Dentist....teeth cleaning

Medical malpractice insurance costs is one of the many reasons the independent dentist/ doctor office is slowly going away and almost complete
This is one area where dentistry is much better than medicine - my malpractice is about $2,000 per year for $6M/$3M coverage. I’m not complaining about this compared to my medical colleagues.
 
I have not been in about 1 1/2 years. My last visit, I believe resulted in an infection that destroyed my aortic valve implant and I had to have it replaced again via open heart surgery. About 80% chance it came from the crown I had done even though I took antibiotics. So, avoiding the dentist at all costs unless emergency. My wife's prophylaxis is running about $175 each time. Expensive.
 
This is one area where dentistry is much better than medicine - my malpractice is about $2,000 per year for $6M/$3M coverage. I’m not complaining about this compared to my medical colleagues.
When I was last in practice (5 years ago), my (medical) malpractice insurance was about $500 - 600/year with unlimited coverage. All future actions are covered if the event occured during a year in which there was coverage. So as a retired physician I no longer need to pay for coverage (which wouldn't be the case if coverage is required during the year in which a claim is made). Almost every physician in Canada gets his/her malpractice insurance from the same non-profit association. The rates now vary by specialty with obstetrics, neurosurgery, and cardiovascular surgery at the high end. Up until about 20 years ago, all physicians and surgeons in Canada paid the same rate.

Some things are cheaper in Canada.
 
I consider myself part of the old guard even though I've been out a little under 20 years. My $150K has been at 0.65% interest while many of the new grads have $400K+ at 7.5% or higher. While it has certainly paid off for me, even paying seven figures to start a practice, all I can do is report how new grads feel and they almost universally feel like they're struggling due to their debt load.

$400K in education debt + $1M plus for a practice + CV-19 either shutting down practices or forcing reduced patient volume not to mention all the staffing issues + there are no guarantees in small business. Dentists don't have hospitals employment as an option and so it's small business owner or work for a corp.

Yep. I feel bad for all the small businesses that were forced to close for an extended period of time.

Some people are now saying the shutdown hurt small businesses to the point they will never be the same.

Home Depot parking lot had 400 cars jam packed during the height of CV shutdown.
 
My wife's prophylaxis is running about $175 each time.
Does she have dental insurance of any kind? Sad thing the Dentist and insurance companies will negotiate and probably settle for less than half that. The uninsured get charged full price.
 
Does she have dental insurance of any kind? Sad thing the Dentist and insurance companies will negotiate and probably settle for less than half that. The uninsured get charged full price.
Not quite. This is how dental insurance operates:

1. Young dentists who need to build their practice sign up for every insurance available based on the idea that even at 70% of their usual fee a butt in the chair is better than no butt in the chair. Overhead is 55% of your usual customary fees and so there is a 15% margin.
2. Years go by and more and more patients with insurance X become part of the practice. Inflation is constantly eating away at that 70% so that 10 years out they are now paying 55% of your fee.
3. The insurance company has not given ANY fee increases in 10 years but has raised the premiums paid by their customers every year.
4. At this point with an overhead of 55% the dentist is breaking even when these patients come in and they know 5 years from now the dentist will be PAYING the patient to come in when insurance pays less than overhead.
5. This can be somewhat mitigated by patients with no insurance who pay the full fee.
6. The dentist now has to make a decision: 1. Cut costs (usually by cutting corners) which is bad for the patients; 2. See more patients to try and make up for the very slim margins which is bad for patients; 3. Drop the insurance and risk pissing off a lot of patients and ultimately lose a lot of patients who will blame the dentist and not their insurance company.

The entire time the insurance company is making record profits. Around 2017 Delta Dental, the largest dental insurance in the state announced that after 10 years of not raising fees they were going to phase out their best-paying program Delta Premiere, force everyone into their PPO program, and REDUCE fees by 30% over a couple of years. They are not passing this "savings" on to their customers and premiums have actually increased for their customers. They have also had record profits for the past 3 years. DD hired a hatchet man for 9 months to devise this plan and he was actually caught on the record gloating how "stupid" dentists are for accepting what he just instituted. It's a game for them and real people, both dentists and patients, are caught in the middle. It's sad how many people think their insurance is on their side. Insurance makes money by collecting as much money as possible and NOT paying as much money as possible.

This "squeeze" by insurance companies is real. Practices that start entirely in-network with PPOs are almost destined to doom. Many practices take some PPOs to start and they can tolerate the squeeze for longer but eventually, everyone moves to be totally out-of-network and fee-for-service. Enter Wall Street and Dental Service Organizations (DSOs) who buy up practices but that's another conversation - hint: Wall Street doesn't give a crap about patients.
 
