only pays the patient contribution) will therefore be of very little help if treatments are not reimbursed or are reimbursed far too little.
But that does not mean that this evolution is unsustainable and that dental care will become unaffordable in the future anyway.
Because there is also good news. You can prevent most dental problems. Because the cause of caries (cavities) and of periodontitis (gum and jaw bone inflammation) is simply “dental plaque”. And it can be cleaned perfectly. It’s a good idea to do this every day at home (yes, between the teeth too), and it’s a good idea to visit a professional regularly to remove the plaque and tartar that escaped daily brushing. That sounds simple, but it is the only way to both boost general oral health and keep oral care affordable.
We have even had “dental hygienists” in Flanders for three years, who are perfectly trained to perfect the brushing technique and to clean the teeth in a professional way. They could also do tremendous work in residential care centers and institutions for people with disabilities. And the very best news: they could limit the number of larger and more expensive concerns! And then there could also be correct rates with a correct refund. Only… those dental hygienists are there, but their treatments are not reimbursed. Unfortunately. A third-party payer rule won’t help there either.
My question to the government is therefore to really work on affordable dental care. One billion costs the dental care to the government, but the actual expenditure is about 1.8 billion. An extra boost of 45 million euros, which Minister Vandenbroucke promises, is certainly welcome, but real change is needed to make oral care affordable. So far I’ve heard that he wants to solve the problem by introducing the third-party payer rule and refunding more expensive care. Now, repaying implants and crowns, that’s a “nice to have“, but that does not improve the quality of our oral care.
That threshold of the dentist, it should indeed be a lot lower. But what we really need is a clear choice for more and better prevention, so that the number of more expensive dental care can be drastically reduced. The goal should be to keep as many teeth as healthy as possible, instead of paying back for crowns and implants.
And that is why it is high time, after 5 years of consultation, for a financial framework for dental hygienists. That is why there must be proper reimbursement for gum treatments, regardless of a person’s age. That is why we must ensure a transparent and comprehensible dental bill, so that the risk of fraud is reduced. That is why a cost calculation of the various dental care is also necessary and reasonable rates must be set, which dentists can adhere to. That is why we must ensure that dentists who come to work here from abroad are subjected to a language test. And that is why we also need to provide a clear framework for so-called ‘chain’ practices.
We have already bundled our proposals into a proposal for a resolution. Hopefully the government will at least sniff it.
Minister of Health Frank Vandenbroucke announces that he wants to do something about the affordability of dental care. He mentions the introduction of the third-party payer rule (meaning that as a patient you only pay the patient contribution) and the repayment of crowns and implants. But I don’t think that’s the right way to go. Dental care needs to be thoroughly reformed. The threshold of the dentist is high in this country. And that often has to do with the costs that dental care entails. Dental care (I prefer to call it oral care, because dentists take care of more than just the teeth in the mouth) is indeed expensive in this country. That is because in Belgium we have to pay about 57% of the costs of dental care out of our own pocket. That is much more than in say the Netherlands and Germany. And that is because the rate that the government puts on the various treatments no longer corresponds to the cost price of modern dental care techniques. Many dentists therefore do not adhere to the official rate, because that is simply not feasible. Some dental care is not reimbursed at all. And it’s not just about luxury care, such as teeth whitening (which is not always a luxury treatment, just think of teeth that discolor after they have been denervated). But then it also concerns the treatment of, for example, gingivitis. This is not refunded if you are 55 years or older. While such infection is associated with cardiovascular disease and dementia. Specific dental care is becoming more expensive, because techniques evolve and because more and more can simply be done. And because a growing group of dentists no longer adhere to the “official” rates, a third-party payer rule (in which the patient only pays the patient contribution) will therefore be of very little help if treatments are not reimbursed or are reimbursed far too little. But that does not mean that this evolution is unsustainable and that dental care will become unaffordable in the future anyway. Because there is also good news. You can prevent most dental problems. Because the cause of caries (cavities) and of periodontitis (gum and jaw bone inflammation) is simply “dental plaque”. And it can be cleaned perfectly. It’s a good idea to do this every day at home (yes, between the teeth too), and it’s a good idea to visit a professional regularly to remove the plaque and tartar that escaped daily brushing. That sounds simple, but it is the only way to both boost general oral health and keep oral care affordable. For three years now, we have even had “dental hygienists” in Flanders, who are perfectly trained to perfect the brushing technique and to clean the teeth in a professional way. They could also do tremendous work in residential care centers and institutions for people with disabilities. And the very best news: they could limit the number of larger and more expensive concerns! And then there could also be correct rates with a correct refund. Only… those dental hygienists are there, but their treatments are not reimbursed. Unfortunately. A third-party payer rule won’t help there either. My question to the government is therefore to really work on affordable dental care. One billion costs the dental care to the government, but the actual expenditure is about 1.8 billion. An extra boost of 45 million euros, which Minister Vandenbroucke promises, is certainly welcome, but real change is needed to make oral care affordable. So far I’ve heard that he wants to solve the problem by introducing the third-party payer rule and refunding more expensive care. Now, repaying implants and crowns is a “nice to have”, but that does not improve the quality of our oral care. That threshold of the dentist, it should indeed be a lot lower. But what we really need is a clear choice for more and better prevention, so that the number of more expensive dental care can be drastically reduced. The goal should be to keep as many teeth as healthy as possible, instead of paying back for crowns and implants. And that is why it is high time, after 5 years of consultation, for a financial framework for dental hygienists. That is why there must be proper reimbursement for gum treatments, regardless of a person’s age. That is why we must ensure a transparent and comprehensible dental bill, so that the risk of fraud is reduced. That is why a cost calculation of the various dental care is also necessary and reasonable rates must be set, which dentists can adhere to. That is why we must ensure that dentists who come to work here from abroad are subjected to a language test. And that is why we also need to provide a clear framework for so-called ‘chain’ practices. We have already bundled our proposals into a proposal for a resolution. Hopefully the government will at least sniff it.
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