Tuesday, December 08, 2009

Can You Afford a Dentist?

I had a dentist appointment yesterday to get a tooth filled. This is a medical group office with three dentists and a dozen support assistants. So when I pulled in at 7:50 for my 8 am appointment the parking lot was pretty empty. I was figuring that I must have gotten the time wrong. But sure enough they were open.

My simple filling turned out to be a ceramic inlay with 2 surfaces. My share was $395 with insurance. They are up front with the costs, you pay first and then they do the work. I balked at the price (choked is a better description). I pointed out that I had already spent $1200 on one root canal and two crowns so far this year. The secretary doing the financing dropped the price down to $250 and let me use a $100 dollar off coupon they had sent me. Between me and my insurance, they got about $450 (the insurance paid $300).

So they "owned" me for two hours. During that time only one other patient came in to my area (there are 4 stations), and that was for an estimate. It was just me, the Doc and three hygienists. After they finished, I got up and went into the outer office and noticed that there were only two people waiting in the lounge. It saddened me, the lounge use to be full of people.

I should have guessed what was happening when I called for an appointment and they wanted to schedule it the next day (I need at least a week to mentally prepare for dental work). People are cutting back. It is all very invisible; you won’t read about it in the morning paper, but you will read it here. Save a dentist and "stimulate" the economy, go get that tooth filled.


Anonymous said...

I find it annoying that many doctors and dentists increase the fees if you give them an insurance card.

Jim in San Marcos said...

Hi Anon 11:13

Around here, you get a cheaper rate if you have insurance. A root canal for a walk in patient is say $750 where it is $600 for me and the insurance pays $400.

I have noticed that with insurance, the doctor makes money by doing more than one procedure. Instead of a ceramic filling one surface, the operation becomes two surfaces with an inlay.

Insurance greases the chute. You get top of the line treatment, that you would not have paid for if it had come out of your own pocket. How necessary it is, is a value judgment.

Around here the rage is getting a Colonoscopy if you have insurance. I imagine its about a $1,200 dollar procedure that my insurance covers. I advised my doctor that I didn't expect to live forever and I would pass on the test.

Anonymous said...

My dentist said it would cost 1250.00 for a filling. I was shocked, but then the receptionist said I could finance the work. I left. Know any cheap dentists?

Anonymous said...

All those medical expenses are inflated. Prices will come down as the economy, after the artificial govmt stimulus stops, continues to fall apart.

Estimated price of a filling in 2014... $50.

Anonymous said...

I am Polish and have been living in US for the past 5 years. It is a shame to me that people in this country do not have accessible, affordable healthcare, especially dental care. When I talk to my friends and they tell me prices they have to pay for a simple dental work I am amazed. I go to Poland every second year and get all my work done over there. Without any insurance I usually pay around $80.00 for a root canal treatment at a private office!I must note that Polish doctors offer same technology and materials as they are available here. The only difference is that drugs and materials in Poland are 70% cheaper! US market is closed to foreign medications and that is why US government drives the prices up. Thankfully to pharmaceutical lobby they are able to screw us all.Another aspect – I pay 12% of my gross wages in my insurance premium for myself and my child. I have 1,5K deductible and pretty high co-pays. My child has a medical condition and I am forced to spend around 8.5K a year in medical expenses. In Poland employee and employer pay 7,5% healthcare tax each and medical services are free. This is what I call real insurance- when you get sick you do not have to think if you can afford to go – you just go. Another thing are schools, public universities are free in Poland so you are not stuck with a loan when you leave your school. My point is that for the services that government offers to people here our taxes are still way too high.Dental services are partially covered by national insurance in Poland – meaning that you have to pay extra for some things i.e. Anesthesia will cost you around $5.00, top-notch filling around $10.00, teeth whitening will run around $100.00Also, private dental offices in Poland have contacts with government so you can go to a private doctor and have that visit partially covered by your government insurance.I am not prizing the social, universal system in Poland because it has its flows. I believe that this system lets people preserve their dignity and feel more secured in the country they live in.

You can go to Poland Most people speak English there.

Jim in San Marcos said...

Hi Anon 8:45

You have got to stop driving your Lamborghini to the Dentist office, --they saw you coming;>)

I can see where a root canal and a crown could cost $1200, but a regular silver filling one surface would be about $125 and add $75 if you wanted it porcelain filled.

