Dentists Detest Dental Insurance

Clear Majority of Dentists Are Eager to Organize Against Insurance Companies

Dental Survey Results When a recent Wealthy Dentist survey asked dentists if they would like to see their colleagues organize against dental insurance companies, the answer was a resounding “Yes!” from fully 94% of respondents.

Dentists’ primary complaint is that insurance payouts have not kept up with inflation. “When I entered private practice in 1970, Chevron was the first to offer dental benefits, with a maximum payout of $1000. Now twenty-eight years later, the norm for maximum payouts is still $1000. The premiums for dental coverage have continued to go up, but not the maximum benefit payout,” said a Mississippi dentist. “There is something badly wrong with this discrepancy.”

Here are some more dentist comments:

“$1000 has been the maximum for 20 years. That’s not right.” (General dentist)
“In my 40 years as hygienist and dentist, I have seen the annual allowance stay the same ($1000-1200) with no increase in benefits and more paperwork and restrictions—totally absurd!” (Indiana dentist)
“If we all (dentists) combined our veto power, insurance companies would have to respond by raising the annual benefit. The customary benefit of $1,000 is laughable. That worked in 1960, but not in 2008.” (Massachusetts dentist)
“It’s a benefit, not insurance. If dental insurance had to be true insurance, it would skyrocket the price or devastate our fees.” (North Carolina dentist)
“Best to leave the organizing to the ADA.” (Washington endodontist)
“Dental insurance is a myth. It is more like a ‘gift card’ with many exclusions.” (New Jersey dentist)
“We need to educate our patients that Dental and Medical Insurances are totally different animals. Patients have become so accustomed to the Medical Insurance model that they expect low co-pays and no out-of-pocket expenses.” (Georgia dentist)
“If patients really analyze the costs of dental insurance, they would see that in most cases it is better to self-insure.” (Texas dentist)
“I would have chosen another profession had I known the dental insurances were going to dictate so much of my profession.” (California dentist)
“Insurance companies have actually called my patients telling them to go elsewhere!” (New Jersey dentist)
“Most companies mislead patients and make the dentist look like the villain!” (New Jersey dentist)
“It’s a nightmare that profits only insurance CEOs.” (New York dentist)

Post your own comments or read the complete dental insurance survey results

http://www.prosperident.com William Hiltz

I view “dental insurance” as the opium to which the much of the profession has become addicted.

William Hiltz
Canada
Dan Gewartowski DDS

Jim,

Reading your article on 94% of dentists being willing to confront the insurance companies, I was struck by two things. First, the obvious lack of knowledge of the history behind insurance and dentistry. All of the comments seemed to reflect an understanding of the product based on how many years the respondent had been practicing. Second, the fact that even you continue to refer to “Dental Insurance” as if there actually was such an animal.

In my office, the first thing we try to explain to patients is that there is no such thing as dental insurance as they understand the meaning of the word insurance. The patient can either purchase a prepaid dentistry up to a set dollar amount or they can join a discount shopping network.

I think that maybe we dentists should begin a movement to strike the term “dental insurance” from our vocabularies.
http://www.Mauismile.com James Merrett

The amount we are reimbursed for a gold crown is a joke compared to what the price of gold is now. I don’t do many gold crowns anymore thank god! The insurance companies having been doing a good job making people believe they need insurance to go to the Dentist. We need to get organized, and fight against the insurance companies deep pockets. They have deep pockets for themselves but not for our patients.
http://www.t-horizons.com Dr. Andrea Brockman

As a new practitioner in 1979 needing patients to fill the schedule, I didn’t heed my first office manager’s advice which was not to participate in any insurance plans. In those years, the reimbursement was not too different from the fees we were charging. Little by little, however, the fees went up and the reimbursements went down. Usual and customary fees had little bearing on the dentist who made every effort for continual enhancement through education, upgrading of equipment, and advancing customer service with competent higher paid employees. If you wanted to practice the kind of dentistry you know people deserved, you could not be profitable or satisfied consenting to the mandatory reimbursements for mediocre dentistry. The highly educated and skilled practitioners who chose to drop out of plan participation would lose patients to dentists who charged less regardless of their competency.

