Posted on 07/08/2011 2:19:10 PM PDT by WOBBLY BOB
Back in April I wrote about a person near and dear to me — yes, my husband — who needed two new crowns for $3,442. I published his experience in a post, Is Your Dentist Ripping You Off? Dentists howled in protest at the provocative headline, though most agreed with the content of the story.
(Excerpt) Read more at shine.yahoo.com ...
But when it’s all done , you’ll have s smile like Julia Roberts!
Three seats so they can steel three times as fast. If the x-ray was good enough this year and it still works, why replace it. Few actually do until they need to. Chairs actually do last for decades, even if they have to be reupholstered the cost is a couple of root canals. You act like the dentist buys new stuff every day. He doesn’t. He also is making money on every member of his staff. He pays his hygienist so he can do more root canals. Dentistry the new Cosa Nostra. Fraud in a white coat. At least they are less cavalier about it these days, they now where a mask and gloves. Keep drillin’ Dr.
Last October while I was in Costa Rica, I broke a molar on a frozen Milky Way bar (it cracked where an old filling was). Got a new porcelain crown there in 48 hours for $500.
I’m in software. I just happen to be able to actually read a balance sheet and see that dentists have a lot more overhead than you’re willing to acknowledge. Keep sticking your fingers in your ear, it’s a good look. But it doesn’t change the facts and the facts are you’re wrong. And your need to label them cosa nostra shows you know it. You haven’t even tried once to present a single fact. Just hyperbole.
I have an expat friend who has lived in the Philippines for years. His wife needed 17 different things done to her teeth and went to this place: http://www.drrowenamarzo.com/team.html
Her total bill was under $600. The dentist offers “dental tourism”, has a nice looking staff, and a plane ticket and hotel are pretty cheap compared to a US dentist.
He says all the dentists there are female, and all are cheap. I’d pick Manila over Mexico any day.
I didn’t see any mention of liability insurance.
I had a dentist who retired back in 1989 because his liability insurance was more than half his cost.
A drill costs $1,000. Paid for in five fillings at $200 a piece. An Amalgam dental filling costs between $15 - $25 for a kit which can do up to four regular sized fillings. netting between $175 and $750 per kit.
Dental Needles are $60 for a box of 1,000. Enough to numb up a small town. Novocain isn't exactly expensive either.
http://interguidedental.com/Dental-Needles-First-Choice-p42258.html
Refurbished chairs run between $2,500 and $4,000. He isn't buying a new one every day or every ten years for that matter.
http://interguidedental.com/Dental-Needles-First-Choice-p42258.html
A complete digital dental x-ray machine costs around $5,000. Less than a bad used car.
http://interguidedental.com/DIGIREX-Digital-XRay-System-p14001.html
One days drilling pays for that! Hell three root canals with stainless Steel caps, not even gold, pays for a system.
Guta Persia pins run 15 - 20 for the kit. Crowns cost 120 wholesale to 200 depending on material and the dentist charges $800 -$1200.
http://interguidedental.com/Adult-1st-Permanent-Upper-p31279.html
As I said. They have no more overhead than most any other business. The cost is in the sheep skin, but that is the case for most professions.
If bankers charged like this they would be imprisoned, after they where bailed out of course.
When you look at the cost a barber has as much over head and he only charges $15 for twenty minutes of his time and if he screws up the pain goes away in two weeks when your hair grows back. Like I said Cosa Nostra: criminals in white coats.
Shouting doesn’t make you right. And your math is bad.
Looks like a good place for a Minnesotan to make a January dental trip.
You can go on and on with anecdotal evidence of insurance and over head. I actually gave links to a dental sight. The equipment is there for the taking and that was with no shopping around. Two clicks.
Are there fixed and variable costs in dentistry, Yes. Is there a high cost to entry, sure but the reward is obviously there. When done correctly a dental practice is gold. That is why existing dentists buy out so many of their competitors when they chose to retire.
