The Delta Dilemma
– Robert G. Griego, DDS
Second opinions are common in health care; whether a doctor is sorting out a difficult case or a patient is not sure what to do next. In the context of our magazine,
the first opinion will always belong to the reader. This feature will allow fellow dental professionals to share their opinions on various topics, providing you
with a "Second Opinion." Perhaps some of these observations will change your mind; while others will solidify your position. In the end, our goal is to create
discussion and debate to enrich our profession. — Thomas Giacobbi, DDS, FAGD, Editorial Director, Dentaltown Magazine
Delta of Washington made the decision to cut reimbursements
to member dentists across the board. This has
caused an uproar with Washington dentists.
What has happened in Washington is nothing new
though. In one form or another across the country and
finally even here in Arizona, Delta has compromised the
best interests of dentists for years.
My experience with Delta is vast. I served on the
Delta board from 2003 through 2010. I was board chair
from 2006 to 2010. As a historical review, Delta was
started by dentists more than 50 years ago. This first
occurred in the states of California, Oregon and
Washington. The goal for Delta was to be an option to
the new types of dental insurance that were being developed.
Delta was to be owned and managed by dentists
to insure quality plans for the patients.
The Arizona State Dental Association (AzDA) incorporated
Delta in the mid-70s as the Arizona Dental Insurance
Service. Years later because of anti-trust issues, all state
dental associations except for Oregon divested themselves
from Delta. This was not necessary to do as proven by
Oregon who maintained their ownership and have thrived
as a subsidiary of the Oregon State Dental Association.
Oregon has managed the anti-trust issues very well.
My involvement started in 1990 when Arizona Delta
attempted to market PPO-type discounted plans as most
other Delta chapters were doing. I led a movement of
Arizona dentists to oppose this and we prevailed. This again
occurred in 1994-95. This time it was a bitter yearlong
battle but again dentists prevailed. The CEO resigned as we
re-established our influence with the insurance company
that we started. We honored our mission of promoting only
quality insurance products.
This set the stage for our incredible run of glory years
for Arizona Delta. We were the envy of many dentists
from other Delta chapters in the country. I stand behind
this statement because at that time we were a small
fledgling company. However by taking the position for
quality insurance for the patients we serve and fair reimbursement
for our dentists, we were able to develop our
niche which was desired by patients. We became the
number-one dental insurance company in the state and
held that ranking for at least 12 consecutive years.
Sad to say, the board and I fell prey to a takeover.
Currently here in Arizona, even under the leadership of
dentists, PPO-type plans are being marketed statewide
for the first time in our long history of
Arizona Delta! It is unbelievable to me that
some long time AzDA leaders would permit
this. Prior to this sad turn of events, only the
premier plans were allowed to be sold under
our leadership. History repeats itself and this
will eventually cause the premier plans to be
greatly compromised here in Arizona. I have attended
numerous Delta national meetings on issues such as
limitations on non-covered services to marketing
steeply discounted PPOs. Usually the dentist's interests
are low on Delta's list of priorities.
The common denominator in each state that has
slashed payments to dentists are people who sell the notion
there are absolutely no other options left. Dentistry, at least
here in Arizona, is in a negative freefall. Some factors are
an oversupply of dentists and the full impact of two new
dental schools here in Phoenix yet to be felt. Corporate
dentistry has entered the Phoenix market and around 65
dental centers have opened. I do not know the quality of
their services, but I understand fees are discounted which will inevitably attract certain patients. Of course, the economy
remains a negative factor as well.
Now Delta, the company dentists started, as the last
bastion of hope and influence for dentists here in Arizona,
is promoting the notion that because the economy is
awful we need to bear the sacrifice to keep Delta highly
profitable. Why would a board dominated by dentists
allow this?
I ask the question: Why is organized dentistry not
in this battle? I cannot speak for Washington but here
in Arizona, AzDA has remained silent toward Delta's
actions. Every AzDA member should be demanding a
strong position against Delta on this issue. AzDA appears
to be more interested in fostering an environment of
cooperation with Delta. Since when do the best interests
of dentists parallel those of insurance companies? As the
economy continues to struggle, will similar actions to
Washington take place here in Arizona? Will this continue
to spread to other states? In many states, the premier plan
is already an insignificant part of Delta's business.
Be prepared to hold your state dental associations
accountable for fighting for the dentists, of course, within
applicable anti-trust laws. The Delta Board of Directors
must also be held accountable. Do not fall for decisions
that do not protect the best interest of our patients. In my
opinion, in these times, quality leaders in the dental
profession are hard to find but this wonderful profession of
dentistry is worth fighting for, so get involved. |