The Most Impactful Legislative Issues Facing Dentistry
by Ty Weisenburger
One of the most impactful arms of ASDA is Advocacy. At our chapter, I have served as the Advocacy liaison while serving as Vice President. During this time, my eyes have been opened to two major things: first, the rousing issues facing our profession and second, the influence that dental students and dentists have in the dental political sector. I have learned and continue to learn about the major legislative issues that have and will continue to impact the dental field.
I hope to shed light on three major topics and controversial issues that Colorado ASDA, with the support of National ASDA and the American Dental Association (ADA) are working to rectify. The three issues are 1) Licensure Reform 2) Competition among Dental Insurance Companies and 3) Student Debt Reform. It is my hope that I can explain the basics of each issue, what ASDA & the ADA are doing to resolve these issues, and review any updates in progression at the state or national level.
1) Licensure Reform – Is it ethical to administer a dental licensure exam on a live patient?
Something you need to know right off the bat is that Colorado accepts all CURRENT pathways to licensure, which is unique. Among others, we have Christian Piers to thank for his efforts as Colorado ASDA President and National ASDA President in 2015. After being turned away by the state dental board about his efforts to increase portability of dental licensure in Colorado, Dr. Piers reached out to his local and state dental organizations. Together, pushed by Dr. Piers’s vision, the Colorado Dental Association (CDA) pushed the Colorado State Dental Board to make Colorado the most accessible state in the country in terms of dental licensure.
The implementation of a clinical examination has been around since 1929. In 1991, a live patient exam was thought to be inappropriate and unethical. In 2016, ASDA published a white paper on licensure and published a new policy describing their view of an ideal licensure process. The white paper outlines the downfalls of the current (in 2016) licensure landscape. The L-1 policy describes the components of an ideal licensure exam:
Does not use human subjects in a live clinical testing scenario
Is psychometrically valid and reliable in its assessment
Is reflective of the scope of current dental practice
Is universally accepted
Since this policy was released, we have seen tremendous progression toward a more objective licensure exam. An alternative to a live patient exam is a DLOSCE, a Manikin - Based Exam or a Portfolio submission of comprehensive patient care. The DLOSCE (which stands for Dental Licensure Objective Structured Clinical Exam) is a high-stakes licensure examination developed by the Joint Commission on National Dental Examinations, with roots tied to ASDA. The ADA recently announced expedited plans to release the DLOSCE in light of the current pandemic. The exam is currently accepted in Colorado, Alaska, Washington, Iowa, and Oregon.
2) McCarran-Ferguson Act – Should dental insurance companies be able to collude to determine price for dental care?
For several decades, ASDA and the ADA have been lobbying each year to amend the McCarran-Ferguson Act. The amendment would empower the Federal Trade Commission and U.S. Department of Justice to enforce the full range of federal antitrust laws against health insurance companies engaged in anticompetitive conduct. Currently insurance companies dictate prices and insurance benefits, NOT our patients.
Repealing/revoking the limited antitrust exemption that health insurance companies currently have would help inject more competition into the insurance marketplace. This, in effect, would promote lower prices, greater consumer choice, and increased innovation through robust competition.
On September 21st, the U.S. House of Representatives passed the Competitive Health Insurance Reform Act. It will now turn toward the Senate for a majority vote before it becomes a law. Recently, the ADA sent out a plea to all Dentists asking them to reach out to their senators of their district to encourage them to pass the bill. This is a fantastic example of how we can make a difference in our profession moving forward. This link will direct you to the publication regarding this topic.
3) The REDI Act – Should dental students pursuing a specialty be responsible for interest on loans during their residency?
As a student, with a small or enormous debt load, it is imperative for you to understand that ASDA encourages Congress every year to reduce student loan interest rates, provide refinancing opportunities to borrowers, and provide opportunities for loan forgiveness, scholarships, grants and tax deductibility. The biggest stride and most immediate impact that ASDA’s efforts can have on us in the next couple of years is the Resident Education Deferred Interest (REDI) Act. This act will grant students pursuing advanced education in a specialty delayed interest accrual during their time in specialty training.
As far as the status currently, our interest rates have been frozen at 0% since March 13th, 2020 and will continue to be frozen until the new year as a part of the CARES Act law which provides relief to Federal student loan borrowers.
Some students say things like, “What’s Advocacy and how does my voice get heard?”, “Why get involved in Advocacy now when we don’t make a difference as students?” or “This won’t impact me because I graduate in 2 years.” I have to be honest; I have said similar things, but my perspective has changed, and it is my personal opinion that the students with this mindset are less likely to be an active ADA member when they become dentists. Don’t let that be you.
I have spoken to many dental providers who not only want change, but they work for it and are passionate about results. I do not claim to be an expert in advocacy, politics, or anything close to legislation; however, I do have a strong belief and determination to be part of a group that lobbies for improvement in the dental profession, and I feel a binding obligation to educate myself in the pressing issues that face dentists and dental students.
My hope from this article is that you have a broadened understanding of the main issues that ASDA’s advocacy efforts are focused on. It’s also my desire that from this article, you are motivated to take the next step to committing yourself to helping our community, in dental school and among dentists, advance the rights and opportunities in dentistry. The easiest way to get involved in advocacy now is join Colorado ASDA at State Lobby Day sometime next year!
References
Advocacy 101 Webinar held by our very own, Jakob Holtzmann: https://www.asdanet.org/detail-pages/event/2020/07/24/default-calendar/advocacy-101
Recent ADA publication: https://www.ada.org/en/publications/ada-news/2020-archive/september/competitive-health-insurance-reform-act-passes-house
ASDA website: https://www.asdanet.org/index/dental-student-resources/dental-licensure
About the Author
Ty Weisenburger is the current Vice President of Colorado ASDA and a third-year dental student. He has served as a leader in Colorado ASDA for 3 years. In his undergraduate experience at Brigham Young University, he served as an ASDA leader for his pre-dental chapter. Needless to say, ASDA has been an integral part in his road to becoming a dentist. When Ty is not studying or planning for ASDA events, he likes to play basketball, work on his personal business venture, and participate in High Intensity Interval Training (HIIT).