FUTURE OFDENTISTRY
ate students, and faculty providing care in commu-
nity clinics and practices located in disadvantaged
areas. Schools must also recruit and retain more
minority students, auxiliary staff, and faculty. Dental
education must include cultural competence and spe-
cial knowledge and skills to deal with these special
populations. Over time, new and creative use of allied
dental personnel is the preferred method for dealing
with changes in needs. Schools will need to be ade-
quately compensated to develop such programs.Financing of and Access to Dental ServicesSome employees participate in voluntary and re-
ferral plans where employers do not contribute to
the premium. In the former type plan, employers
assist in plan administration, but employees pay the
full cost of premiums. In the latter, employers direct
employees to a network of dentists who provide
services at a discount and employees pay for the full
cost of services.
Five other trends in dental prepayment plans de-
serve mention. First is the rise in employee contribu-
tions to premiums. In the average family dental plan,
employees now pay 41% of the premiums (Managed
Dental Care, 1999; and Meskin and Brown, 1988).
As dental prepayment costs increase, employers are
passing some of these costs on to employees in the
form of larger contributions to premiums.
Second is limited changes in member cost sharing
(e.g., deductibles, co-insurance, maxima) or the services
covered under the dental plan. A few insurers are now
offering to cover selected cosmetic services, implants or
other expensive treatments for a larger premium (Mr.
Thomas Meyer, Personal Communication, September
27, 2000; and Meskin and Brown, 1988).
Third, some large employers (i.e., 1,000 employ-
ees or more) offer employees a range of options that
allow them greater choice in paying for dental care.
This includes the option of enrolling in an indemni-
ty plan or preferred provider organization. With
rising dental care premiums, more employers are
only offering the managed care plan (Mr. Thomas
Meyer, Personal Communication, September 27,
2000; and Meskin and Brown, 1988).
Fourth, cafeteria plans, spending accounts, and
medical saving accounts are benefit options provided
to employees working for large companies––see
Appendix B for a description of these benefits. The
number of employees participating in these arrange-
ments and their impact on dental expenditures are
not known. From a theoretical perspective, they pro-
vide employees a financial incentive to opt out of con-
ventional dental prepayment plans, thereby increas-
ing plan costs for employees who do enroll and, in
turn, reducing prepayment plan enrollment and total
prepayment-based spending for dental care.
Fifth, personal financing plans: with the current
strong economy, more insured and non-insured
patients obtain personal credit to finance their den-
tal expenses. Practitioners report an increase in
the number of institutions offering to finance
patient dental expenses. Often, dentists must dis-
count their services by paying the lending entity 2
to 19% of charges. In other plans of this type,
dentists pay an annual fee to have patients eligible
for the loans (Dr. Myron Bromberg, Personal
Communication, October 12, 2000; and Meskin
and Brown, 1988).Cafeteria Plan (Flexible Benefit Plan):
These are employee benefit plans in which an
employer establishes a menu of benefits that are
available to employees. Employees select their med-
ical insurance coverage and other nontaxable fringe
benefits from the list of options provided by the
employer. Participants may receive additional, taxable
cash compensation if they select less expensive benefits.
Each employee chooses the benefits in which he or she
wants to participate. Employees pay for the benefits
they select before taxes are calculated on their wages.Defined Contribution Plan:These are employee benefit plans in which the
employer provides an agreed upon amount of funds
to each employee. The contribution is to be used by
employees to purchase any health insurance plan
they want. The employee may add to the employer