Why is dental work so expensive? Who is driving up the costs?...insurance companies? Supply companies? or dentists? Is a crown really worth $1200-$2000? How is UCR determined and is it a fair process?
Why is dental work so expensive?
- Thread starter coolslugs
- Start date
- Joined
- Apr 13, 2010
- Messages
- 1,996
- Reaction score
- 1,038
Education cost and an effort to get one, cost of materials and supplies, insurance and license, continuing education, relatively short professional life, physical demand on a body. Not to mention the stress of having to explain the cost to the patients
- Joined
- Jan 17, 2006
- Messages
- 8,521
- Reaction score
- 2,797
Why does a loaf of bread cost ~$3.00?
- Joined
- Apr 13, 2010
- Messages
- 1,996
- Reaction score
- 1,038
Good point. Crown comes to 30 cents a day, serving for 10 years
- Joined
- Jul 24, 2011
- Messages
- 136
- Reaction score
- 15
Yes, and one gallon of gas is sold for $0.70 by oil producing countries. I swear I am going to start kicking myself thinking about how a $250k loan at 6.5% interest, for 4 years, is a steal when a crown that lasts 10 years, only costs $0.30. I need to go to Silicon Valley and find out how I can make my own Instagram or Whatsapp and trick Zuckerberg to give me a few billion without showing a $0.01 in profit.
Last edited:
- Joined
- Dec 6, 2006
- Messages
- 1,371
- Reaction score
- 273
If you have to sacrifice +8 years of your life AND +$500K in debt AND all that lost incomes/benefits that you could have working at a government plum job, would you then charge $200 for a crown like in Mexico or Vietnam? There really are places in SoCal, Seattle, Boston that will do crown for $200 if you simply ask.
- Joined
- Feb 18, 2014
- Messages
- 299
- Reaction score
- 188
Don't forget that if you get shoddy work done it Vietnam/Mexico, you can't really sue. But here in America, you can easily sue (and win) if even a tiny little thing goes wrong!
The real question is why in Oregon should PAs (who only went thru 2 years of schooling) make the same amount of dough that a primary care doctor who went through 9 years of schooling makes, when it comes to providing primary care services?
The real question is why in Oregon should PAs (who only went thru 2 years of schooling) make the same amount of dough that a primary care doctor who went through 9 years of schooling makes, when it comes to providing primary care services?
ahha-best part "Not to mention the stress of having to explain the cost to the patients."
Isn't it 4 years? And I thought the average dental school debt is $250K. And $200 is hardly comparable to $1500 / crown.
Because medical doctors are too divided to fight such a thing (~20% are members of AMA?). Unlike where >75% of dentists are members of the ADA that is fighting against mid-level providers.
- Joined
- Apr 13, 2010
- Messages
- 1,996
- Reaction score
- 1,038
We can easily add all school years starting first grade, because without excellent habits one would be unable to succeed in further study in college and dental school. In order to get to the dental school, apart from high GPA, one has to have good reputation, community work and other achievements.
I also noticed, that any supply with "dental" in the name is at least three times more expensive, then without
- Joined
- Jul 24, 2011
- Messages
- 136
- Reaction score
- 15
Slugs,
Read Intro to U.S. Health Policy by Donald Barr. Most U.S. health expenditures are attributed to waste (over 70%) compared to other countries. Single payer systems may be bad in practice or the minds of Americans but it does cut a lot of waste and streamline things. Why? Simply having one insurance to handle all paperwork and using 1 form to ask for payment. This is an oversimplification but I don't think most people know how convoluted our system is. The ACA deadline showed us how convoluted healthcare can get. The federal insurance site was made up of bits and pieces. They tried to make their system able to read info from all 50 states which have their own database system. All these states, instead of pooling their money onto one system, all decided to have a go on their own. Medical care practitioners are often blamed for the high costs. But the piece of pie given to them is prob less than 30%. The AMA represents more than 20% of MDs. It's true that they have dwindling members but that's their own fault. Truth is that Nurse Practitioners have been pushing the mid-level line with over 90% membership. They are even pushing to require NPs to finish a one year PhD so that they are called "doctor" alongside MDs. These midlevel battles will continue into the foreseeable future. But they really should start attacking the healthcare wastes first. Why is it that the US spends more money than anyone else on healthcare but we don't have a basic healthcare system? Obamacare is a start but they need to plug up the holes in streamlining the process. I am only talking about the components of Obamacare that force administrators to streamline btw...such as heaving electronic medical records and reducing paperwork. Cutting payment to hospitals for readmitting the same patient over and over again without justification will provide better care and cut costs.
