Dentristry as a life time preventitve service

[groundhog]

Three are 285,000,000 people in the USA. There are 160,000 practicing dentsits in the USA. Therefore if the entire population participated in a life time preventative dental program through a dental office and each dentist had an equal number of patients, each dentist could generate $500,000 in billings per year by billing each patient $280 per year.

From what I can gather, $500,000 in billings per year would provide a reasonable net income for the average dentist. I know that $280.00 per year per patient would be a very reasonable charge for lifetime dental care.

So what is the problem of putting such a concept into play? Well, for one, dentists are not equally distributed throughout the population. Problem number 2 is that not everyone is willing or able to commit to paying even $280.00 per person per year for life time dental care.

I cannot offer a solution for problem 1 except that dentists are intelligent people who choose locations in which to practice knowing the full economic potentials. Some dentists may desire to do $1,000,000 in billings while others may be happy with $250,000 in billings in exchange for what is perceived as valuable non monetary income.

The second problem, I believe, could be solved by a joint ADA/Federal compact which would also have the desireable benefit of ushering the insurance companies out the door.

I would propose that the Feds allow a $280.00 per person per year dental expense tax credit on federal income taxes. Such a tax credit would even apply to those having no or little income such as that now provided via the earned income tax credit. Would eveyone take advantage of such a tax credit? I don't know, but I suspect most folks would choose to apply the credit to dental care rather than leave the money in the hands of the government. Bingo, the insurance companies are now out of the picture too. The dentists, for their part, would have to agree to start providing life time dental care to patients for $280.00 per year. There would also have to be some method in place to prevent fraud and abuse. Overall, though, a strong patient/dentist relationship would be maintaied without interference from insurance companies or the governmet and dentistry could move towards a desirable goal of providing good oral health care to everyone in the nation.

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[Midoc]

$280 times 285 million people and you have $80 billion dollars plus the additional 50% the extra bureaucracy this would need and you have $120 billion dollars a year. You have also just pissed off all of the dentists by creating socialized dentistry. If you think socialized dentistry is great then check how many British dentists are trying to get into thier socialized plans and how many are trying to get out of them. You could also ask if the Canadian dentists are trying to get their dental system as socialized as their medical system is.

You can't make people have good oral health care by making it cheap. Making it cheap will never ever work. You have to make poeple WANT to have good oral heath. Making it cheap to get a crown or filling or implant isn't going to make people brush more and floss more and eat less cariogenic foods.

 

[HBomb]

Wow. What a dangerous topic I'm engaging myself in, but I think your scenario may severely weaken the incentive structure for dentist to provide quality health care, meaning dentist would be motivated to sacrifice quality for quantity.

Just to run your numbers a little further:
If a dentist only took 2 weeks off a year and worked 5 days a week, that would be approx 250 working days a year. If a dentist sees a patient twice a year and can only charge $280 total (so $140 per visit), in order to make 250K net, the dentist would have to see just about 7 patients a day (doable). To make 500K, the dentist has to see over 14 patients a day (tough). To make 1,000,000, 28 patients (really, really tough).

I'm not saying I don't believe in "universal" health care. I'd like to see that everyone gets health care. I wish I knew what the best answer is, but I don't. This is a tough, tough problem, and I'm glad at least that it's a discussion topic.

 

[Presidental]

what you are suggesting is a gross of 500k, not a net. who is paying for your employees, insurance, instruments, etc?

 

[HBomb]

thanks. yes, I was referring to gross amt

 

[groundhog]

#1: My proposal is not socialized dentistry. Each patient gets a $280 per year tax credit to personally apply towards the services of any dentist of choice without any government involvement other than for the patient who would risk the wrath of the IRS if a false claim is made for the tax credit (which is no different than exists today regarding filing false claims for medical expenses).

#2: 1780 patients (250,000,000/160,000) per year at $280 per patient yields $500,000 in gross billings. Taking an average 65% for expenses (overhead, allied staff salaries etc), against $500,00 gross yields $165,000 net for the dentist. I further suspect that that 65% expense factor will be greatly reduced because the insurance companies will have been removed from the picture. The dentist will only have to deal with the patients.

#3: My proposal does not make dentistry cheap ($280/year over say 70 years is $19600).However, in exchange for that $19600 over a life time most patients would optimally never have need for a crown, root canal, or implant. So my plan provides an economic incentive for patients to seek regular life time dental care which shifts the focus of oral health care from a reactionary failure driven program to a proactive preventative maintenance program. My appraoch is threfore best results orientated for patients in the long run without bringing economic harm to the dental profession. The patients will be better off. The dentists will remain unharmed economically while being left unhindered to do God's work to bring quailty oral health care to eveyone who wants it. The only folks damaged are the insurance companies (Oh Wah)..

#4: Each dentist is left free to take in as many patients as he or she desires. If one wants to do $1,000,000 in billings per year, seek to take in 3560 patients per year.

#5: My proposal would also suck the oyxgen away from the so called dental corporations which are using the long term preventative dental care appraoch as the main wedge to separate patients from private practitioners in a huge segment of the patient market wherein employees are provided dental insurance by their employers

 

[groundhog]

I tossed out my own proposal. It just dawned on me that people have to take responsibilty for a big portion of their oral hygiene habits in order for a preventative maintenance program to work. Well back to the drawing board.