Before I jump back on my soapbox I just have to share this:
Now I’m ready to jump back on my stage. But, before I do let me give you a little background information. During the past 15 years I’ve had dental insurance about 50% of the time. That does not mean I have not been to the dentist on a regular basis. What it does mean, though, is that I’m more thorough with my flossing, brushing, and cleaning.
I have not had dental insurance the past three years. Four years ago I did. This year I do. I’m going to lay out some comparisons for you:
Four years ago I had insurance. The dentist wanted to send me to a high priced specialist for some major work, because this dentist I was seeing at the time told me that I was going to lose my teeth if I didn’t do something about it right away. Price for said specialist—$5,000 to $10,000, or somewhere in that neighborhood.
Here I must admit that the dentist I was seeing at the time had much more schooling than I have ever had, and he is definitely specialized in his field. But, since this was the fist time I had ever heard about losing my teeth if I didn’t get some help quick I decided to take my chances. I declined his offer.
Three years ago I was in Texas and visited a dentist for my checkup and cleaning. She took the obligatory x-rays, conducted her examination, and told me that my oral hygiene was superb. There wasn’t much for her to clean, but she did recommend this laser treatment that she said was the bomb. However, it was a bit pricey. I asked her how pricey. It was $35 more, but in her words “well worth it.” Okay, she convinced me. I left her office $165 poorer—total bill.
Two years ago I visited a dentist in Northern Arizona. He had x-rays taken, and then proceeded to examine me. He put down his mirror and metal probe, and told me that my teeth were in great shape. The only thing he recommended was some light cleaning. In came the hygienist and she did her thing. I was out of that office in an hour and about $150 lighter in the wallet.
Last year I saw a dentist in Central California. He took some x-rays, poked, prodded, did some scraping on a few of the teeth, and told me that I was doing a great job. I left there $220 poorer.
This year I have insurance. I called and scheduled an appointment for a cleaning and a checkup. When the fateful day arrived I sat in the waiting room for one hour and five minutes before being called back to a room that looked pretty much like every other room I’ve been in at a dentist office. After five minutes a young lady came in and asked me if my birthday was in 1986. I looked and here and said, “Do I look like I’m 30 years old.” She left and promptly returned with a folder in her hand and told me that I was the wrong patient, and to follow her back to the waiting room.
Another 15 minutes passed and the same young lady came for me again. She took me back to the same room I had just left, told me to have a seat and someone would be with me shortly. Five minutes later another young lady came for me. She said to follow her to the x-ray room where she introduced me to an older gentleman whose name I couldn’t pronounce if I had help. I expected a half dozen x-rays, and then to be shuttled off to the hygienist. Not the case.
This fine man knew what he was doing. He took close to two dozen x-rays, all digital of course, and then proceeded to take some pictures of my teeth. All of my teeth. Each one was the star of its own photo. Those photos, too, were digitized.
I was then taken through a labyrinth of hallways to another room that looked like it was a close relative to the last two I had visited. There I sat for over 30 minutes staring at a blank wall. They didn’t have the decency to plaster a poster on the wall. All through that half hour I was listening to the dentist telling other patients about the kind of repairs that were going to be needed on their teeth—their overbite, underbite, teeth that needed straightening, and teeth they were sure to lose if they didn’t do something quick.
The dentist finally got around to visiting yours truly. He introduced himself (my doctor from last month should take some lessons), then turned to the x-rays and photos prominently displayed on the screen attached to the wall. This man began talking in code to his helper on the other side of the room. She had snuck in without me knowing. She was probably a graduate of spy school where she learned to come and go without anyone knowing.
The man talked fast. He reminded me of a used car salesman on the tv. There’s more to that later. His young assistant fell behind, and while she was catching up the dentist picked up the sealed pack of sterilized instruments, tore it open, unceremoniously dumped the three items on the tray, and turned to me with a metal probe gripped tightly in his hand. “Let’s have a look,” he says.
I opened my mouth expecting him to look around my oral cavity with a mirror in one hand and a long metal probe in the other. Not the case. The man touched, that’s right, touched, the crown of one tooth on the right side of my jaw and then the crown of a single tooth on the left side. He dropped the instrument on the tray, and turned back to the pictures on the wall.
Once he was done with the pictures he turned back to me and uttered, “I’m going to examine your tongue. Open your mouth. Lift your tongue.” He did a cursory glance into the gaping hole in my face and said, “Looks good.”