Read Intro to U.S. Health Policy by Donald Barr. Most U.S. health expenditures are attributed to waste (over 70%) compared to other countries. Single payer systems may be bad in practice or the minds of Americans but it does cut a lot of waste and streamline things. Why? Simply having one insurance to handle all paperwork and using 1 form to ask for payment. This is an oversimplification but I don't think most people know how convoluted our system is. The ACA deadline showed us how convoluted healthcare can get. The federal insurance site was made up of bits and pieces. They tried to make their system able to read info from all 50 states which have their own database system. All these states, instead of pooling their money onto one system, all decided to have a go on their own. Medical care practitioners are often blamed for the high costs. But the piece of pie given to them is prob less than 30%. The AMA represents more than 20% of MDs. It's true that they have dwindling members but that's their own fault. Truth is that Nurse Practitioners have been pushing the mid-level line with over 90% membership. They are even pushing to require NPs to finish a one year PhD so that they are called "doctor" alongside MDs. These midlevel battles will continue into the foreseeable future. But they really should start attacking the healthcare wastes first. Why is it that the US spends more money than anyone else on healthcare but we don't have a basic healthcare system? Obamacare is a start but they need to plug up the holes in streamlining the process. I am only talking about the components of Obamacare that force administrators to streamline btw...such as heaving electronic medical records and reducing paperwork. Cutting payment to hospitals for readmitting the same patient over and over again without justification will provide better care and cut costs.
- Joined
- Dec 22, 2011
- Messages
- 414
- Reaction score
- 29
Single payer may cut costs but it leads to incredible waits for treatments and tests. Our system can be fixed but not by single payer. We still have the best health care in the world despite the mess that the health insurance system is. ACA made it worse but single payer is pure stupidity. So much control in a central entity is asking for trouble.
http://dentalstudentdds.wordpress.com/
3 Year Air Force HPSP Recipient
Dental Student Class of 2017
Last edited:
The length of education has nothing to do with the cost of dental care. Dental care prices has not been mirroring the increase in price of dental education. It is expensive because of the costs to deliver the good to the market. There is also professional fees built into the price because dentistry is a relatively scarce skill that is physically and mentally demanding.
For example, to receive a crown you must go to a dental practice and receive an exam, diagnosis, & preparation. That utilizes one building (and all associated costs), disposable equipment, a front office worker, assistant, and dentist. Then a lab constructs a crown that uses more equipment, building, and professionals. The crown is then delivered to the practice and it is seated and adjusted as needed to make sure it will last, be healthy, and not hurt your other teeth.
Despite the high costs of delivering dental care to patients there are also professional fees; like any other business dental offices have fee schedules that allow employees to make an income and in many cases a profit for the practice. This is also why any other product is not sold "at cost" to consumers.
EDIT: I agree with the above comment - single payer is bad. We're a unique country & despite the promise of "efficiency" that is made by central planners their policies have negative unintended consequences.
For example, to receive a crown you must go to a dental practice and receive an exam, diagnosis, & preparation. That utilizes one building (and all associated costs), disposable equipment, a front office worker, assistant, and dentist. Then a lab constructs a crown that uses more equipment, building, and professionals. The crown is then delivered to the practice and it is seated and adjusted as needed to make sure it will last, be healthy, and not hurt your other teeth.
