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Why Dentistry Is Separate from Medicine

theatlantic.com

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Re: Why Dentistry Is Separate from Medicine

#61

Post by rs999gti »

mtdewcmu wrote: post #31
pjc50 wrote: post #18

Even further on the fringe of medicine: opticians.

I was thinking of pharmacists. They are sorta kinda doctorish (they even get Doctor of Pharmacy degrees), but not really. They are supposed to be consulted by doctors as the prime authority on medications, but this seems to rarely happen outside of hospitals. Doctors most likely think they know enough about the medications they prescribe to not need regular help. Oh, and what about podiatrists? Health care seems suff…

> podiatrists

Podiatrists are doctors, they just have their own medical schools AKA podiatry school - https://en.wikipedia.org/wiki/Podiatric_medical_school

Podiatrists are sometimes ridiculed for not being real doctors like dermatologists. However, to diabetics they are life savers.

Re: Why Dentistry Is Separate from Medicine

#62

Post by sjwright »

morganvachon wrote: post #45
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.

> The idea is most people can scrouge up 3k but not a million bucks. The reality is far from that, though. Roughly a third of the citizens of the US would have to go into debt to secure $3K on the spot, they don't just have that laying around in the bank. Doing so could easily cause a downward spiral where one would have to choose between basic necessities or moving back in with family for months or even years to pay…

> My bill for removing my wisdom teeth came to nearly $12K

Seriously? You could fly to Thailand or central Europe and get your dental work performed there for a fraction of the price. You could probably fly business class, stay at a swanky hotel, and absorb the loss of two weeks work and still come out ahead. I'm serious. Dental tourism is a thing.

I was an accidental dental tourist a few years ago while travelling around Europe. I had just arrived in Budapest, Hungary when a tooth I knew required root canal suddenly started hurting intensely. Wife found a local dentist, booked me in, the procedure was done over a couple of sessions and the total cost came in well under $1k AUD.

(Your bill seems excessive even by affluent Australian standards. I had four wisdom teeth removed – one of them impacted, requiring a dental surgeon – and the total cost was under $3k AUD at my local dentist. I bet it only "cost" $12k because it was covered by insurance rather than priced by the free market.)

Re: Why Dentistry Is Separate from Medicine

#63

Post by chimeracoder »

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 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.

When costs are easily predictable, that's actually a terrible case for an insurance model. Insurance is about smoothing risk, not making things cheaper. In fact, for services that are relatively cheap and predictable, insuring against those events will always be more expensive than paying for them out of pocket, because of the additional overhead.

Financially, the expected value of insurance is negative (the sum of all expected payouts is less than the sum of all future premiums). The reason it's valuable is because it reduces the variance in the month-to-month payments, which is a useful product for some people.

Re: Why Dentistry Is Separate from Medicine

#64

Post by [deleted] »

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.

[deleted]

Re: Why Dentistry Is Separate from Medicine

#65

Post by [deleted] »

barking wrote: post #20

Dentists in the UK receive a bachelor degree, as do doctors. However it was a sanctionable offence in the eyes of the General Dental Council for a dentist to title themselves Dr. This was purely a Dental Council regulation, anyone at the time could call themselves doctor, it wasn't a criminal offence. With the arrival of dentists from EU countries who were allowed to do so, UK dentists felt they were being put at a d…

[deleted]

Re: Why Dentistry Is Separate from Medicine

#66

Post by kilon »

barking wrote: post #20

Dentists in the UK receive a bachelor degree, as do doctors. However it was a sanctionable offence in the eyes of the General Dental Council for a dentist to title themselves Dr. This was purely a Dental Council regulation, anyone at the time could call themselves doctor, it wasn't a criminal offence. With the arrival of dentists from EU countries who were allowed to do so, UK dentists felt they were being put at a d…

In Greek the equivalent to "dentist" is "odontiatros" which translates exactly as "tooth doctor". So for me a dentist not regarded as doctor sounds extremely weird.

Re: Why Dentistry Is Separate from Medicine

#67

Post by chimeracoder »

AnthonyMouse wrote: post #58
PeterisP wrote: post #51

Earlier quoted context omitted.

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 anyth…

> If anything it will be more expensive because of the added bureaucracy and separation of who pays from who benefits.

Yes, real insurance (like car insurance or renter's insurance) will always have an expected value that is negative - the expected sum of all future payouts must be less than the sum of all future premiums paid. So insuring against completely predictable events is never worth it unless someone else pays for it, and even then it's less efficient than if they gave you the extra money directly.

Not all dental and vision benefits are completely predictable and routine, but the overwhelming majority of covered benefits are, unlike health insurance (which isn't really "insurance", despite the fact that we use the term).

Re: Why Dentistry Is Separate from Medicine

#68

Post by ferongr »

ekianjo wrote: post #57
pjc50 wrote: post #18

Even further on the fringe of medicine: opticians.

in japan you can completely bypass them if you just need corrective glasses. result: glasses are dirty cheap.

In Greece too. As long as you have the older prescription (basically a small form with the required information filed in) you can get new spectacles without having to visit the ophthalmologist. The prescription is not taken away

In many cases, eyewear shops have ophthalmologists employed on site with all necessary equipment and they test you for free.

Re: Why Dentistry Is Separate from Medicine

#69

Post by chimeracoder »

sjwright wrote: post #62
morganvachon wrote: post #45

Earlier quoted context omitted.

> The idea is most people can scrouge up 3k but not a million bucks. The reality is far from that, though. Roughly a third of the citizens of the US would have to go into debt to secure $3K on the spot, they don't just have that laying around in the bank. Doing so could easily cause a downward spiral where one would have to choose between basic necessities or moving back in with family for months or even years to pay…

> My bill for removing my wisdom teeth came to nearly $12K Seriously? You could fly to Thailand or central Europe and get your dental work performed there for a fraction of the price. You could probably fly business class, stay at a swanky hotel, and absorb the loss of two weeks work and still come out ahead. I'm serious. Dental tourism is a thing. I was an accidental dental tourist a few years ago while travelling a…

> Your bill seems excessive even by affluent Australian standards. I had four wisdom teeth removed – one of them impacted, requiring a dental surgeon – and the total cost was under $3k AUD at my local dentist. I bet it only "cost" $12k because it was covered by insurance rather than priced by the free market.

It's expensive by US standards as well. In NYC, which is a high COL area, the price I've seen quoted is around $200-250 per tooth.

$12K must mean that they were complications that are being included - insurance will always be more expensive than a free market self-paying system, but not that much more.

Re: Why Dentistry Is Separate from Medicine

#70

Post by chimeracoder »

badminton1 wrote: post #38
barking wrote: post #20

Dentists in the UK receive a bachelor degree, as do doctors. However it was a sanctionable offence in the eyes of the General Dental Council for a dentist to title themselves Dr. This was purely a Dental Council regulation, anyone at the time could call themselves doctor, it wasn't a criminal offence. With the arrival of dentists from EU countries who were allowed to do so, UK dentists felt they were being put at a d…

In the US they have the title of DDS (doctor of dental surgery).

Though in the US, they receive a postgraduate degree (as do medical doctors), not just a bachelor's.

Technically they could receive that degree without a bachelor's degree, but I've never heard of anyone getting into medical or dental school without having received an undergraduate degree.

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