Special interests aside, I never understood the rationale for the imaginary line between the mouth and the rest of the body when dealing with healthcare coverage. For example, in the US there is...
Special interests aside, I never understood the rationale for the imaginary line between the mouth and the rest of the body when dealing with healthcare coverage.
For example, in the US there is already a byzantine system (sic) of paying healthcare costs that involve parallel companies and parallel policies within those companies and parallel treatment options within those policies that all nominally guarantee efficiency -- and for some reason there also exists in America an entire other byzantine system that deals with just the 8 cu in between your nose and chin.
In Canada, I believe a long long time ago, someone decided that seeing a GP was essential for health, but for some arbitrary reason, decided dental was not. So dental's always been separate, which...
In Canada, I believe a long long time ago, someone decided that seeing a GP was essential for health, but for some arbitrary reason, decided dental was not. So dental's always been separate, which honestly makes no sense, especially if we're talking about things beyond a general cleaning. Though to be fair, in Alberta at least, surgery is covered, so some dental will be covered that way.
Note: randomly, drugs are also not covered in universal health care in Canada.
Some insider baseball, I used to work in medical billing and the tug of war between medical and dental insurance companies over oral surgery was some of the dumbest and most wasteful work I've...
Some insider baseball, I used to work in medical billing and the tug of war between medical and dental insurance companies over oral surgery was some of the dumbest and most wasteful work I've ever done. It was the same dance almost every time, sometimes for the same patient.
For example, I billed a wisdom tooth extraction to a dental insurance company and used the billing code that was acceptable for that procedure for that company. They came back with a refusal to pay saying it was a medical, not dental, procedure and should be billed to medical insurance. Sent all the paperwork to the medical insurance who wrote back saying that it was not medical and should be considered dental. Sent all of that paperwork back to the dental insurance who then paid what the policy described. Every time I dealt with that kind of procedure and that company it was the same hoops. This and hundreds of other examples like this made me step back and wonder why this system exists at all.
That sounds super frustrating. I know I narrowly dodged something like that when I needed surgery. Luckily, I was sent to a specialist and pretty much everything they do is covered by CHA. Though...
That sounds super frustrating. I know I narrowly dodged something like that when I needed surgery. Luckily, I was sent to a specialist and pretty much everything they do is covered by CHA. Though I still ended up paying out of pocket for the x-ray that determined I needed surgery itself...since neither side would pick it up, and I'm lucky enough to have the funds to cover it.
It was not arbitrary. The Royal Commission on Health Services (1964) recommended targeted stakeholders receive public coverage for dental services (e.g., children, expectant mothers, public...
for some arbitrary reason
It was not arbitrary. The Royal Commission on Health Services (1964) recommended targeted stakeholders receive public coverage for dental services (e.g., children, expectant mothers, public assistance recipients) but due to the introduction of public health fluoridation, dentists aggressively lobbied for private control over fees and billing using the age-old sanctimonious argument condemning governmental interference in such intimate relationships as those existing between patient and practitioner1. In truth, dentists foresaw private services, insurance coverage, and personal responsibility (i.e., brushing teeth) as leverage for higher earnings, albeit with the higher overhead that comes with keeping in-house lab and diagnostic services (e.g., radiology).
Dentists who complain about oral health not being given the same legitimacy as health have their own legacy of political influence to blame. Although, most dentists only complain about provincial governments interfering by demanding fee guides and sterilization guidelines. Generations of professionals raised in this milieu only strengthen the perception that dentists are much more concerned about dental fees and call-backs than about your oral health. The ultimate decision to position profit before patient will forever place an asterisk after the title DDS, in my opinion, demarcating that prioritization.
Additionally, and because I hear time and again from dentists that they need to charge high fees in order to afford the high cost of operating a dental clinic, there is no reason that the public system could not build large, publicly-funded dental clinics, where dozens of dentists share radiology, lab services, surgeries, etc. But the dentists would then be professional employees or consultants to the "dental hospital" and they have vehemently and aggressively acted to smother and kill any suggestions of such models because it would completely re-define their earning potential. On the other hand, it often feels unbalanced that dentists typically earn as much or more than highly-trained medical specialists (e.g., neurologists, cardiologists) when 90% of dental practice is not that complicated or delicate in nature.
tl;dr The system was designed by and still works for dentists. The fact that fewer and fewer people can afford dental service (and fewer have access to comprehensive dental insurance) is not an issue for dentists. They simply see it as an issue to be remedied by private insurance companies (e.g., QuickCard, CDSPI).
You're welcome. Apologies for the bias; I provide consulting services to dentists and they're often bemoaning financial circumstances with no appreciation for how/why the system was organized in...
You're welcome. Apologies for the bias; I provide consulting services to dentists and they're often bemoaning financial circumstances with no appreciation for how/why the system was organized in this fashion.
Here in So Cal, dentists are a dime a dozen and many try to upsell you on procedures. Before my current dentist, our last one would always try to get us to sign up for his whitening procedures or...