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The entire time the insurance company is making record profits. Around 2017 Delta Dental, the largest dental insurance in the state announced that after 10 years of not raising fees they were going to phase out their best-paying program Delta Premiere, force everyone into their PPO program, and REDUCE fees by 30% over a couple of years. They are not passing this "savings" on to their customers and premiums have actually increased for their customers. They have also had record profits for the past 3 years. DD hired a hatchet man for 9 months to devise this plan and he was actually caught on the record gloating how "stupid" dentists are for accepting what he just instituted. It's a game for them and real people, both dentists and patients, are caught in the middle. It's sad how many people think their insurance is on their side. Insurance makes money by collecting as much money as possible and NOT paying as much money as possible.
That's basically what happened to me, I think I was paying around $35 a month for dental insurance through the state ACA plan and it was actually cheaper than paying the walk in rates. Then when covid started, my dentist dumped that Delta Dental plan but there was a more expensive Delta dental plan at about $65 a month that they took. So I basically ended up paying more for dental insurance but basically it was the same coverage.

There's a reason Warren Buffet likes insurance companies, they collect all the premiums and of course they have to pay out a percentage, but in the meantime those dollars accumulate before they're spent.
 
Many dentists are crooks and take advantage of the uninsured.
There are crooks in every profession and business sector - there's nothing special about dentists.

I'm not in-network with any insurance and my fee is what it is because I've calculated what it needs to be to make the economics work. If I charge $100 and a patient's insurance pays me $70 then the patient owes me $30. If the patient doesn't have dental insurance then I charge them $100. I don't discount my services for the uninsured or insured. At the end of the day, I will collect my $100 and I didn't charge a different fee for that service - it's the same $100 for everyone.

BTW it IS becoming ALL THE SAME. The new move for insurance companies is they are simply a "prepayment plan". With these newer plans, if someone has dental insurance that provides $1000 of coverage every year I can guess what their premiums will be within a few dollars - hint take $1000/12. You're getting exactly what you put in over the year. You still paid my full $100 fee! You simply prepaid some of it to your insurance ad they siphoned off some of it for themselves.

Dental insurance is a prepayment plan in general and not a catastrophic coverage plan like medical insurance. Many patients would be better off not paying for dental insurance and just paying for dental services as needed since you're rarely getting more services than you paid in premiums anyway and you keep your money if you don't use the services. How many people pay $1200 per year in premiums to use $800 in services? A lot!
 
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I'm fortunate in that my employer offers dental coverage through Aetna. The basic plan is no cost, the enhanced that covers more is like $10/paycheck. If you choose a dentist that is on Aetna's preferred provider's list, you save the most. I pay very little out of pocket for routine services for my family of 6 and even more major procedures are a fraction of the cost of what I'd pay w/out the Aetna coverage and a dental group on their list. For instance, I chipped/cracked a lower left molar back in January that had a 30-40yr/old amalgam filling in it. The dentist cleaned it up and filled it with resin based composite. The bill was $256. I paid $119. Well, of course I pay ~$40/month, but with a family of 6, that's a lot of dental appts per year.
 
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Chain dental services like "Smile Bright" and "Aspen Dental" are like chain brake services. The "29 point multi check" isn't for your benefit or "protection". It's for their profit margin.

Dentists who operate on their own can be bad enough. Get a bunch of them in one building, and it's like a woman getting gang raped.
 
I have bad teeth in general and require deep cleaning or 3 to 4 times a year regular cleaning. Deep cleaning they usually charge insurance like 400 each for two visits, and my portion would be like 110 copay.

You should be able to negotiate with dentist if you pay cash and have flexibility on scheduling.
 
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I wonder how many of us floss everyday
I do and have done so for seventy some years. Didn't see a dentist until I was fourteen, and that was to have three teeth rotted of to the gum line pulled. Parent's were skeptical of doctors and downright hostile to dentists. Still have twenty nine, some with caps and fillings, but they will last me till I die.
 
Same what happened to the independent pharmacy they we're forced to sell there client list while it had value the longer you held out less valuable it got. Corporate America like CVS put the screws to them ,sell or be crushed
That's the way the "free market" works. It ain't trickle down, it's trickle up.
 
I dealt with something Similar to this a few years ago. I went to a highly recommended dentist. I had a chipped molar, and a bottim tooth chipped not cracked, but nothing too serious. They took x-rays etc and said nope can't be fixed, $3k on one side $2k on the other. I went to another dentist who was closer who was able to fix the chip, and so far three years later it's still holding and for a couple of hundred. It doesn't hurt to shop around, and if they have the latest high tech gadgets then they are going to be expensive.
 
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