Members of Congress wrestling with the future of American health care should take inspiration from what unfolded Friday and Saturday on the Duquesne University campus. Hundreds of people stood in line for a free dental clinic hosted by nonprofit Face2Face Healing.
It was a clear sign that universal access to health care remains a huge national challenge. It was a poignant reminder of the need for change, whether that means replacing or improving the Affordable Care Act.
“Dental coverage isn’t an essential health benefit for adults,” says the ACA website, HealthCare.gov. “Insurers don’t have to offer adult dental coverage.”
Dental care for children is considered an “essential” benefit, but that doesn’t mean every child gets it, especially when families purchase coverage from the marketplace. “While dental coverage for children must be available to you, you don’t have to buy it,” the website says.
Even having a plan with dental insurance is no guarantee that care really is accessible; some families choose low-cost plans with high deductibles. When push comes to shove, they may choose to forgo dental care so they can pay other medical bills or put food on the table. Also, according to The Pew Charitable Trusts, only about one-third of dentists accept public insurance such as Medicaid.
Many of those who showed up at Face2Face Healing’s event, called Mission of Mercy Pittsburgh, had no insurance. Some had neglected preventive care for years, meaning they arrived at the clinic with multiple problems and had been living with pain.
Pittsburgh’s event — a huge undertaking involving hundreds of volunteers and supported by the University of Pittsburgh School of Dental Medicine, UPMC, UPMC Health Plan, PNC Foundation, TeleTracking Technologies Inc., Huntington and private donors — was not unique.
On Sept. 9, Steven Shwedel, a dentist from Taylor, Mich., will hold his ninth annual free clinic, where he and a team of assistants donate cleaning, filling and extraction services to needy adults. He’s helped 950 people so far, according to the News-Herald of suburban Detroit. Dr. Shwedel is part of Dentistry From the Heart, an umbrella organization for free clinics nationwide.
Another organization, Team Smile, focuses on needy children. It has partnered with professional sports teams to provide free care at churches, social service agencies and sports venues, including Progressive Field in Cleveland. “If you have ever experienced a toothache, you know how difficult it is to think about anything other than your teeth,” Team Smile quotes one school principal as saying. “Providing dental care means that our students can focus on learning and achieve.”
The point is well taken. For too long, dental and vision care have been treated as the stepchildren of the health care system, with access to these services considered less important than treatment of physical health problems. This state of affairs is out of step with the growing focus on holistic health care, and it contradicts evidence showing how different kinds of health problems are intertwined. According to the Mayo Clinic, poor dental care has been linked to cardiovascular problems and premature birth.
Those served at dental clinics get only a respite from their problems. Many will need follow-up care, all should have regular checkups. Where and when they get that care? Those questions should be central to the nation’s conversation about health care.