Here in So Cal, dentists are a dime a dozen and many try to upsell you on procedures. Before my current dentist, our last one would always try to get us to sign up for his whitening procedures or he would try to convince us that any imperfections in the base of the tooth were unsightly and needed to be touched up. I hated that dentist. When my daughter needed braces, we switched our insurance plan to include the orthodontics option (based on talking with the insurance rep), but then were told once we went to the actual orthodontist that our insurance didn't cover braces. It allowed all orthodontics except braces. I cancelled my insurance after screaming at them that the only reason we switched was because they said it would cover the braces.
It's like if I went to my regular doctor and she started trying to get me to dye my hair I would tell her fuck off. Why do I care if my teeth are not as pearly white as photoshop can get? It truly...
It's like if I went to my regular doctor and she started trying to get me to dye my hair I would tell her fuck off. Why do I care if my teeth are not as pearly white as photoshop can get? It truly baffled me how hard the guy pushed, until I realized how much profit he probably makes from the whitening procedure.
I won't say it's a scam because your teeth actually do get whitened, but labor per dollar it is probably the highest ROI of any procedure in a dental office. The kit doesn't cost very much, the...
I won't say it's a scam because your teeth actually do get whitened, but labor per dollar it is probably the highest ROI of any procedure in a dental office. The kit doesn't cost very much, the dentist can pretty much walk away once the laser is on, it's usually not covered by insurance so the payment is up front and often in cash, etc. etc.
That's so weird. I would hate to have to sell something I don't believe in (I also hating selling anyways). On another note, it's nice to know my dentist wasn't doing this. Years back I remember...
That's so weird. I would hate to have to sell something I don't believe in (I also hating selling anyways).
On another note, it's nice to know my dentist wasn't doing this. Years back I remember asking my dentist about it once, and she told me just to run to the drug store and do it at home, since the results are pretty much the same.
I honestly really dislike how popular teeth whitening has gotten. I don't have the whitest teeth and never minded, but now I do feel a little pressured to whiten them at least a little before...
I honestly really dislike how popular teeth whitening has gotten. I don't have the whitest teeth and never minded, but now I do feel a little pressured to whiten them at least a little before weddings and such events.
And it's so bad for the environment, and so unnecessary...
It's a fad that I wish would go away. Our teeth stain. It just happens, and it doesn't hurt anything. When I would see it on the schedule I knew I could kick back for like an hour, but I also knew...
It's a fad that I wish would go away. Our teeth stain. It just happens, and it doesn't hurt anything. When I would see it on the schedule I knew I could kick back for like an hour, but I also knew I wouldn't really be helping anyone.
Unfortunately this seems a common thing across several countries. In Italy, dental care is provided by the national health service but in UK it's not. Unless you're a student or below a very low...
Unfortunately this seems a common thing across several countries.
In Italy, dental care is provided by the national health service but in UK it's not.
Unless you're a student or below a very low yearly earning you have to pay for everything.
The resulting effect is that the average english citizen has lots of issues with is teeth and it's quite normal to see yellow or missing teeth in the mouth of the average middle class person.
It doesn't help that regular health insurances leave the dental care out of their policies. And this applies to both UK and Italy.
As someone who avoided going to the dentist for a few years, be aware that root canals and crowns cost a fair bit more than filling cavities. On the order of 3 to 4 times as much for me. In the...
As someone who avoided going to the dentist for a few years, be aware that root canals and crowns cost a fair bit more than filling cavities. On the order of 3 to 4 times as much for me. In the end, I would have saved myself a lot of pain and money if I had gone in sooner and dealt with the problems that were developing.
Special interests aside, I never understood the rationale for the imaginary line between the mouth and the rest of the body when dealing with healthcare coverage.
For example, in the US there is already a byzantine system (sic) of paying healthcare costs that involve parallel companies and parallel policies within those companies and parallel treatment options within those policies that all nominally guarantee efficiency -- and for some reason there also exists in America an entire other byzantine system that deals with just the 8 cu in between your nose and chin.
In Canada, I believe a long long time ago, someone decided that seeing a GP was essential for health, but for some arbitrary reason, decided dental was not. So dental's always been separate, which honestly makes no sense, especially if we're talking about things beyond a general cleaning. Though to be fair, in Alberta at least, surgery is covered, so some dental will be covered that way.
Note: randomly, drugs are also not covered in universal health care in Canada.
Some insider baseball, I used to work in medical billing and the tug of war between medical and dental insurance companies over oral surgery was some of the dumbest and most wasteful work I've ever done. It was the same dance almost every time, sometimes for the same patient.
For example, I billed a wisdom tooth extraction to a dental insurance company and used the billing code that was acceptable for that procedure for that company. They came back with a refusal to pay saying it was a medical, not dental, procedure and should be billed to medical insurance. Sent all the paperwork to the medical insurance who wrote back saying that it was not medical and should be considered dental. Sent all of that paperwork back to the dental insurance who then paid what the policy described. Every time I dealt with that kind of procedure and that company it was the same hoops. This and hundreds of other examples like this made me step back and wonder why this system exists at all.
That sounds super frustrating. I know I narrowly dodged something like that when I needed surgery. Luckily, I was sent to a specialist and pretty much everything they do is covered by CHA. Though I still ended up paying out of pocket for the x-ray that determined I needed surgery itself...since neither side would pick it up, and I'm lucky enough to have the funds to cover it.