The cost of most dental procedures is way too much. Particularly root canals, crowns and bridges. When a look at the costs of the products are considered, it is obvious. If you chose to believe that you are getting what you pay for from the dentist,be my guest.
I personally deal one on one with the dentist and pay cash. I usually get the work done for half the traditional cost. I bargain for his business and time the way people bargain for anything else. When a cash payment can be made for 1/2 what he charges those with insurance or those that are too shy to ask, well you do the math. That shows how much real profit is in the work.
The problem with your math is you’re taking it all individually, like 1 filling only has to pay for that thing. Back here in reality that 1 filling has to pay for EVERYTHING on your list AND the rent AND the dental assistant AND the office aids AND the computer AND the insurance AND the taxes AND the electricity AND the water AND the advertising AND all the other junk neither of us thought of. Plus the guy would like to make a little money to live on himself.
Now when you open the door to insurance there’s a whole other problem. One of the things you need to understand about insurance is they don’t pay the bill that’s offered. Insurance companies all pay a percentage of the bill that comes from the doctor, each insurance company sets the percentage different. Which causes the doctors and the insurance companies to play a really stupid game. If the doctor needs $100 from the insurance company but has learned (well really his accounts payable person has learned, there’s another somebody he has to pay for) that said insurance company will only pay 80% of the bill that comes to them then he has to send them a bill for $125, knowing that they’re going to chop off the top $25 and only send him a check for $100. Problem is then the insurance company figures out that he’s figured out their percentage so they lower, so the next time he sends them a bill for $125 when they send him a check for $75 he finds out they’re now only paying 60%. That’s why all doctors drop their prices dramatically when you say you’re paying with cash not insurance, because then they know you’ll pay what they’re asking, not some percentage you dreamed up on your own, so they can just go ahead and bill you for what they need to perform the procedure profitably.
As for the OTHER overhead, of course they have over head, I realize that. I am saying that I know for a FACT that I get my dental services for half the stated price, because I PAY CASH. that is why I know it is a profitable business. They are RAPING most people. They can do so because the guy down the hall prices the same services at relatively the same price. It is PRICE COLLUSION and the ADA should be up on charges.
I am as much of a capitalist as anybody, more so than most, but the dental profession is little more than the local auto mechanic writ large. That lift costs allot too and that flugal valve cost $275.
Anecdotal evidence of SO many dentists forced to drive high end luxury cars and live in McMansions shows the poverty that they continue to suffer as a profession.
Want to save some real money? Ask the price up front and offer half in cash, you may be really surprised. Go in strong with three other dentists on speed dial on your cell phone and start calling for prices. He will make a deal with you. He knows he is ripping you off.
Dental insurance still decides they’re not paying that much for that. Because they’re still insurance companies. My dental insurer is MetLife, an insurance company.
Again you’re really back to the insurance. Even if the dental insurance doesn’t act like all the other medical insurance companies, which they are and do, it still takes longer to get the money from them with more overhead. When you pay for all your own dental work your dentist gets the money NOW, when I make my insurance company pay for most of my dental work my dentist’s AP people have to fill out the MetLife form (which of course they had to be trained in) pile a bunch of them together for submitting to the insurance company, then they have to wait for the insurance company to get around to paying. There’s a 2 or 3 month delay in getting the money, not to mention the dramatically increased labor cost in getting it.
I’ve got 3 different friends that have done medical billing. One of them specifically handled medicare and 4 private insurers, that was it, there were other people in the AP department that handled other insurance companies. There were 3 doctors in the office and 4 AP people handling insurance billing. Now this office was an oncologists, so they had to deal with the most flack from the insurance companies. But it was really only the quantity of crap they dealt with that’s different from dentists, not the content.
If you want a bad guy in the cost of medicine look no further than insurance companies. They’re ripping off everybody. They’re #1 goal is to not pay out a dime, but they still want money from you so you’ll be “covered”. And the games they play drive the cost of doing medical business through the roof.