The difficulty was (and still is) the patient’s perception and financial resources combined with the entrenched view that dental health is not as important as the rest of the body. Dentists who reluctantly continue to participate in plans to accommodate their patients, find that if the insurance plan won’t cover the service, the patient often chooses a less expensive (and less appropriate) alternative or elects not to have the work done at all. This is a lose-lose situation and almost certainly a contributing factor in rising medical costs.

The ridiculous maximums and exclusions in dental insurance are a hindrance to overall health. Even though the scientific and professional literature document the connections of periodontal disease to heart disease, diabetes, pre-term births, and post-operative pneumonia; bite imbalances and TMJ dysfunction with headaches and chronic pain; lack of teeth and improper chewing with digestive problems and allergies, dental insurance is abysmally inadequate.

Ironically, investigating ways that I could save money on my own and employees’ increasing medical insurance premiums, I found a health insurance plan that would cover dental work. In the late ‘90s we switched our health insurance over to Medical Savings Accounts. In 2003, the government upgraded this plan to Health Savings Accounts tied to a compatible high deductible health insurance. The premiums for health insurance were cut in half and the government allows almost $3,000.00/year/individual and $$5,900.00/year/family to be put away tax free for eligible medical expenses. Unused amounts roll over collecting interest. This is the only medical plan that deems dentistry an eligible health expense. In other words, one can tap into their health savings account to pay for dental expenses, without having to file claims or predeterminations. The dentist gets paid up front and the patient doesn’t have to postpone or neglect treatment. This is a win-win situation.

In 2003, I co-founded a company, T-Horizons, LLC to help dentists learn more and acquire cost-effective consumer directed health care, both for their own personal needs and for their practice health. Patients can augment their dental insurance with health savings accounts. Dentists can obtain printed consumer brochures to educate their patients who may be searching for ways to afford their dentistry and control health care expenses. You can learn more about health savings accounts by downloading a whitepaper, “Health Savings Accounts: How Health Providers Can Effectively Use Consumer Directed Health Plans for Both Increasing Patient Revenues and Saving Thousands in Personal and Employee Health Insurance Benefits”, on our website. We would be happy to answer your questions personally.
Dr. Jim Crummett

Andrea, Thanks for the useful information. I will look it up.

Until we for some sort of guild, none of the existing organizations in dentistry will take any position at all regarding dental insurance companies, as they believe their mission is to further the “art and science of dentistry”. Many practitioners who belong are not in private practice, as owners or employees, and have no concern with dental insurance issues.

In fact, there historically has been significant cross pollination between the high chairs of organized dentistry and the board rooms of dental insurance companies. In my simple view, that is an ethics issue and an obvious conflict of interest.

In 1992, the year the Clintons came over the horizon waving the banner of national health insurance, health insurance companies, notably Delta and the Blues (who are step siblings according to rumor) began taking measures which would ultimately draw a stranglehold on practitioners in the name of cost containment. They increased the interval between fee increases from 6 months to 12 months, and they also began using hidden formulas to determine how little of an increase they would allow. You will recall that the big issue in those days was the cost of health care, as opposed to the number of uninsureds in today’s debates. Those two little changes transformed our relationships with Delta into participation in a PPO. Regrettably, very few out there today realize what happened, when, or why.

Riddle me this: if Delta is still a “non-profit service corporation” where does the money go? My guess is out through the Executive Suites and the Boardroom. Is there any way to learn more about that, or does anyone but me even care? Who are the big Execs and Board Members, and what do they take out a year? Before Delta recently revised their website, they had a page showing their purchasers how much they were saving them by turning away nearly 30% of the claims they received for one reason or another. I just checked, and that page is not there now. I wonder why?

Talk’s cheap. If anyone is really ready to organize and look into things, I’m in. Beware, though, that the name of the game will be hard ball, and they don’t plan on losing, or even being scored on. Ask that consultant from Minnesota that they went after for advising his clients to drop Delta. Only in large numbers with a war chest could we possibly prevail. Until then, I’ve dropped them, but I’m keeping my head low. Jim Crummett, Redding, CA