I doubt it, we have regulatory commissions that help set prices. This, however, is part and parcel of the problem. My suggestion could not be accomplished without much needed reform anyway. It wouldn’t matter though,because dentists set the prices for their services. Your insurance plan would be crappy because it would stick the client with the tab. Which is not any different then what most people have now. I would say the plan would probably be something like:
In state X, there are four major medical insurance providers. They consist of 90% of the market. To keep their license current, dentists and doctors must accept those plans, they are free to take whatever patients they choose. Just as they are free to charge whatever they like. The point is that dentists and doctors should not be able to jump from provider to provider just to milk some extra cash at the expense of public health and welfare. They should post a schedule of fees and have customers sign a form that makes them responsible for balances and deficiencies unpaid by their insurance company. The customers are then free to choose a doctor or dentist at their whim, an insurance plan of their choosing, and medical care providers get paid. Crappy insurance plans will quickly get dropped out of the market in favor of plans that pay an acceptable cost to providers, and there will not be a problem of access.
You leave out another big problem. You know where patients end up after going to the ER and getting pain medications? In my office. I can’t tell you how many calls and visits I’ve had in my Internal Medicine practice for dental problems. I don’t have any way to get dental X-rays and I’m not trained to read them even if I could. Patients have no money to pay for dental care so they come back to me over and over for antibiotics and narcotics. Most of the time they don’t want to come in for a visit since they don’t want to pay the copay. Even if they do come in, I can’t get paid for a dental problem.
In the worst case scenario, my diabetic illiterate patient with no transportation walks into my office with a mouth full of abscessed teeth and an uncontrolled sugar because of the infection. I end up begging and pleading any oral surgeon I can find to please, please extract all his teeth so I can control his sugar. The nearest dental school is over an hour away and has a 6 month wait for Medicaid patients. Even if I admit him to the hospital, I can’t get a dentist to see him there.
Not to mention that dental disease has been linked to heart disease; the American system of health care is a horrible mess.
Heart disease for sure, and it’s having an impact even at young ages, before tooth loss is severe. Just those inflamed gums mean bacteria that can take the Secret Squirrel route direct to the heart valves.
But for patients with more severe tooth loss, it’s also things like malnutrition, wasting or failure to thrive (can’t chew to eat, eating becomes exhausting due to the effort of chewing with a reduced tooth surface, pureed food doesn’t stimulate the appetite), as well as overnutrition and obesity (highly refined nutritionally empty foods tend to be softer and more easily chewed and swallowed with little chewing.), not to mention the horrendous psychosocial effects of poor dental health. People truly feel unlovable without good teeth, at least in front; it’s heartbreaking.
I mean, I know nurses are trained to think more holistically than doctors are, but I can’t see how anyone can logically claim that the condition of the mouth and teeth are not part of the human medical profile.
People will go to the ER for a hangnail, especially if they think they can get narcotics out of it.
I do see a lot of people at work that go to the ER for dental problems, though. They simply can’t afford to have their problem taken care of so they just keep coming back for painkillers and antibiotics. It really does suck. Dental pain is truly some of the worst there is because it just doesn’t go away.
Just to throw in a twist - at work I also see quite a few drug addicts (that do have insurance) that will actually KEEP their dental infection specifically so they can go to the ER and get pain meds. They’re told at the ER “get an appointment with a dentist” but never do because they don’t WANT to get it fixed. They’ll hop from hospital to hospital, showing up every few days with a mouth full of horrible and get a script for Percocet or whatever. This goes on until someone at the ER gets smart and runs their name through the controlled substance database and busts 'em (if I were an ER doc I’d run damn near everyone’s name through that thing but then I’m a cynical bitch like that).
I’m well aware of that link, and no, it doesn’t change my perspective.
With your plan, they won’t have 90% market share for long.
Do you not see a conflict between these two statements? I have to accept Medicaid, but I am free to not take any Medicaid patients? What does this even mean?
That is not how participating with an insurance plan works. You are not free to charge whatever you like if you are under contract.
Sigh. What does this mean? Dentists and doctors are the providers. Do you mean carriers?
Fees might not be posted, but they are available on request in general. Dentists usually charge up front, in fact. Charges have very little to do with reimbursement when it comes to medical insurance, however.
Er, if as you say dentist and doctors are free to take whatever patients they want, why won’t they just take insurance that pays them a lot and not see the patients with no insurance/crap insurance. You know, exactly what happens right now?
