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Why Dentistry Is Separate from Medicine

theatlantic.com

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Re: Why Dentistry Is Separate from Medicine

#51

Post by PeterisP »

mtdewcmu wrote: post #35

The real question is not why is dentistry kept separate from medicine. The real question is why dental insurance is treated like a luxury, compared to regular health insurance. The problem is that so many people are unable to afford dentistry, because of poor or no coverage.

If you have a type of expense that's (a) unpredictable, and (b) rare, then it's a good fit for insurance.

Car crashes are unpredictable and rare, so it makes sense to insure them.

Regular car maintenance is predictable and tends to happen in (almost?) every insurance period, so it's not - some payment plan or bundling may be an option, but insurance makes no sense, it would only be more expensive than paying directly because of an extra middleman.

Getting a broken leg or cancer is unpredictable (there are individual risk factors, but they are just as relevant for car crashes) and rare, so it makes sense to insure them.

Dental care, on the other hand is common and regular - e.g. someone who didn't have coverage for broken leg or cancer most likely won't get a broken leg or cancer in the next year, but all the people who have been unable to afford dentistry generally almost all will need dentistry in the next year. Some payment plan or bundling may be an option, but insurance makes no sense, it would only be more expensive than paying directly because of an extra middleman. If you are unable to afford dentistry, then you'd be unable to afford the insurance price hike.

It's not a problem of insurance as such, it's a problem of who pays for healthcare of poor people. USA has a weird historical artifact in that in the last >100 years insurance has become almost a synonym for employer-funded healthcare payment plans, not as real insurance. If you want employer-funded healthcare to include dentistry, then that's not going to be solved by medical people but the employment market - industries where workers have market power (e.g. IT) will get such conditions, and industries where worker's don't have market power (e.g. fast food) won't. Also, this can't solve the manner of dentistry for unemployed or underemployed people who don't get employer-funded insurance and thus a dentistry-included insurance would be as expensive or more than just paying for a dentist.

Re: Why Dentistry Is Separate from Medicine

#52

Post by [deleted] »

barking wrote: post #25
peteretep wrote: post #23

Earlier quoted context omitted.

That's a bit different, as an opthalmogist is a real doctor who treats eyes. Dental equivalent would by a dental hygienist, I guess.

Ophthalmologists are specialists just like any other medical specialist, e.g. a dermatologist. Does the fact that general practitioners refer people on to dermatologists mean that family doctors are not 'real doctors'? Sorry if that sounds aggressive, I am unfairly taking the inference from what you said that opticians are somehow 'fake'.

[deleted]

Re: Why Dentistry Is Separate from Medicine

#53

Post by mivade »

autokad wrote: post #50

i'm very happy its under a separate umbrella. think of all the years of unnecessary education they'd pile on to dentistry and the bottle necks they would put up to raise the wages to MD level. currently it costs 150$ to show up 10 minutes early for an appointment to be seen 20 minutes late for an interaction that lasts 5 minutes. and then i say 'my knee also hurts' and they say you need to schedule another appointmen…

> think of all the years of unnecessary education they'd pile on to dentistry and the bottle necks they would put up to raise the wages to MD level.

That seems more an indictment of the medical education system than the insurance system. There are already parallel medical education systems in the US (MD vs. DO, although there is little practical difference). Seeing either type of physician is treated equally by health insurance. Why can't health insurance also cover DDS visits as well?

Re: Why Dentistry Is Separate from Medicine

#54

Post by Broken_Hippo »

autokad wrote: post #50

i'm very happy its under a separate umbrella. think of all the years of unnecessary education they'd pile on to dentistry and the bottle necks they would put up to raise the wages to MD level. currently it costs 150$ to show up 10 minutes early for an appointment to be seen 20 minutes late for an interaction that lasts 5 minutes. and then i say 'my knee also hurts' and they say you need to schedule another appointmen…

This isn't necessarily true.

