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The Dental Probrem

September 16th, 2011 · No Comments · Lori, z. blacklist

While the entire healthcare industry is a racket full of it’s own bullshit, I’m going to rant blog [1] today about the dental niche.

The Dental Probrem[2]

We pay for dental “insurance”. Apparently, the morons who designed this system don’t understand how insurance is supposed to work. Insurance is supposed to go like this: everyone pays a little money into a pool. When something goes wrong, the pool pays that person’s bill. It’s not really more complicated than that unless you want to factor in every case detailed in the industry regulations. Rates are figured based on the likelihood of something going wrong. If you live in a Hurricane town, you pay more insurance on your house. If you live in a place with a lot of bad drivers, you pay more insurance on your car. If you smoke, you might find it difficult to get health insurance at all. We all pay a little, some a little more, so there is money to use when bad stuff happens.

When Bad Stuff Happens

Dental insurance, however, just barely covers the cleanings and xrays needed per year. It’s a wash. Fine. But the kicker is when you need work done…and they only cover %50…aaaaannnnnnnd, they cap that! So, someone has to shell out a bunch of c-notes ($1200-1500) when my bridge needs replacing.

Bridge #1) My parents paid for the whole thing. Dental insurance wouldn’t cover it. They claimed my missing tooth was a pre-existing condition. Um, yeah, if you count my great aunt and skip a generation all the way back to Eve. Their “logic” was that they didn’t pull the baby tooth, therefore, they didn’t start the work. Um. I was like 9 when they pulled that tooth. Was that insurance company even in business, then? Maybe. Was my mom a potential customer? Probably not. Dental insurance for teachers in rural Texas would be a luxury back then, I’m sure! WTF?
At the next open enrollment, Mom ripped the insurance rep a new one, dropped all her coverage, and went on Daddy’s insurance with his school district. You see, when she signed up for dental with that dolt, she asked the very question: missing tooth, braces, bridge, etc. And, they paid for the braces including that fancy spring, and the retainer with that fancy fake tooth…so why not the final step? I think it was ~$4000. That’s more than my flute cost….and it’s good for way more than ten years! It’s a bridge, not computer!

Bridge #2) Insurance covered half. I paid $1200 for a beautiful bridge that was improperly installed.

Bridge #3) Insurance covers half up to the cap. Emil paid $1500.

Furthermore, both DDS’s for Bridges #1 and #2 wanted to do implants, instead. Yes, I love the idea of you tying a tooth to my jaw with a wire. And repeating that process every ten years, too! Fortunately/unfortunately insurance didn’t cover that extra expense. So, my first bridge was a pair of veneers along the front of my two good teeth to hold the one false tooth. By Bridge #2, we had to move to caps, so my original (healthy!) teeth had to be ground down even further. Remember, kids, this was all in an effort to keep as many of my own teeth in my head as possible. #fsckrs.

Backstory

You see, here is what adult-Lori would have insisted upon: pull the baby tooth #10 and it’s matching “friend” #7. File down the canines (#6 and #11) so they look like incisors. Pull the additional teeth necessary (if it was seven their way, this way needs four more or six total) to fit my mouth. Use braces to shift the canines and remaining teeth into place. All real teeth…which is what they said they wanted for me. None of the mess or expense. I wasn’t mature enough at nine years old to devise this plan or insist upon it. Or, if the baby tooth was going to be a problem, cap just that tooth. It was nicer than the little subs I have, now!

This—the decision to force me into the pain and expense of a new bridge every decade for the rest of my life…when that could have very well been avoided—is what has me so pissed off!

What We Can Predict

They expect bridges to last about a decade. This is predictable information about my dental future.

Another thing that’s predictable: I’m a 5-month patient. I really need my teeth cleaned every 5 months. Insurance won’t cover you if you schedule a cleaning early. Even if it’s the holidays, they expect you to wait until January instead of sneaking in in November.

Also predictable: a cavity every couple of years. I think I was a real grown-up before my first cavity. I attribute the rise in frequency to two things: new-Army dentist philosophy is “fix it fast” (old-school philosophy was “watch” to see if it will develop into a cavity) and money. They make more money when you are in the chair than when it’s empty!

And a known fact: I take good care of my teeth. I’m not perfect, but I usually get compliments from the hygienist.

Emil gets cavities a little more often (once a year, maybe) and doesn’t floss often, but his teeth aren’t falling out of his head or anything. And, he doesn’t have any “appliances”. I think he might even still have his wisdom teeth.

If we know all these things, can’t the “big insurance computer in the sky” predict what we should pay to cover this and cushion for emergencies, too?

How I Think It Should Work

Granted, this scenario has me (and Emil) paying a little more per month, but it’s what I’d prefer over $1500 “surprises”.

  • Cleanings/Xrays: $175 each, every six months for him & every five for me: $770 annually
  • Fillings: $140 each, 3 every two years: $210 annually
  • Bridge: $3000 each, 1 every ten years: $300 annually
  • Emergency: In ~70 years of adult life, let’s just say everyone has one dental emergency that is $1000 (this is where the “insurance computer” could nail this. The industry is about nothing if not averages and predictions.): $2 annually
  • Dentures: Again, assuming we live long enough to need them, $3000 each: $7 annually
  • TOTAL: $1290 per year, $107 monthly

Now, I take good care of my teeth. Let’s compare that with the “good driver” discounts and say *I* save 10%. $102.09 monthly.

Normal. So, if you’re a “good” dental patient, it might look like this:

  • Cleanings/Xrays: $175 each, every six months: $350 annually
  • Fillings: $140 each, 1 every three years: $47 annually
  • Emergency:  $2 annually
  • Dentures: $3000 each: $7 annually
  • TOTAL: $406 per year, $34 monthly

Isn’t that a lot easier? On everyone except me/Emil? If I can do this in a blog post, why can’t that part of the Dental Industry get their shit together? Oh, because it’s a racket, that’s why.

Finally, let’s assume that we all pay the number in the middle: Averaging what Emil should pay, what I should pay, and what a good person pays, ~$45 monthly. Hey, now wait a minute…that’s even a little less than what we pay!

See? Racket. #fsckrs.

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[1] To me, a rant doesn’t have to have a solution. When there is a solution to the rant-worthy problem, it’s no longer a “rant” by my definition.

[2] http://www.southparkstudios.com/full-episodes/s12e08-the-china-probrem

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