Heh, that is a shitty situation. No Teaching Hospitals Nearby? But to be fair, a full mouth extraction when the patient has a bunch of decay and abscesses is a beating in terms of time and technical difficulty, and you basically get paid nothing.
The obvious answer is to reimburse providers for providing indigent care. (Or allow it to be deducted. Always thought that was an interesting idea). But you know, no one really seems exciting about providing funds to that end. I doubt that will change any time soon in the US.
I agree. It is just too much. I accept we pay for the skill they have but 100 bucks for just a minute’s service? Also the further treatment is also quite expensive. Is that the reason that its not covered by insurance?
Either dentistry is really important, thus the high prices are legitimate and it should be covered, or it is unimportant, and the costs should be much, much lower. You can’t have it both ways.
And I’m sorry, but you can’t really make me feel sorry for someone complaining about lack of funds if they make three times the average salary. The one dentist around here who still takes Medicaid patients is still the richest guy at my church and is easily in the top 1% of the community as a whole.
Oh, and dentists are hardly the only people who can’t take back their services upon nonpayment. You can use collections like every other business.
I just wish the “initial patient” fees weren’t so ridiculous for most dentists. I mean, I realize that it’s best to have a baseline from which to work, and you need x-rays and labs and a good deep cleaning to do that.
But it’s frustrating for people who could probably afford to get a basic cleaning or a filling, they just can’t afford the $500+ in labs and other fees to become a patient in the first place.
I think that a lot of people that are on Medicaid tend to feel a little guilty about it, and therefore do not use it to its full potential. It’s “other people’s money”. Therefore, they use it for emergencies, or to care for whatever chronic problem that rendered them disabled in the first place and/or unable to get or pay for “regular” insurance.
If I were on Medicaid, I’d feel kind of guilty if I was using it for superfluous stuff. Also, if I were disabled / broke enough to qualify for Medicaid in the first place.** I would likely not have access to reliable transportation and the stable lifestyle that would permit me to show up regularly for my twice-yearly teeth cleaning and fluoride treatments. Preventative care would probably be the least of my worries.
**No easy feat, to qualify for Medicaid these days. If you’re not pregnant, disabled, or the minor child of one of the beforementioned, or the child of someone who’s unemployed or making less than a living wage, no Medicaid for you. At least in Texas, where I live, from what I’ve heard.
You could go to dental school and take care of it yourself because dental school and paying for an office, equipment, staff, and everything else is free, right?
My wife has, within the last year, started grinding her teeth while she sleeps. It’s probably due to her prozac.
Anyway, the dentist gave her a mouthguard that she now has to sleep with. After six months, she went in for another checkup, and it turns out that her bottom four teeth are getting really loose- so much so, that she will probably lose them within a year or two. He recommended a retainer.
Our dental insurance won’t pay for it- they say it’s “cosmetic”. Of course, if she loses the teeth, then she’ll have to get dentures or somesuch- which insurance will likely pay for, and which will probably be more expensive than the retainer is, now.
So it looks like we’re going to have to buy the retainer out our own pockets… to the tune of a thousand bucks.
Read the post you are complaining about again, and try to see if you can properly diagnose the complaint. Let me help you a little, adding emphasis:
So what’s the bigger problem? The lost 2 hours and $100, or the potential to lose thousands of dollars because you cannot refuse service after the first loss? Reading comprehension FTW.
If my dentist says “Hey, I see you have a blastoma here, and it’s growing as we speak!” and says nothing else about it, and I’m too out of it to realize what he’s talking about until later, do I go back to the dentist for care regarding this or to my regular doctor? I just got laid off, so my insurance will go away in a week or so. I will be on my husband’s after that, just waiting for the paperwork.
There’s no reasonable way you can cut $1,000 out of your annual budget? Or is there no reasonable way you can increase your annual budget by $1,000?
I don’t understand this gripe and I don’t mean to slight you but you are using the Internet, which I presume you pay for. Could you not remove your Internet services to aid in recuperating money for this unexpected bill, for example?
I’m sure he could. Then the next time he needs medical care, he can sell his computer, since he doesn’t need it anymore. Then he can cancel his cable TV, then sell his TV and couch. Then sell his car and bicycle everywhere. There’s nothing wrong with our medical system that can’t be remedied by living the life of an ascetic.