While I was attending a post-doctoral educational meeting the subject of achieving and maintaining dental health came up and the lecturer (a renowned dental health educator) said “THE NUMBER ONE HINDRANCE TO THE OVERALL HEALTH OF THE PUBLIC IS INSURANCE”. It occurred to me that this was a pretty radical statement until I really thought about and he gave some good reasons for his statement. Then when he was asked what advice he
had for the public concerning action they could take, he said “TELL YOUR DENTIST TO START TELLING YOU WHAT DENTAL CARE YOU NEED INSTEAD OF WHAT THE INSURANCE COMPANY WILL PAY FOR AND FIND A DENTIST WHO PROMOTES HEALTH AND PREVENTION AS A PRIORITY INSTEAD OF JUST TREATING DISEASE AS SOMETHING THAT JUST HAPPENS”. He said if people knew it was possible to get healthy and if they knew they could completely prevent dental disease there would be a constantly reducing demand for “dental insurance”. It seemed to me this was the obvious reason that insurance companies refused to pay for highly effective preventive programs, refused to pay for microscopic cultures, refused to pay for dental antibacterial preventive programs, refused to pay for adult fluorides, refused to pay adequately for almost all new diagnostic procedures and refused to pay for procedures which made teeth easier to maintain or stronger. The story is that the dentist who signs up with the insurance companies and accepts insurance company fees as his only compensation although earning little money and therefore being discouraged or prevented from performing procedures that would prevent or reduce any need for dental care MORE THAN MAKES UP FOR THIS LOSS OF INCOME/ REVENUE BY HAVING PATIENTS WHO END UP WITH CROWNS, ROOT CANALS, BRIDGES, PARTIAL DENTURES, IMPLANTS, ETC. , ETC, ETC. When I heard this I thought that it didn’t make any sense in terms of the insurance companies’ purpose of making as much profit as possible from the sale of their policies. BUT THEN I HAD A MAJOR REALIZATION A “BOLT FROM THE BLUE” SO TO SPEAK.
BY DISCOURAGING OR PREVENTING PREVENTIVE AND ROUNTINE DENTAL CARE THROUGH MAKING IT UNPROFITABLE TO THE DENTIST, THE INSURANCE COMPANY WOULD ONLY PAY OUT A MINIMUM AMOUNT ON A
6MONTHS BASIS. IF PATIENTS DELAYED NEEDED REGULAR CARE AND PREVENTIVE CARE DUE TO THE “COST” OR IF THE DENTIST DID NOT HEAVILY PROMOTE PREVENTIVE CARE THE PATIENT EVENTUALLY WOULD END UP WITH EMERGENCY CARE AND CARE THAT “HAD” TO BE DONE. WHAT THE INSURANCE COMPANY REALIZED IS THAT THIS EMERGENCY CARE AND THE CARE TO FIX THE SITUATION (i.e. – root canal , crown, bridge, implant, etc) WHEN LOOKED AT ON A FIVE YEAR OR LONGER BASIS COST THE INSURANCE COMPANY A LOT LESS THAN WHAT GOOD PREVENTIVE DENTISTRY AND GREAT DENTAL HEALTH CARE WOULD HAVE COST THEM. HERE ARE SOME FIGURES FROM A HIGH QUALITY PREVENTIVE DENTIST:
EVERY 6 MONTHS: ONE HOUR AND TWENTY MINUTE PREVENTIVE MAINTENANCE VISIT INCLUDING—MEDICAL HISTORY UPDATE, CLINICAL EXAMINATION BY THE DOCTOR, BITEWING X-RAYS PERIODONTAL EVALUATION, MICROSCOPIC CULTURE, PROPHY LAXIS , FLUORIDE TREATMENT, RE-EVALUATION OF HOME CARE EFFECTIVENESS AND INSTRUCTON AS NEEDED.
COST — $317
ANNUAL (OPTIONAL BUT RECOMMENDED) VIZILITE ORAL CANCER EXAM- COST — $68
BIANNUAL ADDITIONS: COMPLETE SERIES OF X-RAYS OR PANOGRAPHIC X-RAY WHICH EVER WAS NOT DONE 2 YEARS PREVIOUSLY.
COST — $155
VIA REDUCED FEES (WHICH BY THE WAY DISCOURAGES THOROUGH DIAGNOSTIC AND PREVENTIVE CARE)
THE COST TO THE INSURANCE COMPANY— $264 PER YEAR!!!!!!!!!
AS A RESULT OF THIS POOR PREVENTIVE CARE THE AVERAGE PERSON ON A FIVE YEAR BASIS WILL END UP WITH A CROWN , ROOT CANAL, LOST TOOTH NEEDING A BRIDGE OR IMPLANT AND WHAT COULD HAVE BEEN AN AVOIDABLE FINANCIAL EXPENSE OF SEVERAL THOUSAND DOLLARS .
THE COST OF THIS EMERGENCY OR OF THIS “NEEDED CARE” FOR THE INSURANCE COMPANY IS THE “MAXIMUM ALLOWANCE” USUALLY $1000. OR $1500.
FINAL TALLIES: AFTER 5 YEARS:
COST OF COMPLETE PROGRAM PER YEAR FOR 95% OF PATIENTS AT
WILTON AND BETHEL DENTAL ASSOCIATES——————————— $733.
COST OF CARE PER YEAR FOR INSURANCE COMPANY WITH $1500 MAXIMUM ANNUAL BENEFIT ————————— $564.
COST OF CARE PER YEAR PAID BY THE PATIENT WITH INSURANCE BASED ON AVERAGE INCIDENCE OF DENTAL DISEASE IN U.S.A.————– $975.
NOTE THAT A PATIENT WITHOUT A COMPLETE AND EFFECTIVE PREVENTIVE CARE PROGRAM NOT ONLY PAYS MORE MONEY OUT OF POCKET, BUT DEFINITELY SUFFERS MORE DISEASE AND IS NOT AS HEALTHY! ! DESPITE SUPPOSEDLY HAVING “INSURANCE”.