Despite the high costs of delivering dental care to patients there are also professional fees; like any other business dental offices have fee schedules that allow employees to make an income and in many cases a profit for the practice. This is also why any other product is not sold "at cost" to consumers.
EDIT: I agree with the above comment - single payer is bad. We're a unique country & despite the promise of "efficiency" that is made by central planners their policies have negative unintended consequences.
Last edited:
- Joined
- Jul 24, 2011
- Messages
- 136
- Reaction score
- 15
The ACA officially went into effect this month, April/2014 for people to sign up without penalties (ACA is still incrementally rolled out). So how can anyone claim that the ACA made it worse or are you just borrowing from the GOP candidate playbook with your eyes closed? Wouldn't you need some time to see the system affect healthcare? I bet people like Rand Paul know how tall his kid will grow up to be when they come out of the womb. As a doctor, he can tell you exactly how many days it will take for Bobby's flu will be gone as soon as he starts his pills. After all, they were ranting how ACA killed the American healthcare system over a year ago when the deadline for the ACA was just last month. It's amazing how his crystal ball couldnt tell him that his dad wasn't going to get the nomination.
I can name several things that it was good for right off of my head: 1. no pre-existing conditions clause 2. college students can still be covered under their parents pass 21 3. preventative care like breast screenings are covered and free (it's cheaper to prevent something than to cure it later) 4. accountability, hospitals will be penalized if they keep re-admitting people for the same problem. 5. Practitioners who take Medicare must switch to an electronic medical record system to streamline and lessen the paper trail.
Do you have any idea how long it would take before you can see effects? Wow, I wish your crystal ball can be lent to the medical/dental profession. How many drugs we can test and approve without waiting for years for clinical studies. It will take at least 5 years to see how the ACA will affect the rising costs of healthcare. I don't know about you. I want to make a lot of money and keep it for myself, not get bankrupt by healthcare costs if I have heart problems or cancer. Healthcare costs will keep rising but if you can lower the rate at which it is rising, you have already won. Ask the major insurance carriers who set healthcare rates and they will tell you that it is too early to tell because people are still enrolling. After a couple of years where people start using insurance policies will they be able to adjust figures and give rates that we can use to argue whether the ACA succeeded or failed. Nixon proposed universal health care in the 70s to rein in rising healthcare costs that HE was afraid was going to keep the US economy from spending money on anything else besides healthcare. So don't think it's just Democrats who thought about reforming healthcare costs.
I didn't champion single payer nor am I going to ever champion it. However, many people use anecdotal evidence about Canada and base it on the beginning years of the system. Surprise, many wealthy Canadians come to the US for medical procedures and Canada pays for it. The rest comes out of their pocket. How does Canada implementing controls on pharmaceuticals and make pills cheaper keeps them from having good medical care. So Merck can sell drug X for $100 and sells it for $25 in Canada, and that is perfectly fine. Canada is not stupid. They didn't wake up one day and say "hey let's have a single payer system".
What good is the best medical system in the world if only 1% of your population can afford it? How will practitioners make money if everyone is only able to go after that 1%?
How great a country's healthcare system is usually measured by child mortality rates. Please look at World Health Organizations rankings athttp://www.who.int/mediacentre/news/releases/2013/child_mortality_causes_20130913/en/
which links to this website which is theirs too
http://www.childmortality.org/
And even the CIA worldbook made an easy list for you (yeah, I don't go by Wikipedia).
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html
Look at the US's rate and then look at Japan, Norway, Sweden, England, Switzerland, Singapore, Hong Kong, Canada, even Czech Republic. Tell me how great our healthcare system is when we have more kids dieing per 100,000 population. Of course, those figures are just that figures.
Out of all the systems, I like Taiwan's system. Taiwan appointed a non-partisan university professor as their health czar. He looked at all the diff systems in the world and took the good parts from each to try to make a better system, very mindful of Canada and their dreadful long lines.