A lot of people here go to Mexico for their dental work it is about 50% less in price and they do good work.

Jim in San Marcos said...

Hi Anon 11:35

I don't see it getting down to $50. People don't like going to the dentist. I read a while back that about 50% of our population has never been to a dentist. I haven't been able to check it out, but it is surprising if true.

Jim in San Marcos said...

Hi Anon from Poland

Welcome to the USA.

I think we need to define some terms here, the media is guilty of mixing apples and oranges.

When you buy insurance, you are agreeing to pay in small yearly payments for an event that will probably happen. You will pay the full amount, it just won't be all at once. This is the concept behind life insurance, home owners insurance, car insurance etc. If you don't want it, you don't have to pay for it.

With a government health care plan, everybody has to join, you can't say no. You cite that in Poland, the employer pays 7.5% and the employee pays 7.5%. I beg to differ, the employee pays it all, the employer pays none of it. The part that comes out of your paycheck is taxable. The part the employer pays is a business deduction. That is part of your calculated wage. So in Poland, you pay about 15% for health insurance.

In this country if you are healthy, you could get away without health insurance for 30 years. So take your yearly base pay over the 30 year period and figure that 15% is paid to health insurance, that amounts to 4 and 1/2 years worth of earnings.

As for college, if it is free, why doesn't everyone in Poland have a college degree? There must be a limiting factor.

There is a concept here that needs to be understood. If you need something and can't afford it, and I don't need it, it can become affordable to you, if I get taxed so you can have it. There is no free ride.

If you wanted a good dental policy over here, figure about a dollar a day for full coverage. It's not much, but nobody wants to pay it.

In this country people don't need insurance until they get sick and then they whine that they can't afford it. What insurance company wants to insure someone that is really sick? It makes no sense. You insure healthy people knowing a certain percentage will get sick and charge accordingly.

The thing that really makes me wonder is the fact that the real charges paid to the doctors are hidden in your country. Our costs here in the States, are what I consider reasonable. You might look at our costs as being unreasonable,from your standards in Poland, but I get the feeling that your doctors are paid quite well, nobody discusses dental rates on a state level. I have never seen a state run program that isn't full of financial abuse. Your government could be paying $2,000 for a root canal and your cost is only $80.

Thank you for your comments.

Take care.

Anonymous said...

It took time but it is here. Not many realize that we are in a depression. Who knows what it will be called by economic historians... The Greater Depression?

IMHO: After this artificial govmt stimulus fades away and its short term results disappear, the nasty fundamentals (that everyone in the govmt and the Fed have ignored) will then continue to drive the economy downwards (more bank failures, more catastrophes in residential and commercial real estate, unemployment continues dropping or flatlining, stock market dips, etc. etc.) everyone will run back to the USD and it will then strengthen and maintain that trend for a good time.

I’m not buying gold or going into commodity based currencies… the USD will come back strong for a decent period as deflation and economic disruption has its way with us. Later in time, when inflation hits hard, will be when you jump out of the strong dollar and get into hard, tangible assets.

The Center for the Study of Cycles forecasts a major uptrend for the USD within the next 2-3 years. It could happen sooner too I would surmise.

Jim in San Marcos said...

Hi Anon 7:53

All of that will probably happen, I am just not sure of the order of the chain of events. One thing for sure people act in groups. What we think of as unique approaches to a problem, others have the same thing in mind.

It's a little like two cars approaching head on. If you take his lane, is he going to swerve back at the same time? Or both of you decide to play chicken? The unconventional approach is to get off the road and sometimes that isn't an option.

The big unknown here (and a very irritating one) is that governments change the rules and that is where your best laid plans run amok.

We all have front row seats and its hard to say whether that a good thing or a bad thing. Enjoy the show, we paid for it.

Thank you for your comments.

Anonymous said...

Jim you are right. The government is one big dangerous variable. Who knows what Obama and Congress will pull off or what monkey wrench they'll throw into the works in the future (not to mention all of the unintended consequences that will occur from the incipient monkey wrenches that they've already thrown in).

They've extended TARP; a whole new financial regulation and control is going in on the financial sector (just passed the house and is going to senate now); they are in bed with the banksters; they continue to meddle and create bubbles and/or false conditions wherever they go; the Fed is printing away; they are controlling businesses and determining which are threatening to the economy (that's fascism); etc. etc. etc. etc.

God save us.