Phoenix, AZ – A few weeks ago Kevin Earle was working quietly in his office at the Arizona Dental Association when a message arrived in his inbox that he found both startling and upsetting. The message was from another dentist, also upset - and all over one line in a document he'd attached, 82 pages long, detailing the health insurance plan for a consortium of school teachers and other public employees in Yuma.
To my knowledge, the statement in the benefit plan says that it excludes coverage for services provided outside the United States and in parentheses it says, except in Mexico. Closed parentheses. That's the way it reads.
In other words, public employees in Yuma are covered at the same rate whether they see a dentist in the U.S. or in Mexico.
That concerns us. First of all we're talking about public monies that are being expended to the benefit of public employees, for services that may be provided by a provider that doesn't meet the same standards as that in the United States. And I question why that exception is in their provider directory.
For years, dentists in Arizona have watched their patients leave and go across the border for care that costs significantly less. A root canal might be $1000 in the US, but only $200 in Mexico. Unhappy with the exodus, many Arizona dentists in 2008 asked the biggest dental insurance provider in the state - Delta Dental of Arizona - to publish a brochure about the quote untold story of dental tourism. Why, the brochure asked, would you seek dental care in a country where you are afraid to drink the water?
When Mexican dentists like Jorge Cruz read the brochure, he was very upset. He wrote a letter to delta dental of Arizona threatening a lawsuit.
It was a bunch of lies they were just telling over there. I know they are just losing their customers, but why can't they compete by lowering their prices or offering a better service?
Furthermore, Cruz was struck by what seemed to him an incredible irony: At the same time Delta of Arizona was circulating its brochure warning their American subscribers about Mexican dentists, they were reimbursing Cruz's patients, at an out of network rate, for the care he provided in Mexico.
Delta is paying me to see their patients, so doesn't make no sense because in the end they're using us to provide them a service to their patients and they know they're paying us less than they would to an American dentist.
The American insurance industry remains somewhat divided on the issue of cross-border coverage. Delta Dental of CALIFORNIA, for example, covers dentists in Mexico in-network. Their reaction to Arizona delta's brochure was to quote disown it. Part of the reason why these two insurance companies - and they are two, separate companies -- are on opposite sides of the debate has largely to do with who runs the company. Arizona's delta is majority DENTIST-run. California's - majority run by people who buy the insurance plans for companies or consortium's, like Yuma's. One of Yuma's plan purchasers, Debbie Hedrick, says the plan lets employees choose for themselves - spend less money in Mexico or more money, but keep it in the U.S.
Dentists - you can use any dentist you want in the world, and our insurance will pay the same amount. A dentist is a dentist is a dentist.
Kevin Earle doesn't think so. He's already contacted three state legislators that represent Yuma to ask them to introduce a bill that would prevent any American public employee from using their benefits for care in Mexico.