Research urges gov't to provide dental insurance

National dental insurance would save state money and improve economic productivity, in the long run, says report.

By JUDY SIEGEL
A Jerusalem research team recommends that the government establish a national dental insurance program to provide basic dental services, including those aimed at prevention, to the entire population.
Although this would cost NIS 3.3 billion a year, such a program would lead to significant savings in national expenditures in the medium and long term, the two researchers wrote in a report, released Thursday by Jerusalem’s Taub Center for Social Policy Research.
The study also found that when state dental insurance is available, very few exploit it by undergoing unnecessary treatment at public expense.
The report was written by Guy Navon of the Bank of Israel’s research division and Prof. Dov Chernichovsky, a veteran health economist at the Taub Center and Ben-Gurion University of the Negev in Beersheba.
National dental insurance exists in numerous countries, particularly in Scandinavia, and has been shown to improve public health. Yet, even though it has been recommended by various Israeli commissions, it has never been implemented. In fact, only a minority of Israelis – the wealthy and the seven percent of households that have private dental insurance – actually get regular dental care, the authors note.
Most of those in the lower socioeconomic groups completely forgo dental care, though when it comes to orthodontic care for their children, some scrape together money to pay for it, the report says.
Instituting a national dental insurance system, the researchers predict, will bring down the cost of care per patient, as dentists will have a larger patient population to work on and charges will become more uniform. In addition, as preventive care would be offered, dental health will improve, and the population will need less treatment for dental problems.
Lack of dental care can cause psychological and physiological damage, chronic pain and work absenteeism, thus reducing economic productivity.
The average Israeli household spends 1.5 percent of its expenses on dental care, but only a third of homes actually reported spending money for dental treatment, the report says. Thus, of all households that actually spend money on dental care, it constitutes an average of 6.4% of their income or NIS 540 a month.
The team note that when mouth and jaw surgery – needed especially bythe elderly – is included in the calculations, the expenditure is“catastrophic” – some NIS 2,000 or 18% of household expenditures permonth.
Such care is enjoyed almost only by the well-off or those who haveprivate dental insurance, the report says. Therefore, expenditure ondental care is “very regressive” and not borne and enjoyed equally bythe various socioeconomic strata.
Those families that need comprehensive dental rehabilitation areusually those who can least afford it, Navon and Chernichovsky write.Most of those needing such rehabilitation are the elderly who haveother problems, both medical and often psychological and cognitive.
Thus they recommend that the state set criteria for financialassistance, including a means test, for those who request it.  Theyalso recommend that less-expensive treatments such as dentures, ratherthan tooth implants be offered.