Since Republicans took control of the Wisconsin Legislature in 2010, they have enacted an impressive slate of pro-growth, free market reforms. These legislative accomplishments include income tax reductions, entitlement reform, prevailing wage reform, and a Right to Work law that makes Wisconsin the 25th state where workers cannot be forced to join a union as a condition of employment.
However, protectionist legislation currently pending in the Wisconsin Assembly, which will be heard in committee this week, would reduce access to dental care in the Badger State and drive up costs. It would be an uncharacteristic bill for Wisconsin’s Republican-controlled legislature to approve.
The bill in question, Assembly Bill 368, would grant the Wisconsin Dentistry Examining Board unnecessary and inappropriate powers to regulate Dental Service Organizations (DSOs), despite the fact that DSOs do not practice dentistry. Dentists contract with DSOs to handle non-clinical, administrative functions, such as bookkeeping, payroll, and marketing. The DSO-model is similar to those employed by a number of medical professionals, such as oncologists, emergency room managers, optometrists, and other doctors.
Dr. Tim Quirt, a Wausau, Wis.-based dentist, explains how the DSO model assists caregivers:
“Running a dental office has many non-clinical aspects like managing supply procurement, facility maintenance, and bookkeeping, to name a few. I turned to a well-established practice of working with a dental support organization, or DSOs. DSOs first came on the scene in the 1970s and have been a boon to patients across the country by working with individual dentists to solve the unique problems of their practice. In my case, the non-clinical tasks of a large practice combined with providing the dental care meant I was working seven days a week and losing the passion and fire necessary for a caring profession.”
The DSO model is advantageous because it frees dentists up to focus on patient care. This model is also attractive for new dental school graduates, who are beginning their careers in an industry with significant startup costs. Any legislation that could hinder the DSO model, such as the misguided bill being considered in Wisconsin this week, would have negative consequences for consumers.
Underscoring the importance of this issue, the MacIver Institute, a Madison-based free market think tank, recently joined with two national conservative organizations – Americans for Tax Reform & the National Taxpayers Union – in sending a joint letter to Wisconsin legislators outlining the unintended negative consequences of making it more difficult for dentists to contract with DSOs:
On behalf of our supporters across the state, we write today to express concern and raise questions about Assembly Bill 368, legislation…that would grant the Wisconsin Dentistry Examining Board onerous and unnecessary new regulatory powers. The proposal takes aim at Dental Support Organizations and would restrict the ability of dentists in Wisconsin to run their practices more efficiently and cost-effectively by contracting with management companies to handle administrative and other non-clinical duties. Impeding the ability of a dentist to run his or her practice as needed will harm consumers and taxpayers across Wisconsin by limiting access to care, increasing costs, eliminating jobs, and discouraging in-state investment.”
Wisconsin is not the first state where protectionist, anti-DSO legislation has been introduced. A bill was introduced in North Carolina in 2012 that would’ve effectively prohibited dentists from contracting with DSOs. Passage of that bill would have reduced access to care in a state that already ranks as one of the worst states in the nation when it came to access to dental care.
When that bill was being debated in the North Carolina legislature, the John Locke Foundation, a Raleigh-based non-partisan think tank, pointed out that instead of infringing on dentists’ ability to contract with DSOs, state lawmakers “should be looking at ways to expand dental care…not restrict it. If a management company is interested in assuming purchasing, billing and administrative duties and a dentist wants to spend more time on patient care, they ought to be allowed to work out whatever arrangement works best for them.”
North Carolina lawmakers were right to vote down that protectionist, anti-DSO bill three years ago, and Wisconsin lawmakers would serve their constituents well by doing likewise this week.
Patrick Gleason is director of state affairs at Americans for Tax Reform and a senior fellow at the Nashville-based Beacon Center of Tennessee.