What Do Your Dental Insurance Premiums Actually Pay For?
Any individual who has dental insurance may be interested in seeing the attached video and article. Every dental patient in the state of Washington (and really this country) should be aware of the growing issues with dental insurance. The largest dental insurance company in the state of Washington just recently announced a huge change. This change basically reduced the dollar amount covered/reimbursed to dentists and the majority of dental procedures affecting every field of dentistry (Endodontics, Periodontics, Oral Surgery, etc...). This means that the company basically requires all dentists to do the same work they have been doing, but be reimbursed/paid less for each procedure. I have encountered people that have casually expressed mixed reactions to first hearing this.
From one perspective, I have heard some react with the view "Well that's no big deal, dental professionals can afford to make less money, etc..." I suppose this would be the most extreme opinion on one end regarding this issue. I am about to make a statement that reflects my personal opinion and perspective in reaction to this view and does not represent the view of all dental professionals: Let's consider the fact that materials, technology, and science in the dental profession are the main factors that dentists must consider when they decide how much a filling, root canal, etc...will cost. Dentists must be able to cover the costs of materials, equipment, compensation for their staff, rent/lease expenses, utilities, etc... Of these, often the cost of materials and equipment is the most signficant and what accounts for the majority of the cost of a dental procedure (especially in Periodontics when someone undergoes a dental implant or bone graft procedure for example).
A contrasting reaction might include the view that "this is unfortunate, what does it mean for the profession and the care I am receiving?" This is more of the question that one must ask when you read in this article how much the CEO's of the dental insurance companies are being compensated. The dental insurance companies basically exhibit a "corporate friendly" model. In the most extreme example to illustrate this, suppose a patient needed a heart transplant from a Cardiac surgeon. Hospital procedures, materials, equipment, etc., add up and make these types of procedures fairly expensive. Would you rather pay a little more or want your insurance company to make a little less profit on covering this procedure and pay/reimburse more to cover the cost of this procedure as opposed to the insurance reimbursing less and demand that less money contributes to the expenses of performing this procedure? Allow me to briefly present the domino affect this might have. When insurance pays less for a procedure like a heart transplant/surgery, less money is reimbursed to cover costs/expenses. This means the doctors and medical personnel must perform more procedures per day to offset the cost of being able to operate. Potentially this means the doctor must spend less time to perform the same procedure so that more procedures can be squeezed into the same daily schedule. This way the same amount of revenue can be generated to cover the costs and expenses associated with being able to perform the surgery. What should one suppose may happen to the quality of patient care and personal interaction when this situation is perpetuated and the financial strain of growing costs are implemented on healthcare professionals?
The fact is, this scenario is already all to familiar in medicine. I doubt it feels very good when you are trying to talk to a health professional about a concern and he or she has one hand on the door knob to leave to rush to the next patient. I have heard people complain about going to the doctor and the appointment lasted barely 10 minutes because the physician seemed to be rushing. It was likely because that doctors schedule demands 10 or 20 more patients must still be seen before the end of the day in order to generate enough income to cover the operating expenses. This may seem like an extreme example but for some people it is not far off from reality.
Unfortunately, insurance in the dental profession appears to be heading down that same road. One of my faculty mentors puts it this way, "Dental patients need to know that dental work is not inexpensive by any means. When you pay for dental care you need to look at it as an investment in yourself. Don't you think you are worth investing in?" That same faculty member would joke that, "Dental patients can have their work performed FAST, CHEAP, OR RIGHT...but they can only have 2 out of the 3." The question is, which 2 of the 3 would you wish for if it were care for your mouth?
I hope that you will take the time to view the video and read the article that is linked below. It is very eye opening.