I don't like the single payer system because I don't trust the government to be efficient. Neither do I trust a corporation to know what's best for my health or pay for the best treatment for my health. But, I do know that somebody had to do something about healthcare and the ACA is the FIRST to try. Pardon my rant, and apologies to the wordiness. I am not attacking jmh018, just at the stupidity of people claiming the ACA has ruined healthcare when it did not fully go into effect for more than 2 years later. Healthcare costs were ruined decades ago. Instead of fixing it, even at Nixon's time, they made it worse with stupid inventions like HMOs. I am all for leaving practitioner's pay alone and cutting the excess fat first and foremost. But let's not be delusional and think our healthcare system is fine and the greatest in the world. Our science is the greatest, our healthcare not so great. As a future clinician and business owner, I sure dont want to waste a ton of money on my employee's healthcare costs. Do you? But if it helps more people afford healthcare, fine, I'll take a 10% cut in pay. Because high healthcare costs will be passed on to me as an employer anyway. I don't know how many of you have helped your grandma fill out that stupid prescription drug plan every year. Why do we even have it? That's right, the President in office didnt want Medicare to be able to bargain with drug companies for discounts. Seniors were left to importing drugs from Canada. States re-directed their seniors to Canadian pharmacies until Congress outlawed it. Yes, THAT same crappy Canada with reformed healthcare.
http://www.nhi.gov.tw/English/webdata/webdata.aspx?menu=11&menu_id=290&WD_ID=290&webdata_id=1885
http://prescriptions.blogs.nytimes.com/2009/11/03/health-care-abroad-taiwan/
http://www.npr.org/templates/story/story.php?storyId=89651916
Here read up on the different types of healthcare systems in the world.
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/models.html
http://www.pnhp.org/facts/international_health_systems.php?page=all
http://www.who.int/whr/2000/en/
http://www.commonwealthfund.org/~/media/Files/Publications/Fund Report/2012/Nov/1645_Squires_intl_profiles_hlt_care_systems_2012.pdf
Read how we are #1 in the world for healthcare.
http://www.theatlantic.com/health/a...ankings-of-17-nations-us-is-dead-last/267045/
Last edited:
- Joined
- Feb 18, 2014
- Messages
- 299
- Reaction score
- 188
You had some good points, but also had some things that seem like they come straight from the Democrat talking points. I wouldn't attack people with stuff like 'Rand Paul or GOP playbook' when some of your stuff is completely narrow-minded and detached from reality.
You say that accountability is such a great thing. Some of these 'quality controls' and 'accountability' and 'performance measures' encourage doctors to dump high-risk patients so they can meet the standards and not be penalized. You mentioned point 5 as if it were a great thing. EMR has been a disaster for most MDs. The EMRs that doctors are required to use have extensive requirements and place an tremendous amount of burden on physicians. What's worse is that the only EMRs that meet ACA's requirements are large, commercially available EMRs like Citrix, Epic, etc (crony capitalism, anyone?), which are daunting to use and slow down doctor's time with patients. The effect of this on solo physicians who practice often in underserved areas has been deafening. EMR is a mess, and your open praising of it shows that you are absolutely clueless regarding certain aspects of the practice of medicine. ACA's onerous requirements have helped consolidate hospital power and control and have pushed solo MDs out of business. Don't tell me you actually think that is a good thing (You a fan of Wall St?). You also say that no pre-existing conditions is a good thing. I fully empathize with people who have fully pre-existing conditions. However, when you force insurance companies to do this, you pretty much kill the whole concept of insurance. Insurance (be it health or car) is based on the concept of pooled risk. ACA is essentially nothing more than a redistribution of wealth. I wouldn't mind this, if we subsequently reduced income tax rates. I'm also not really a fan of having payments for doctors not adjusted for inflation, but having hospitals have their reimbursement adjusted for inflation (which is what the ACA does). The ACA also appoints a panel of people known as IPAB, who determine reimbursement and allocation of financial resources for ACA. These IPAB members are not elected officials and are accountable to no one, and can include people who aren't even doctors. Do you seriously think this is a good thing?
