This week marked my third root canal this year. Ouch! 2009 also included a dental implant and subsequent crown.
Who pays for this professional service? See figure 1…
950 dollars is indeed the going rate. Notice the guarantor is yours truly, not Anthem, Humana, GE, General Motors, UPS or anyone else. A regular Discover card pays. Even if dental insurance was involved, this family would have been over the 1000 maximum months ago.
Lessons learned and thoughts..
Akin to the Mickey Mantle quote, “If I knew I was going to live this long, I would have taken better care of myself,” I say: “if I only knew these necrotic painful teeth were in the cards, you bet there would have been more brushing and flossing.” Yes, I admit, a failure of personal responsibility in my own dental care.
A number of thoughts rumble through the white matter as the credit card swipe renders me 1000$ less rich. Thoughts like, I may have checked the wrong box on career day, or envy that the endodontist has no forms to justify the bill to a third party payer and then no denials of payment, or about the financial pain 7000 dollars/year of dental care would have caused less fortunate families.
After the drilling, as the jaw thumps and heart races form the epinephrine, I wonder about the parallels to medical services. It costs 950$ for a root canal because the specialist is providing a valuable service to improve quality of life. This skill required training, dedication and capital investment in high tech equipment. Econ 101: consumers pay for a service and create supply/demand dynamics, except in medical care, where a third party pays and often consumers consider the medical service free. Let’s see, do not care for your teeth and pay your own money for root canals, do not care for your arteries or lungs and your employer, or in medicare’s case, your neighbor pays for your heart cath and stent and medicines and dialysis and stroke care and lung cancer treatments, etc. It is December, the heart procedure is free.
So what about an hour defibrillator implant, pacemaker or ablation procedure. Or, an office visit to a medical doctor for evaluation and management. These are valued services too, but yet the payment schema is convoluted, with third party payers, deductibles and co-pays. Why is dental care economics so different? What if, individuals payed more of their health care bills like they payed their dentist?
As said by fellow cyclist and a famous podcaster, health and success is about making a series of good choices. If one had to swipe their credit card for a medical service rendered, would this not help incentivize these good lifestyle choices? I suspect so, don’t you.
No misinterpretation please, I am not denying the role of insuring against major hospitalizations, surgery or chemotherapy. An electrophysiologist’s career is often spent fixing arrhythmia that are not at all lifestyle dependent and admittedly, there is much in medicine which is an aberrancy of nature rather than lifestyle dependent.
Another master of the obvious, Mary Barry, MD said it well in her monthly editorial in the Greater Louisville Medical Society journal…
Risk-taking on a personal level has long been celebrated in America, to the point where NASCAR fans take their ATVs on the trail without helmets and end up dead or paralyzed (with all of us paying their medical bills). The addiction community sees obesity as a disease, along with alcoholism, narcotics abuse,etc. I see it also as a series of wrong choices bolstered by a lifelong failure to learn ways to exercise regularly and well. Once people feel imprisoned in their bodies, it is far harder to get them out and about and motivated and happier – but they can do it. Taking responsibility for “being the best we can be” should be our national goal. Acting on that responsibility should save our patients’ health, and it should also save them money.
This author has learned his lesson in dental prevention. Money and pain schooled me; why should it be so different for acquired diseases that “good choices” can prevent?