Monday, September 15, 2008

When the only choice is Jim Beam and Pliers

I didn't have my first dental visit until I was ten years old. I only remember it because my dentist was really nice and that first visit led to a string of visits that culminated with a root canal which, given my candy obsession, was probably inevitable.

Avoiding the dentist wasn't a conscious choice or even the result of some wacky parental belief; we had no dental insurance until my mom took a mail clerk job, making minimum wage, at a health care company. Only then did the doors of dental offices open for us.

But my life is different. My girls have been getting twice yearly dental checkups since they were three years old. We go in, they get a cleaning, some cherry fluoride rinse, a bag of toys, and we're out of there. The whole visit is covered by our dental insurance carrier. Since the girls have never had any cavities, I have been completely and blissfully unaware as to how much our dental insurance sucks.

Olie recently had two teeth pulled for which we were charged $306! Our insurance paid a whopping $123 and I paid the remaining $186; paying that bill was more painful than Olie's extractions. Believe me, I was in the room with her and the nitrous oxide and Novocaine was laid on so thick that I was high. We have another visit scheduled, to pull two more teeth, in two weeks - another $186 is due then too. Then, Lizzie has oral surgery next month for which our out-of-pocket portion is $513. And I need some dental work too: another $664.

Madhubby is employed with a large company that provides us with a good low deductible benefits package, but our out-of-pocket costs for certain services can be costly.

I don't think universal health care is the answer because I believe overall health care quality would decrease; everyone would have universally mediocre health care. Right now, we could switch to a different dentist, one that isn't so specialized; the entire practice is strictly pediatric. Our costs would likely decrease because different dentists charge different rates but I think you get what you pay for and I like to think we're paying for quality and expertise.

But what about those other families whose purse strings are tighter or those families that have high deductibles? How can they get the care their families need without breaking the bank? I don't have any answers. I'm no political pundit, though I play at being one from time to time, but I think surely there must be a better way; I just don't know what that better way is. For now, programs like Stan Brock's Remote Area Medical, a non-profit, volunteer, airborne relief corps is certainly a pretty good start.

1 comment:

Hyphen Mama said...

I have no answers either. But what I do know is that when I was in college, I was a dental assistant. The dentist I worked for had to decline to accept certain types of insurance because those insurance companies dictated everything the dentist could or could not do. They dictated the length of time he could spend with each patient (15 minutes for exams, 30 minutes for other things). He thought that was crazy and that HE should decide how long to spend with each of his patients. Also they dictated that he could only charge 80% of what his fees were. That meant he had to see more patients on each day to make ends meet.

In the end, it made no sense to deal with those insurance carriers.

What I see with Universal health care is something similar. My kid will get 5 minutes with the pediatrician... regardless of how many questions I may have. No ifs ands or buts--because they have to see more children each day to make the money to pay the bills.