You also blindly name other countries that supposedly have better healthcare systems than us. Keep in mind the individuals of those countries have much healthier diets and lifestyles (our diet consistently ranks near the bottom). Keep in mind our population is also much more diverse, complex, and larger than all those countries you named (California's pop is more than Canada lol). You also completely committed the fact that nowhere in the world is the legal climate as horrendous for doctors as it is in America. This is huge. Many doctors have to order unnecessary tests because they are afraid of getting sued. And why shouldn't they be afraid of getting sued especially considering the overly litigious climate of America? ACA does nothing to address this, and Obama was adamant in not budging on tort reform (didn't want to upset his trial lawyer donors). Keep in mind that Democrats' biggest donor are trial lawyers, who are vehemently opposed to tort reform, or setting up special healthcare courts to try medical malpractice cases. By omitting this, someone could easily accuse you of "borrowing from the Democratic Party candidate playbook with your eyes closed". Without tort reform, don't expect things to get better. They won't.
ACA does have some good things, like preventing radiologists from making thousands with unnecessary X-rays and preventing cardiologists from making thousands in overbloated cath labs. But like I said, I wouldn't go around harshly criticizing others, when you yourself don't have a comprehensive understanding of medicine. Have you worked in the healthcare industry before? (I have).
- Joined
- Dec 6, 2012
- Messages
- 341
- Reaction score
- 146
You also have to factor in the cost of all of the employees in the dental office
- Joined
- Jan 30, 2005
- Messages
- 2,752
- Reaction score
- 659
Daurang,
Are you serious? I saw a Bright Now office today advertising crowns for $599. I can't believe someone would actually do it for 200 bucks.
Hygienists are overpaid.
- Joined
- Feb 25, 2011
- Messages
- 1,544
- Reaction score
- 115
From what I understand, it is getting more difficult to find a job as a hygienist. If there is an over-supply of hygienists, I find it difficult to believe they are overpaid. In most cases I imagine they are being paid a competitive wage that reflects the value they bring to a dental practice.
Why do you think hygienists are overpaid? How does their income increase the price of most dental restorations that was germane to the question?
Where I'm from they can place restorations, perform local anesth, SRP independently, do 80% of the work for new pts, and are pretty much the lifeblood of most practices. Brass tacks they can bill a lot of services (that pts value) in order to get paid well; in some states they're figuring this out and are on the road to removing hygiene from dentistry by opening up independent hygiene offices.
Last edited:
- Joined
- Aug 2, 2010
- Messages
- 424
- Reaction score
- 40
Bingo.
And you didnt even factor in the cost of building up the mind to figure out what type/tilt/margin of crown is needed, or if it even should be done (perio/crown:root/opposing/vertical).
Edited to add: It isnt so much the proceedure that costs so much. But the training of when to know and not know do do them. A trained monkey can do a surgical procedure; a trained monkey doesnt know when to NOT do the surgical procedure.
- Joined
- Apr 12, 2011
- Messages
- 1,199
- Reaction score
- 461
The future is going to be all about that vertical integration =)
Advancements in 3d printing:
cerec, e4d ?
Advancements in 3d printing:
cerec, e4d ?
- Joined
- Feb 18, 2014
- Messages
- 299
- Reaction score
- 188
The field of academia and private practice are quite different. It would be nice for academics to see how medicine is practiced in the real world and in private practice, not just academic centers and large hospitals.
- Joined
- Jul 24, 2011
- Messages
- 136
- Reaction score
- 15
Of course, people should balance articles from New England Journal of Medicine and AMA (both conservative leaning) and Health Affairs (liberal leaning).
Politicians need to see practices in different settings. We can see academics and look at their methodology and study design to see how valid their results and conclusions are.
