25 things vanishing in America, part 2: Dental coverage
Filed under: Health
I did a little poll with my friends. Who among you has lost dental coverage? No hands went up. Then, finally, just when I began wondering if I should fish out a pack of breath mints for them, one person piped in. "I never had it," she offered.If you're under 40, it's likely you're on your own when it comes to arranging your dental care. In your daddy's day, every self-respecting company included full benefits as part of its package. That cushy treatment is in the rear-view mirror. If you have a dental plan as part of your job, smile! You're one of the lucky ones.
Across America, dental patients are being brushed aside. In some states, Medicaid is trying to cut costs by having HMOs and provider networks take care of the care. Result: One in four primary care doctors had fled Medicaid in the past 18 months, according to the Associated Press. Meanwhile, as a Florida paper reports, one county has seen dental patients surge 40% since before Medicaid reform began. Another clinic in California's Bay Area is predicting six-month waits to see a dentist because their federal matching funds may not come through.
In other words, thousands of Americans are resorting to the very last refuge of dental health coverage: Medicaid. There's nowhere else for us to get our teeth care anymore, and since Medicaid is the bottom rung on the health-care ladder, there's nothing below it but an abscess-- er, abyss.
And that's just people whose income is low enough to qualify for Medicaid. Many millions more make too much money. Yet dental coverage, when it's offered at all by an employer, is usually offered as an add-on, and not as part of the basic plan. To cut costs (that is, to make sure there's some money left in the check on payday), people simply don't buy the dental portion of employer coverage. So even people who make a decent living are finding themselves tooth out of luck.
Freelancers (including the self-employed) face the same quandary. Lots of the "dental plans" offered on a non-group basis aren't insurance plans at all, but paid memberships (like Dental Care Advantage, Amacore Dental Program, or Vital Savings by Aetna) that entitle patients to reduced dentist fees. Faced with having to pay twice for a procedure, even one at a reduced rate, many people happily use the inconvenience as an excuse to procrastinate forever.
When Americans decide not to opt into their employer's dental plan, they usually do it saying, "I'll just pay for a cleaning on my own." But they don't. Forbes quotes a Kaiser Family Foundation poll that said that 34% of Americans had not gone for dental care last year.
Technological advances have made going to the dentist relatively easy, dramatically less painful, and quick. My dentist's office looks more like a spa than a den of torture, and I've never heard a drill in there. The stigma is gone. But just when dentists modernized their practices to become truly non-threatening, the financial end of the deal has driven patients away again.
And people oppose national health care why?
Even the Tooth Fairy is under economic strain. Two Minnesota dental insurers came out with their polls of how much the Tooth Fairy is giving kids for teeth these days. One had the average going from $2.09 to $1.88. The other saw a 23% drop, from $2.10 to $1.62.
Remember the "British smile"? The world used to laugh at the English for having mouthfuls of bad teeth. World War II was to blame. During rations, the country's dental care fell into a filthy state. The British have cleaned up their old habits, and nowadays, the only Brit I know with stinky snaggleteeth is Austin Powers. But at this rate, America is set to take the yuck-mouth crown back from Great Britain. Pretty soon, the British will be pointing at us and mocking our "American smiles."
Reader Comments (Page 1 of 1)
4-06-2009 @ 12:35PM
John said...
when my employer offered dental i did the math before i signed up, i would have payed $1500 a year and it had a maxamum of $1000 of work done so i opted out, and the national health care? im from MA were we took a step towerd national health care by making it required to have health insurance. now im stuck paying $300 a month when im a healthy young man needing to see the doc a max of once a year at $300 a visit. and i have to pay out or have penaltys on my tax return. i opted to have my truck repoed so i could pay for the required health care.
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4-06-2009 @ 3:29PM
Jen said...
Really no big deal. Dentist prices vary a lot. There are some very reasonably priced ones out there who won't unneccessary work on you. It's about time we are forced to price around. It helps keep the doctors and dentist prices down and keep them honest.
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4-06-2009 @ 4:19PM
Richard Large said...
Ahhhh... the joy's of the NHS! When was the last time I payed for dental treatment? Well, theoretically every month when I pay my tax, but never have I been asked to sign a bill when I see my destist. It doesn't look the greatest, but when it's free, who cares! You guys really need to feel the joy of state supported health care.
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4-06-2009 @ 7:32PM
david said...
Right on John! For most people, dental insurance is a scam. Insurance is for protection against catastrophic loss, not regular maintenance. Your car insurance doesn't cover oil changes. People who take care of their teeth have few problems with them--the regular checkup and cleaning, the occasional filling, maybe a crown every few years. There ae a few who got a bad mouth from genetics,and for them the $1,000 annual maximum doesn't help muchj--and it costs $1,500! Thats a 33% profit for the insurance company, zero for the dentist. As for HMOs, don't get me started!