It was not arbitrary. The Royal Commission on Health Services (1964) recommended targeted stakeholders receive public coverage for dental services (e.g., children, expectant mothers, public assistance recipients) but due to the introduction of public health fluoridation, dentists aggressively lobbied for private control over fees and billing using the age-old sanctimonious argument condemning governmental interference in such intimate relationships as those existing between patient and practitioner1. In truth, dentists foresaw private services, insurance coverage, and personal responsibility (i.e., brushing teeth) as leverage for higher earnings, albeit with the higher overhead that comes with keeping in-house lab and diagnostic services (e.g., radiology).
Dentists who complain about oral health not being given the same legitimacy as health have their own legacy of political influence to blame. Although, most dentists only complain about provincial governments interfering by demanding fee guides and sterilization guidelines. Generations of professionals raised in this milieu only strengthen the perception that dentists are much more concerned about dental fees and call-backs than about your oral health. The ultimate decision to position profit before patient will forever place an asterisk after the title DDS, in my opinion, demarcating that prioritization.
Additionally, and because I hear time and again from dentists that they need to charge high fees in order to afford the high cost of operating a dental clinic, there is no reason that the public system could not build large, publicly-funded dental clinics, where dozens of dentists share radiology, lab services, surgeries, etc. But the dentists would then be professional employees or consultants to the "dental hospital" and they have vehemently and aggressively acted to smother and kill any suggestions of such models because it would completely re-define their earning potential. On the other hand, it often feels unbalanced that dentists typically earn as much or more than highly-trained medical specialists (e.g., neurologists, cardiologists) when 90% of dental practice is not that complicated or delicate in nature.
tl;dr The system was designed by and still works for dentists. The fact that fewer and fewer people can afford dental service (and fewer have access to comprehensive dental insurance) is not an issue for dentists. They simply see it as an issue to be remedied by private insurance companies (e.g., QuickCard, CDSPI).
That was very informative, thank you.
You're welcome. Apologies for the bias; I provide consulting services to dentists and they're often bemoaning financial circumstances with no appreciation for how/why the system was organized in this fashion.
Here in So Cal, dentists are a dime a dozen and many try to upsell you on procedures. Before my current dentist, our last one would always try to get us to sign up for his whitening procedures or he would try to convince us that any imperfections in the base of the tooth were unsightly and needed to be touched up. I hated that dentist. When my daughter needed braces, we switched our insurance plan to include the orthodontics option (based on talking with the insurance rep), but then were told once we went to the actual orthodontist that our insurance didn't cover braces. It allowed all orthodontics except braces. I cancelled my insurance after screaming at them that the only reason we switched was because they said it would cover the braces.
Ugh. I remember trying to push teeth whitening on patients. It's weird trying to sell a service that I would never bother to get for myself.
It's like if I went to my regular doctor and she started trying to get me to dye my hair I would tell her fuck off. Why do I care if my teeth are not as pearly white as photoshop can get? It truly baffled me how hard the guy pushed, until I realized how much profit he probably makes from the whitening procedure.
I won't say it's a scam because your teeth actually do get whitened, but labor per dollar it is probably the highest ROI of any procedure in a dental office. The kit doesn't cost very much, the dentist can pretty much walk away once the laser is on, it's usually not covered by insurance so the payment is up front and often in cash, etc. etc.
That's so weird. I would hate to have to sell something I don't believe in (I also hating selling anyways).
On another note, it's nice to know my dentist wasn't doing this. Years back I remember asking my dentist about it once, and she told me just to run to the drug store and do it at home, since the results are pretty much the same.
I've worked around rotten and decaying mouths, but what skeezed me the most were teeth whitenings and botox.
I honestly really dislike how popular teeth whitening has gotten. I don't have the whitest teeth and never minded, but now I do feel a little pressured to whiten them at least a little before weddings and such events.
And it's so bad for the environment, and so unnecessary...
It's a fad that I wish would go away. Our teeth stain. It just happens, and it doesn't hurt anything. When I would see it on the schedule I knew I could kick back for like an hour, but I also knew I wouldn't really be helping anyone.
That really sux. My braces weren't covered either, so my parents paid out of pocket, and those are crazy expensive.
Unfortunately this seems a common thing across several countries.
In Italy, dental care is provided by the national health service but in UK it's not.
Unless you're a student or below a very low yearly earning you have to pay for everything.
The resulting effect is that the average english citizen has lots of issues with is teeth and it's quite normal to see yellow or missing teeth in the mouth of the average middle class person.
It doesn't help that regular health insurances leave the dental care out of their policies. And this applies to both UK and Italy.
Definitely unfortunate. Dental care is such a huge part of physical and mental health.
As someone who avoided going to the dentist for a few years, be aware that root canals and crowns cost a fair bit more than filling cavities. On the order of 3 to 4 times as much for me. In the end, I would have saved myself a lot of pain and money if I had gone in sooner and dealt with the problems that were developing.
The full radio broadcast and transcript of this is available near the top of the summary article.