If medical/dental students had low student loans then it will offset the cuts in pay they will be getting from the ACA when they graduate and start working. At least it's a tradeoff. Dental care is not even part of the ACA.
Senator Warren is reintroducing a bill next month to lower student interest loans, along with graduate students. I hope everyone writes to their senators to support this at least.
https://chronicle.com/article/Sen-Warren-Proposes-Allowing/145903/
- Joined
- Dec 6, 2006
- Messages
- 1,371
- Reaction score
- 273
Why lower student loan interests? So more idiots can major in garbage majors like women's studies and photography in which they'll never pay off their loan and screw the taxpayers? You didn't see what easy and lower mortgage interests did to the housing market? Everybody that had a pulse took out a loan and then what happened? Oh yeah your darling Barney Frank and Ben Benanke said there was no problem and guess what happened? Obama sued Citibank to force them to lend money cheaply to typically unqualified people and guess what happened? Now you have this fake Indian American trying to do the same good...I'm sure she meant well but it's not her money she's playing with.
- Joined
- Feb 25, 2011
- Messages
- 1,544
- Reaction score
- 115
While I understand the federal government not individualizing student loans, what I don't understand is why private institutions lump all fields of study together when determining credit-worthiness. If I were a private institution, I would want to know the individual's likely ROI and would want to compete against other private institutions for the least-risky borrowers. For example, an individual with a strong FICO score, a well thought out business plan, and a strong work history that wants to borrow money for a state dental school would receive a better rate than an individual with no credit history that wants to go to a pricy third tier law school and has no business prospects to speak of. As far as I know, the only credentials private institutions consider is FICO score and make no discrimination amongst likely ROI of said degree.
- Joined
- Dec 6, 2006
- Messages
- 1,371
- Reaction score
- 273
Private institution make a killing on the student loans guaranteed by the government, so why should they care? It's so profitable that these private institutions even went to homeless shelters to enroll the homeless. Google University of Phoenix if you wanna read more.
- Joined
- Feb 25, 2011
- Messages
- 1,544
- Reaction score
- 115
Daurang, forgive me for not being more clear, but I was referring to banking institutions such as Wells Fargo and Discover rather than private schools.
- Joined
- May 6, 2014
- Messages
- 2
- Reaction score
- 0
Cost of the materials used in dental laboratory is high. Dental lab equipments set up not cheap compared to other general doctors.
- Joined
- May 23, 2002
- Messages
- 457
- Reaction score
- 100
Time. Dentistry cost money, like any other service field because it involves a lot of time by a lot of people. The materials and facility are a small part but anytime that you ask an employee to work, it's going to cost money. Front desk, insurance coordinators, treatment coordinators, assistants, etc. That is all before the doctor gets paid. The doctor did not earn an income for 8 years and also has to make up for that in the amount that he/she borrowed. So add employee time, current doctor time, student doctor time, supplies, facilities (rent, utilities), advertising, insurance, and taxes. I didn't include all the other dental auxiliaries (supply, computer, IT, regulation companies) that drive up the cost by overcharging.
- Joined
- May 8, 2014
- Messages
- 1
- Reaction score
- 0
Two reasons - doctors get paid a lot and the cost of the equipment is super high. Dentists go through years of training in college and dental schools, which are expensive places to learn. The pay for dentists will be adjusted according to their market value. The equipment they use to perform care can total up to hundreds of thousands of dollars. A simple x-ray machine can go up to $20,000. I work with dentists in Los Angeles and do their medical billing for them, I can see from their balance sheets just how much they spend on the latest equipment.
- Joined
- Oct 22, 2012
- Messages
- 457
- Reaction score
- 172
I guess it depends on where you live. Back home, dental work is relatively avergae (never heard anyone complain about how expensive dental work is, and I also never heard of any fellow bragging about how our country provide cheap dental work). I guess USA problem is the long term education and new dentists have about 30years to practice and then having to retire.
Similar threads