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4-06-2009 @ 7:49PM
Michael said...
I live in San Diego, CA. Most of my friends and I have found an alternative to the expensive American dentists.
Guess what?
Mexico has qualified dentists many who were trained here in America! And they charge much less!
Similar to other parts of the world (Mexico, Thailand, etc..), if we got rid of the health insurance industry ( face it who is really getting rich with this system?... ) the prices charged would be far lower!
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4-08-2009 @ 1:05AM
CARMEN BENNETT said...
You are so right about Mexican dentists! We live in Albuquerque, and we were blessed to have a friend tell us about the dental clinic he went to in Juarez. We went to El Paso Texas and stayed at a motel. We called Washington Dental Clinic in Juarez and they come and pick you up with their van and return you to the motel for free, and its very safe. We did our main work in Dec of 2005 and have had good results. I had a new upper denture done, a bottom partial, and 6 bottom teeth capped. Cost: $1600 ! In Albuquerque it would have been over $9 grand ! My husband had all of his teeth capped, for about 5 grand, which in the states would have been about 30 grand. Big savings ! We were just down there again in early March, but we were very safe and well protected. Washington Dental Clinic does not advertise, and usually depends on word of mouth. They are highly recommended!
4-17-2009 @ 11:02AM
Arthur said...
Michael..Did you ever wonder WHY its sooo cheap in third world countries? Maybe they don't worry about the cost of malpractice insurance, steriliztion and governmental regulation. Let's add to that the cost of hiring local staff..I presume the avg assistant in the states makes $15-$20 an hour. Oh by the way they use that income to go to your shop and buy stuff. And yes I'm a dentist and do missions work in Mexico as well as other third world countries..I've seen local dentist there and how Sterile the enviroment is. Anyway I could go on but will leave you with one thought...When buying goods pay as little as possible..but when getting services especially on onself find the best and pay accordingly!
4-07-2009 @ 3:57PM
The Dental Maven said...
Clearly, you have not read about dentistry in the UK.
http://www.dailymail.co.uk/health/article-1166263/One-NHS-dentist--half-afford-one.html
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4-08-2009 @ 3:27PM
Jerry Berggren said...
Through 2007, the number of people with dental benefits has increased every year except 2002, according to the National Assocaition of Dental Plans (of which I am the Director of Research). Preliminary 2008 numbers indicate this trend will continue. A study of employers conducted last year, 6 months after the beginning of the current recession, 72% of employers said they offered dental benefits, and another 19% said they were considering adding the benefit and very few were considering dropping the benefit in 2009.
As for the value of dental benefits, plans are going to vary, but the comparison that david peovided left out one very important component of dental benefits: the discount. Most dental plans have negotiated a deeply discounted price for services that you would not get on your own. That discount can be as high as 80%. So that $1,000 maximum is probably equivalent to at least $2,000 worth of services the policyholder can receive.
Insurance of any sort can be difficult to understand. I would encourage anyone with questions about dental beenfits to explore www.ineeddentalbenefits.com to learn more about dental benefit options and the importance of carrying dental benefits.
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4-26-2009 @ 7:48PM
Patricia said...
I have been in the dental field for over 45 years and have witnessed the beginning of dental insurance in California when it was great! $1000 per person in 1970 was quite a deal when a cleaning might be $20.00 and a crown $150.00 but then gas was only 35 cents a gal and bread 25 cents a loaf.. Here in year 2009 a coverage of $1000 per year is unreasonable: crowns are usually about $800 or more due to the cost materials and labor. If patients ask me whether they should get dental coverage I have them do the numbers: if the cost for coverage and out of pocket expenses is more than your yearly coverage then opening a savings account for major dental work seems more appropriate and then going to an office (like mine) who will work with the patients and not necessarily charge the highest allowable fee. As for going to a foreign country for care: you get what you pay for: They may not have the highest quality sterilization techniques (ie Hepatitis, staph, etc) or the best materials. Also a lay person may "think" cheaper care is better, but I can't tell you how many crowns and bridges we have to replace due to recurrent decay and possibly needing root canal therapy or periodontal care. Bad dental care is nearly as bad as no dental care: either can cause health problems ie heart or other systemic infections.
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6-13-2009 @ 11:05AM
Mark Turner, DDS said...
Dentistry is and always has been discrectionary, elective treatment. No insurance company or government will ever be able to provide a patient with anything more than a limited financial benifit for limited services. One thing that has not changed in 4,000 years, and is not going to change. Pharoahs had their mouths restored with gold and their adult chamber servents likely had no natural teeth remaining. As I like to say, patients today fall somewhere in between. Dental Insurance only helps some patients push the arrow indicator a click or two to the right, and for the masses it comes to silent halt!
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