Are the health funds' bubbles bursting?

It is desirable that the ADA not rely on its own data but have the PHIAC data examined forensically by one of the large accounting groups in order that its utterances carry as much weight as possible.

Typical of dentists' comments is one received from a dentist of 30 years, who says:

My experience is that my practice base has been stealthily eroded in recent years by the hijacking of health funds with ADA's tacit support.

While the ADA stance may be changing, it is yet to be proven that it can do this on a sustained basis. Certainly over many years it has been seen by its membership to have been insufficiently active on the members' behalf in this area or in relation to health funds changing rules.

Received from an oral and maxillofacial surgeon:

I'm not sure whether you are aware that two major private health funds are now refusing to cover hospital admissions for patients with top benefit cover if they are having dental implants without any other treatment (such as tooth extraction or bone grafts). This is on the grounds that dental implant treatment, even for someone with no teeth at all and having 8-10 implants placed in a lengthy surgical procedure, is cosmetic!

That comment would have related to hospital cover tables, but there are also many observations of dentists indicating that health funds change the rules with respect to the classifications of the treatments that they will rebate.

It does seem that Jane & Joe Public pay their premiums only to find out at a later date that what they thought they were covered for is not the case.

Conclusion

All of the above indicates that while the health funds are likely to be even more tenacious with respect to the way that they interact with dentists and dental patients, their own business models have substantial weakness.