Friday, March 7, 2014
Maine voters will decide next week on two bond proposals totaling $14.75 million.
Under one proposal, Maine would borrow $5 million to expand access to dental care by creating a new school for dentists and expanding community-based clinics around the state.
The other asks voters to borrow $9.75 million for land conservation and state parks.
The conservation bond will be familiar to Maine voters. It would provide $9.25 million for the longstanding Land for Maine’s Future Program so the state can preserve valuable natural areas, waterfronts and farms. Voters have supported the program in four previous statewide votes, most recently in 2007.
The remaining $500,000 from that bond would be invested in the state park system.
Less familiar to voters is the so-called dental bond.
The proposal is intended to help solve a statewide shortage of dentists that is especially severe in rural communities, according to supporters. Its backers include the Maine Dental Association and the Maine Medical Association, the chambers of commerce in Biddeford and Portland, and Maine’s Catholic diocese. All of the major candidates for governor have expressed support.
“About 40 percent of dentists in Maine are going to be at retirement age in Maine, and there’s no real plan to replace them,” said Kneka Smith, associate dean of planning at the University of New England.
One prominent dentist has been speaking out against the proposal.
Dr. Jonathan Shenkin, a dentist in Augusta and a former president of the Maine Dental Association, said the bond wouldn’t solve the problem of getting dental care to rural and low-income Mainers.
“A dental school in Portland is not going to get them to move to Calais and Madawaska,” he said.
The $5 million dental bond would provide $3.5 million to help create a teaching dental clinic affiliated with or operated by a college of dental medicine. The $3.5 million would have to be matched by at least $3.5 million in private funding.
If passed, the bond also will include $1.5 million to create or upgrade community-based health and dental care clinics, where the new dental students would train and serve patients.
All of the funding would be distributed on a competitive basis, although the University of New England, a lead supporter of the bond, has been planning for a new dental school and will apply for the funding if the bond passes. The school estimates that the state funding would be matched by three to five times as much private funding.
The shortage of dentists is one reason that tooth pain is a leading cause of hospital emergency room visits for Mainers age 15 to 44, Smith said. Such visits cost an estimated $7 million a year and are avoidable, she said.
A new dental college and expanded training clinics would provide dental care on a sliding-fee scale so that residents with low incomes and no insurance would be able to get more care, Smith said. “The clinics will provide 60,000 dental care visits that don’t occur in the state of Maine right now.”
Maine has one dentist for every 2,300 people, compared with one dentist for every 1,600 people nationwide, according to the Dental Care for ME coalition. Advocates say a dental school and rural training clinics in Maine would help because 60 percent of dentists end up practicing where they train, according to the coalition.
Smith said other efforts to recruit new dentists, as well as tax incentives and loan repayment programs, have helped but will not eliminate the shortage.
Shenkin, the dentist in Augusta, said low-cost recruiting has brought about 60 new dentists to Maine in the last seven years, and Maine could reach the national average in a few more years without spending millions of dollars.
He said it would make more sense to provide additional tax incentives and loan repayment programs to encourage dentists to serve in rural areas where the shortage is most severe.
Shenkin also said Maine’s bond issue wouldn’t solve the bigger problem of affordability.
“If you do get (more dentists) to the people who need the care, they still can’t afford it,” he said. “It’s going to have virtually no impact on improving access for people who have no means."
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