Folks, that was the extent of his examination. He then proceeded to tell me that I should see a specialist, or I’ll be losing my teeth very soon. Sound familiar? I looked at him and said, “How much are we talking?”
The price begins at $8,000 and goes up. But, it’s very necessary. I told him I didn’t think so. I guess he didn’t see that my insurance has an annual maximum of $1500, and I do know that he didn’t know that three previous dentists all said things looked great. He understood where I was coming from, but he insisted something needed to be done. He had this other option that would only cost $1534. He said that I should have this specialized treatment or I would lose my teeth.
By now I got the real distinct impression that he had gone to used car salesman school. When I told him no he looked rather hurt. Since I didn’t want to go with the big guns there was one final option available to me. Before he could tell me all about it I informed him that all I wanted was a cleaning. At this point he said, “You don’t need a cleaning. There’s no buildup. But, I want to tell you about….”
When he got through with his monologue he said that another employee was going to come in and go over the pricing options with me. They were bringing in the closer. This young man was very good at his job, but I’ve been on a car lot or two in my day. This last option available to me was $770, with only $220 coming out of my pocket. I’d have to come up with 100% of my portion today, and they could get me right in to have this “deep irrigation” done immediately. I don’t think anyone in that office realized that I irrigate my teeth quite regularly; coffee, beer, water, coffee, more beer, and don’t forget about the wine. I told the young man no. I had come in for a cleaning, and that since I didn’t need a cleaning that I was leaving. After 3 1/2 hours I was fed up. The young man insisted that I take his written proposal. He circled the phone number and told me to think about it. They would stand by their offer if I would call within the next week. Just show the receptionist the paperwork, and she’d schedule me an appointment. On my way out I did not stop at the receptionist’s desk. Hell, there were five of them, so I wouldn’t now which one to see anyway. All of this for an amount charged to the insurance company well into three figures, maybe even approaching four. I haven’t seen the bill, yet.
Alright. Now let me step up on my soapbox. The only difference between all of these professionals is that I had insurance when I saw #1 and #5. I did not when I visited the middle three. Did the lack of dental insurance cloud the judgment of the dentists who didn’t find anything wrong? I think not.
Is there a class, or semester, in dentist school where future dentists are taught what the insurance companies will pay for, and how to go about receiving the maximum amount of dollars from those companies? Are they taught how to scare the beejeesus out of their patients so said patients will subject themselves to these treatment plans that will allow the doctors and dentists to drive Porches instead of Fords?
The problem with the health care in this country is that the medical profession has us by the short hairs. They’ve got the insurance companies buffaloed into believing that what they have to say is gospel. The insurance companies have to recoup their loses someway, so they charge it all back to the consumer—me and you. And, the government is helping all this along by mandating that we have coverage, at least for this year anyway.
Why is it that we are fleeced so badly in this country when citizens of other countries can get the same health care at a much reduced rate? And, guess what? Their doctors are trained in the same manner as the ones in this country. In many cases at the same schools. We haven’t even discussed prescription drugs, yet. If you throw that into the mix, a person can get to the poor house damned quick if they ever get sick.
I had surgery not long ago, and within a week of arriving back at home the hospital called and told me that they’d reduce my bill by 20% if I could pay all of my portion that day. For that kind of discount, of course I could pay it all. If they are willing to take a reduction in their payment, then why charge so much in the first place?
If a doctor is willing to accept $150 from the insurance company after charging them $600, then why charge so much in the first place?
If a lab is charging over $900 for a blood test and receiving less that $100, then why charge so much in the first place?
I just don’t understand the medical profession in this country. Our health care is supposed to be some of the best in the world, yet our life expectancy continues to fall and infant mortality continues to rise.
Why are people opting for medical tourism when it comes to major surgery? They can spend one to two months in another country, traveling before surgery, recuperating after surgery, and spend less (plane ticket included) than what it would cost for the operation to be done in this country. In most cases the doctors they see in these other countries are medically trained in the U.S. and are affiliated with a major hospital/university like John Hopkins, Mayo Clinic, etc.
The medical profession (doctors, hospitals, insurance) needs a drastic make-over. The government has been trying to fix it for years, but has been failing miserably. They will continue to fail. Too much money is involved.
Gone are the days of the country doctor, or general practitioner. Now it’s all about specialization. They can charge more for that. The insurance company may not pay it, but it sure sounds good at the cocktail party when all the doctors get together and try to decide how to spend all the money they’re making. Meanwhile, the rest of us eat beans while they dine on caviar.
Short of a boycott (not practical), I don’t know what the answer to this problem is. If you do, please share it.