Now you have strayed into an area that you know nothing about. Dental insurance is nothing like traditional insurance in any way shape of form. Dental insurance is more of a prepaid service agreement. They will pay X for cleaning and check ups twice a year. They will pay UP TO 1/2 of the cost of dental work, fillings, extractions etc. and they will pay a certain definite dollar amount for dental services, often $1,000 per year. A generous plan would cap benefits at $1,500. Remember, they will only pay half the price in most instances, you pay the rest. They have a HARD cap on benefits.
If a dentist is willing to take my cash for dental services and charge me half and if they bill you half at the time the services are rendered and bill the insurance company for the other half, I think it is safe to say that the entire payment from the insurance company is PURE PROFIT.
Also: Dental practices are among the highest profit margin professions of all. http://www.bizjournals.com/columbus/stories/2010/03/29/focus1.html?b=1269835200%5e3096961
In 2008, Forbes ranked dental services as the third most profitable business to start – behind accounting and legal services firms – with an average pretax margin of 21 percent. Dental practices enjoy an average 17% profit margin. WOW! That is a whopper, just ask any businessman. As a matter of fact they rank as the MOST profitable industry in a 2008 study by StageWorks,Inc.
As far as the Oncologist is concerned, they have so many people billing because the Federal Government SETS THE TONE for medical billing. It is their ridiculous pricing in Medicare that drives the costs to the private insurers up.
Medicare has a schedule of payments, regardless of actual cost. They dictate the pay, the procedure and whether or not the doctor will get paid at all. Medicare turns down more claims than any insurance company by total dollar and by percentage.
If Medicare rejects the claim, the doctor gets $0. He can not BY LAW charge the Medicare Supplement company or the patient. He therefore has to bill MORE to you, the person with private health insurance.
The doctors also are required to fill out a different form for every insurance company. The process of streamlining the billing is frustrated by the asinine rules of fifty different insurance boards in fifty different states and one huge Behemoth of a steamroller in the Federal Government Medicare and Medicaid Services.
Doctors also have to treat the uninsured and the indigent, regardless of ability to pay. A large portion of a medical doctors time is with patients that are uninsured or Illegal Aliens, both of whom pay nothing in the end. You get to pay for these people through your insurance as well.
A dentist treats NOBODY for free. They are not required to do so by law, medical doctors are.
The doctors are forced to overcharge the private insurers to pay for the discounted prices of the Medicare system. Medicare/aid pay doctors below cost and STILL are unable to balance the books and that is when they are confiscating a not insignificant amount of the GDP. Why? A full 1/3 of the Medicare system is outright FRAUD. Between $90 - $150 Billion dollars a year is stolen outright in Medicare. Add in Medicaid and the fraud is even greater.
Medicare and Medicaid funding totals $489.3 billion and $264.5 billion respectively. The Center for Health Care Solutions estimates that just eliminating the Fraud in the two programs would save tax payers close to $250 Billion yearly.
The fraud doesn't include the retiree who decides that since they pay $200 a month for a Medicare supplement, they decide to go to the doctor three times a week because it is ‘FREE’. My knee hurts better see the doctor, has that spot gotten bigger, better see the doctor, I saw a commercial for so and so, I have those symptoms, better see the doctor.
Ever watch daytime TV? Notice all the rascals and electric wheelchair adds there are? Ever notice that everyone of them has a ‘testimonial’ stating ‘My new chair didn't cost me one red cent!’ Of course it didn't, It cost the tax payer $5,200 and you died three days after it was delivered and nobody EVER buys a used one. Why would they when the government will send them a new one for ‘FREE TO ME’!
Ever wonder why Dentists where never subject to Medicare. The ADA lobbies heavily to keep them out of the Medicare and Obamacare system. They would go broke. That is why so few dentists take Medicaid. It is a loser.
