Why the cost of your dental care really hasn’t increased that much? In fact it has either tracked or lagged behind the consumer price index and this is despite all the advances in dental technology. Compare that observation to your medical care costs. If you go in to see your dentist and ask for an estimated cost of treatment, 9 times out of 10 you will get a quote. Try doing that in your physician’s office. Why? Because your dental care has been a product of the free market system. The insurance companies have yet to invade the purview of your oral health the way they have dominated, if not destroyed your overall health care.
You get your teeth examined, cancer screening, teeth cleaning and x-rays twice a year for less than $300.00. And that’s about two hours of actual treatment from your dentist and his/her team. At the physician’s office you go in once a year, see your physician or his PA for about 10 to 16[i] minutes on average and it costs $300 to $900.00, depending on possible immunizations and your blood work (which costs more than twice what an independent lab charges if you have it done outside of your physician’s office).
Physicians are paid by insurance and Medicare submittals based on the procedures they perform and not by the amount of time they spend with you.
So the quicker the visit the more procedures they can bill insurance. If they take too long it cost them money, not you. And all their revenues are based on negotiated fees with your insurance company, not the free market system. Ah, finally, the key phrase – free market system. Dentistry never bought into insurance coverage for your treatment and care, and as a result of the free market system there has been a reasonable or to put it better, an affordable increase to the cost of your oral health care based on the supply and demand curves.
So how much does insurance influence the cost of your health care? Anecdotally, let me tell you about my daughter’s experience, but really my experience with health care and why we are the losers in this battle to secure adequate health care treatment at an affordable price. My daughter had a cyst under her eyelid. It was not visible to you or me, but it irritated the dickens out of her cornea. I found a specialist and accompanied my daughter to the examination. It was determined that the treatment required general anesthesia to safely perform the surgery. When I asked ‘how much’, I received no answer. I was passed on to the patient coordinator for that physician. So I asked ‘how much’, and again I received no answer. They didn’t have a clue what this was going to cost me. So I immediately said ‘sign me up, I’ll take two’. Seriously though, they needed to contact my insurance carrier and they would let me know, great.
I get a call from the physician’s office. It’s going to cost you $800 and change. Ok, great, and is that my drive out price? ‘Oh no, that’s just the doctor’s fee.’ Ok, so what else? I have to call the surgical center. Ok, how much does that cost? We [the doctor] don’t know, you just have to call and find out. So I called. The gentleman quoted me $1540.00 including 2 hours of facility and the anesthesiologist. ‘Oh, and you won’t be needing a biopsy, since this is cosmetic.’ No wait, this is not cosmetic, it’s required surgery. So the gentleman backs up and re-quotes the price. It will be $4 to 7 thousand for the surgical suite, $1800 & change for the anesthesiologist and X amount of dollars for the biopsy.
Wait, hold on, back up a minute, you just quoted me a price that is almost 7 times what the same procedure would cost if it was elective surgery. Ah, that key phrase creeps back in to the conversation. Under a free market system, elective surgery only garners what the market will bear. But under an insurance based system, physicians don’t know what it costs, so they inflate the costs and hope for some remuneration equal to or in excess of what it really costs under a free market system to treat you. In other words, it’s a crap-shoot your physician is playing with your health insurance company. And the loser is you. So the next time you go to the physician or the dentist, remember why you’re paying what to whom, the physician or your insurance company. And the next time you discuss health care reform; you’re probably talking about insurance reform. If we can answer your questions or concerns, please do not hesitate to contact us.
Novy Scheinfeld, DDS, PC
290 Carpenter Drive, 200A
Atlanta (Sandy Springs), GA 30328
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[i] About.com, Trisha Torrey, November 14, 2008.