Most dentists won't even need additional education - after all, we are actually just trying to get what they do covered. It doesn't mean the system or education must change, and in practice it will be like going to a specialist without having to visit the GP first. You wouldn't complain to the gastric specialist that your knee hurts either.

The bigger changes would be in health insurance coverage and things like that. Basic cleanings are more likely to be cheap: extractions might wind up costing more if one must pay their deductible first. Sure, some of the services will continue to be cosmetic only - but plastic surgeons (who often also do reconstructive surgery along with complicated dental extractions) seem to manage this just fine.

You being seen on time isn't an issue with this, honestly. Some doctor's offices have a habit of being on time. You can let them know upfront that you have multiple issues as well - this allows them to schedule more time with you (and bill insurance accordingly).

Re: Why Dentistry Is Separate from Medicine

#55

Post by ar-jan »

Rainymood wrote: post #34

Make sure to poke a very thin wooden stick regularly (daily, before bed, after brushing) between your teeth and marvel (or be disgusted) at the amount of plaque that comes out which you missed by just brushing -- honestly it's an insane amount.

> after brushing

Before brushing, I'd say. Then the fluoride in the toothpaste can better reach between the teeth.

Re: Why Dentistry Is Separate from Medicine

#56

Post by bigtex »

Break a tooth on a Friday night and need dental work? You think, I will goto the ER and they can help. Nope, they will just give you medicine to deal with the pain until you can see your dentist on Monday morning. I am not aware of a ER in the DFW area that has a dentist on call.

Re: Why Dentistry Is Separate from Medicine

#58

Post by AnthonyMouse »

PeterisP wrote: post #51
mtdewcmu wrote: post #35

The real question is not why is dentistry kept separate from medicine. The real question is why dental insurance is treated like a luxury, compared to regular health insurance. The problem is that so many people are unable to afford dentistry, because of poor or no coverage.

If you have a type of expense that's (a) unpredictable, and (b) rare, then it's a good fit for insurance. Car crashes are unpredictable and rare, so it makes sense to insure them. Regular car maintenance is predictable and tends to happen in (almost?) every insurance period, so it's not - some payment plan or bundling may be an option, but insurance makes no sense, it would only be more expensive than paying directly…

> If you want employer-funded healthcare to include dentistry, then that's not going to be solved by medical people but the employment market - industries where workers have market power (e.g. IT) will get such conditions, and industries where worker's don't have market power (e.g. fast food) won't.

And how is that anything useful anyway? It's not like dentistry is any cheaper when your employer pays for it. If anything it will be more expensive because of the added bureaucracy and separation of who pays from who benefits. This is one of the reasons costs have spiraled out of control in the US healthcare market. If you need money for dentistry, ask your employer for a raise, not dental insurance.

Re: Why Dentistry Is Separate from Medicine

#59

Post by peteretep »

barking wrote: post #25
peteretep wrote: post #23

Earlier quoted context omitted.

That's a bit different, as an opthalmogist is a real doctor who treats eyes. Dental equivalent would by a dental hygienist, I guess.

Ophthalmologists are specialists just like any other medical specialist, e.g. a dermatologist. Does the fact that general practitioners refer people on to dermatologists mean that family doctors are not 'real doctors'? Sorry if that sounds aggressive, I am unfairly taking the inference from what you said that opticians are somehow 'fake'.

    > Ophthalmologists
Doctor

    > dermatologist
Doctor

    > general practitioner
Doctor

    > optician
Not a doctor

Re: Why Dentistry Is Separate from Medicine

#60

Post by maxerickson »

nerdponx wrote: post #48
brianwawok wrote: post #43

Earlier quoted context omitted.

I think it is cost scale. Get cancer? That could be a million dollars in treatment. You need insurance. Get a bad tooth? Maybe 3k max to replace it with a bridge or similar. The idea is most people can scrouge up 3k but not a million bucks.

This is ass backwards to me Preventative dental work is dirt cheap and corrective dental work is relatively rare, and costs rarely spiral out of control. That sounds like a much better deal to me, as an insurer, than insuring any other body part.

Preventative care isn't really insurable though.
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