Your entire last post shows you are talking completely out of your A$$. You have no knowledge of the insurance industry or the dental industry beyond being a passive consumer. Yo don't even engage in the commerce directly as you have an insurance company as a third party payer. To you the costs are justified., You see a shiny piece of equipment and believe it is purchase just for you.
I, on the other hand, have an intimate knowledge of the Insurance Industry and the Medical industry. I worked as an Insurance Executive for many years, I hold licensing and certifications in four states. I have also dealt with Insurance companies and health care professionals as a patient and an advocate for one of my children.
I have literally spent years acquiring real knowledge, because I was forced to, both professionally and personally. Millions of dollars in claims have been paid out by my insurance carrier for medical services provided to both my son and for myself.
Insurance companies as crooks goes over like a lead balloon with me and those in the know. Insurance companies operate on a 1%-3% profit margins, that is when they are a for profit company. A vast MAJORITY of insurance companies are NON-PROFIT Mutual companies. Look it up.
I think you have been shown to know absolutely NOTHING about the dental, medical and insurance professions. Please, leave business up to the professionals.
I have actual knowledge, you have none. I have experiences and facts. You have anecdotes and friends and relatives ‘WHO SAY’ or here-say.
You should stop showing your ignorance on this topic and maybe stick with what you know.
Dentists are just short of a criminal enterprise based on the FACTS, not conjecture. Al Capone would have enjoyed the profit margins of the average dental office.
Sorry but you’re just plain wrong. The problem even dental insurance faces is that what they’ll cover according to the plan is more than they take in, they’re banking on the people NOT using the plan to the fullest extent. My MetLife plan will pay out up to $2000 a year, but they only take in (between me and my employer) $600 a year to cover me. They’re hoping all I do is get some cleanings and maybe a filling, enough for me to consider it profitable (knowing I’m only paying a portion) but less than the total money brought in. So far the joke has been on them, my company switched to them at a bad time, years of laziness caught up with me, I’ve tickled the underbelly of the cap 3 times in 5 years, they’ve laid out over 6 grand on me and only taken in 3. The bad news for them is that those years of laziness I was on other dental plans, my company switched to them right before the troubles started. They need my company to stay on them for 5 years with nothing but cleanings for our relationship to get back in the black. Oh and for most stuff they’re paying 2/3s.
Insurance companies are still insurance companies. They still have a certain amount they take in, and they still want to not pay that much out.
That 17% profit margin you’re linking to shows MORE overhead than the 80% you refused to believe a few days ago. There’s nothing wrong with a 17% profit margin. You want to see a profit margin that’s crazy look up the fine jewelry business, every step of the process is between 300 and 500% markup, now THAT’S a profit margin.
You have appeals to authority, ad hominems and hyperbole.
Who is acting just like a liberal? You. Shown the facts and give an explanation from someone in the know you decide to cling to your beliefs, no matter how wrong.
Like I said: I believe Dentists are overpriced. I provided you with facts and links to articles explaining those facts. They are among the highest profit industries in the country if not the highest.
You, on the other hand, tell me about people you know who do medical billing. They do not even bill for dentists. Yet, you think that is a substitute for real experience, education and knowledge. Well it is no substitute.
I am done with you. Go back to hacking.
That is Mark up not profit margin. Restaurants generaly have a 400% - 500% mark up on the food they sell. Yet, A vaste majority of them go BK in less than a year amnd Mark up is not profit, it isn’t even gross profit.
You dane to tell someone in the industry for twenty years that you knw morte about a insurance products than he does?
What an arogant ass!
You do understand the jewelry stores aren’t nearly as labor intensive as restaurants. The majority of the cost in jewelry is the jewelry, not the employees, so a 500% markup is rather intensive. The majority of the cost in restaurants is the labor, not the food, so that really isn’t much of a markup at all.
Oh look more ad hominems. You’re so predictable.
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