April 8, 2010; Associated Press | The headline of this article—“Ala. dental spat may foreshadow Obama plan effects”—is wrong. It’s not about the Obama health care plan. The fact that health care reform expands Medicaid dental coverage for poor children is not at issue. There aren’t enough private dentists to handle the patient load. What comes through loud and clear in this story is the animus of the private dentists toward nonprofit dental clinics.
In this case, the trustees of the Alabama Dental Association in a meeting they thought was private and off-the-record—or at least not on the record for the nonprofit Sarrell Dental Center to see—complained about their nonprofit competition that offers dental services to children on Medicaid, suggesting that the Sarrell nonprofit’s quality of care might not be up to snuff.
But the private dentists of the ADA and the nonprofit dentists of Sarrell know that the issue is competition. The AP article acknowledged that this for-profit/nonprofit fight has been ongoing for a decade, long before anyone contemplated an Obama health care plan. Sarrell’s argument is that there aren’t enough private dentists who will take Medicaid patients, but that doesn’t faze the ADA. The interim executive director of the ADA acknowledges that there’s a problem of inadequate dental services for poor children, but the idea of nonprofit dental clinics in Alabama is “new” and “established dentists aren’t sure what it will mean in the long-term.”
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No matter, the ADA is trying to undercut the nonprofit clinics. At the meeting, participants complained that nonprofits had a business advantage over for-profit dentists who faced business pressures that nonprofits didn’t. They discussed getting legislation considered by the state to “control” nonprofits.
One of the participants at the secret ADA meeting on January 31st was a professor from the University of Alabama at Birmingham. This past week, UAB just happened to announce it would no longer make UAB dental students available to work at Sarrell clinics. Sarrell is suing, claiming that the school was pressured by alumni and private dentists to prevent students from working at Sarrell. The reality is that in many localities and many states, it’s not all hunky-dorey between for-profits and nonprofits, and frequently, state agencies will on occasion treat the nonprofit sector as a threat to business.—Rick Cohen