The Dental Treatment Services Scheme has shown substantial growth in 2009. A staggering 399,262 (34%) more treatments were provided year to date in 2009 than was targeted. At the end of December 2009, the cumulative number of treatments 'above the line' (i.e., routine services, extractions, fillings) was 1.4 million (35% growth) and the number 'below the line' (i.e., specialties like root and gum treatments) was 144,000 (26% growth).
Amazing how resilient dentistry seems to be to the recession.
Of course one must consider that since the beginning of 2009 a lot more people were granted medical cards, due to the dire economic circumstances of the country. This is what the HSE suggested. But the actual increase in the number of people with medical cards over the year was 55,000; which was 4% above target. So by safely assuming these projections are meaningful and represent normal levels of demand in the system, the increase in supply should be attributed to the demand from new card holders; this is the HSE suggestion.
My rough calculations of this appealing hypothesis suggests some bizarre results: every new medical card recipient got about 8 fillings or extractions AND about 3 root canal treatments! Crazy right, but there's more to consider.. these new recipients were mostly the newly unemployed so as PSRI payers they previously had a very generous dental package (now cut) which included two free check-ups and cleanings per year and sizable reductions for most treatments.
To me, unless i'm missing something, the increase is now down to two possibilities: either the quality of existing medical card holders' teeth declined significantly or dentists started to be more sensitive to the dental "needs" of their medical card-holding clients. The former doesn't seem plausible (a 30% decline in dental health in one year!?) yet there is considerable reason to suspect the latter, given the possible fall-off in dentist services from purely private patients (note: general domestic demand for goods and services in Ireland contracted by about 10% in 2009) .
The phenomenon of 'supplier induced demand' (SID) has been empirically validated in many instances and across health professions; it is well documented in the health economics literature. It can also be controlled and managed and, at times like this, it's probably worth considering.
