Dental benefit plans, then (1976) and now (2015): Progress but not panacea

In 1976 the State of California commissioned a project: summarize the history of dental plans, create several plan designs, and project costs of each for State employees, retirees, and dependents. This study compares dental plans in the mid-1970s (as reported in that project report and elsewhere) with dental benefit plans forty years later. Although changes have occurred, much remains same. The plan design recommended most highly in 1976 (100% D&P, $50 Deductible, 80%/50%, $1,000 Annual Maximum) is common in 2015. In 1976 there were no widely-accepted standards of dental quality.  Insurance companies and TPAs were on their own dealing with quality.  They still are. In 2015 a committee of the ADA is meeting to develop a list of parameters intended to serve as the basis for quality assessment. During 1976 about half of the population visited a dentist at least once. By 2012 utilization had increased to approximately 60%, according to US governmental surveys. In the mid-1970s approximately 25% of the US civilian population had some form of dental insurance.  By 2012 67% had coverage (50% in private plans, and 17% in public plans).   After four decades utilization of individuals with dental plan coverage remains far less than 100%, higher than utilization by those without dental benefits, but not as high as anticipated in the mid-1970s. Forty years ago dental plan managers assumed that dentists would charge higher fees to patients with insurance.  Today the situation is reversed.  Due to the widespread presence of dental PPOs, often the patients who are billed the most are those without coverage.  Further, in many states dentists now are able to charge more than PPO-fee amounts after patients have reached annual maximum benefit levels.  Dental benefit plans, while important, have not been THE solution to increasing the demand for dental care to the almost-universal need for care.