APPENDIX 1
THE RATIONALE FOR THE COMPULSORY INSURANCE SOLUTION
5.5(c):
There are approximately 57,000,000 people resident
in the UK at the beginning of the 21st century.
There is a dental NHS gross annual spend, without
the huge costs of administration, of £1.635 billion which
is totally inadequate and is, as proved by another paper published
in January 2000, a gross underspend since 1990 of 59.8 per cent
in the fee-scale compared to what the DDRB intended and thought
to right and fair. This represents, therefore, an annual shortfall
of £870 million which would produce an annual minimum of
£2.5 billion.
The vast bulk of claims that are made for treatment
carried out do not reach £660, even on an annual basis and
at present day costs. It follows, therefore, that a 50 per cent
rise in the fee-scale, would represent a level of remuneration
that most GDPs would consider adequate and would raise that £660
level to £1,000 per annum.
In the past a private dental insurance scheme
DENTOPLAN, run by Cornhill Insurance provided £1,000 of annual
cover for a premium of £60 and at a fee-scale of 150 per
cent that of the NHS—so it provides the perfect base.
If 57,000,000 people had to pay £60 each
a premium income of £3.42 billion would be required. Twenty
five per cent of this applies to adult patient who are, at this
moment, not exempt form charges = £855,000,000. This group
would be required to pay their own premiums and thus £2.565
billion would be required from other sources.
The liability could be further reduced if those
in work pay the premium for their families, whilst others pay
according to their ability to pay. This is not a decision for
the GDPA to make.
There are other statistics to be considered
at this point.
1. Half the population are children.
2. Less than 50 per cent (the Dental Practice
Board [DPB] say 45 per cent) of the adult population go for treatment
each year.
3. Very few of those who do attend would
involve a cost of the order of £1,000. The DPB say that the
average adult claim is of the order of £50.
4. To produce a worst case scenario let us
suppose that each and every adult makes a claim of double = £100
and that fees were raised by 50 per cent = £150 then £150
x 28,500,000 (the total adult population in UK) = £4.275
billion.
However, in the reality only half are likely
to attend which gives a liability of £2.17 billion. [This
coincidentally is about the current spend £1.635 billion
plus the 33.3 per cent rise Mr Blair promised].
5. The annual cost for the treatment of children
(DPB says 63 per cent attend) £400 million with an average
cost per annum, per capita, including capitation of £23.50.
Again, with 50 per cent fee increase the liability is £600
million.
6. This produces a worst case scenario liability
of £2.73 billion.
7. It should be borne in mind that the costs
of DPB are substantial and not included in these figures.
There would be considerable savings from its
demise.
It can be seen from what is written above that
raising the fees and keeping the present system or a compulsory
insurance scheme with all patients being private show little difference
in cost. Furthermore, the choice between a private insurer or
the State acting as it's own insurer would, also, bear little
difference in cost to public funds.
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