It doesn’t make a whole lot of sense, but the US healthcare system has long viewed dentistry and optometry as some sort of secondary thing that’s not part of the primary medical and healthcare profession. It’s silly IMHO. It should all just be part of an overall healthcare plan instead of separate insurance.
Routine dental care is routine, so calling it "insurance" is really odd in my opinion. Insurance isn't mainly providing protection against tail risk when it comes to eye care, dental care, and even predictable routine checkups. Obvious exceptions exist for accidents that require surgery to eyes or the inside of the mouth, but a dental hygienist (for instance) wouldn't be the healthcare professional involved in those procedures.
It could make sense for some categories of routine care to be included in insurance because they reduce risk or are cheap enough to be affordable perks of the insurance product. I just wouldn't call those features insurance.
If you're unconcerned about health insurance compared to health care as such, that's also OK. But the US healthcare system is mostly not a single payer healthcare system, at least not right now.
I would love dental insurance that covers that tail risk, but it doesn't seem to exist. Every dental plan I've had covers at most $1500 or $2000 per year. That's meaningless when something comes up that costs ten times as much.
Routine checkups are part of regular health care too, so I don't grok the assertion here.
Maybe insurance isn't the right word for what our medical plans are, but this feels like some serious mental gymnastics to avoid seeing what obviously is.
> It could make sense for some categories of routine care to be included in insurance because they reduce risk or are cheap enough to be affordable perks of the insurance product. I just wouldn't call those features insurance
It seems to me that "It makes sense to include them with insurance but I wouldn't call them insurance" is needlessly pedantic
Same in the UK. You get GP stuff on the NHS for free, but dental and optical is only subsidised if you're on state benefits. If you go to the GP with a health issue that's related to the mouth in some way, you'll be told to see a dentist. I've never understood it.
> You get GP stuff on the NHS for free, but dental and optical is only subsidised if you're on state benefits
This isn't really the whole picture though, is it? I pay £25.80 for a dental check-up thanks to the NHS. If I wanted to do that on a private basis I'd probably be paying double.
Counterpoint against that. Because optometry isn't considered part of the "healthcare" umbrella when I went to get LASIK it was the easiest medical transaction that I've ever done. They explained what they would do, said this was the price, then said they could offer a discount and when I was still considering they said they could give me another discount. I got the upfront price paid for it got my surgery and went on my way. This wasn't some shady Nick Riveria place either it was one of the premier LASIK facilities in the world.
By contrast trying to do something as simple as buying a new medical device for my wife has been a Kafkaesque nightmare with random charges, wrong billing codes, switching companies, fighting insurance, demonstrating need, etc, etc for something I am willing to purchase. The device is also marked up several thousand percent to boot.
Part of the problem with the healthcare discussion is that we need to clarify what we mean by healthcare. When I hear people complain about healthcare they either are complaining about medicine, or hospital stays with crazy and confusing billing processes, and these 2 problems are completely different than each other and require a whole different set of discussions apporaches and solutions, but everyone just talks about "healthcare" with no nuance and it obscures any possible forward progress.
As a final question for pondering how much healthcare does everyone deserve? I think we'd agree it probably isn't reasonable to say a 96 year old woman should get a multimillion dollar experimental cancer treatment that will extend her life by 6 months before dying, on the other hand simply having access to Ibeprofun and Antibiotics means you have access to better medical care than anyone else at any point in history longer than 40 or 50 years ago?
Your nuanced plan of paying for things yourself completely falls apart once you or a loved one contracts stage II or higher cancer, suffers life threatening injuries from a car crash or any of a panopoly of unfortunate situations that would completely exceed your ability to self insure.
I am also not impressed with all of these just asking questions it's so complicated asides; there are dozens of existence proofs that demonstrate a diverse set of approaches that more or less solve this problem at the nation level. But that would require a bit of curiosity about how the rest of the world works, I suppose.
The problem with health care/insurance in the US is not because of unanswered economic theories (or lack of half baked econ 101 approaches), rather it's because of hard ideological commitments to maximize rent extraction based on historical contingencies.
Ever wonder why US corporations generally provide health insurance? World War II something something.
Optometrists don’t do LASIK though, only medical doctors. So you just saw an optometrist that works outside the insurance sphere since most medical insurance doesn’t cover LASIK. I do take your point though that when it’s a competitive environment away from insurance claims yes the service magically improves dramatically and the BS goes away.
Right, when most people complain about health care, they aren't complaining about quality of care when they get it. They're complaining about not being able to afford it.
Or, it being too confusing. That's a problem with health insurance, and not with money.
That's why some think that a national health care system that is designed primarily around effectiveness of distribution of payment, rather than extracting maximum profit from the flow of money between patient and provider, is the moral and effective solution.
To your last point, rationing low availability health care is nothing new. Alcoholics can't get liver transplants for example. There's a whole field of bioethics that can surely answer some of those questions.
Most people would still prefer going through all that bureaucracy than paying $10k out of pocket though. Your slight convenience doesn’t make it a good idea. You can still go to a private hospital in the US and feel free to pay out of pocket.
"Health insurance in my country is so obtuse and convoluted I would rather not put my basic medical needs in there, and rather just pay out of pocket for it separately."
Approximately 0% of parachute-wearing is based on validated research. Doesn't mean it's not a good idea.
While I agree that dentistry absolutely has an overtreatment problem, there's enough evidence that some procedures result in pain relief at a minimum that we don't need to insist on double-blind trials -- and in fact performing such trials would be unethical.
>Approximately 0% of parachute-wearing is based on validated research.
But this is simply untrue and it undermines the rest of your point. The actual satirical statement is supposed to be about clinical trials (research studies involving humans), not validated research in general.
The study linked is not simply about clinical trials but rather than dentistry lacks validated research in general.
I guess if the benefits of a treatment are obvious you don’t need a lot in the way of research, or even science at all, to recommend it.
But if the benefits are subtle or borderline, then it’s an interesting ethical dilemma. Which is the least unethical: withholding a potentially-beneficial treatment from a control group, or giving a potentially-non-beneficial treatment to everyone?
Funnily enough the paper you are citing has that quote but they cite another paper. The paper they cite says “It has been suggested that perhaps as little as 8% of dental care is justified…” and cites two more papers.
How is this acceptable in academic research? Nobody is citing the primary source and everybody is citing interpretations of some source that I can’t find the text of (probably because I’m on mobile).
tl;dr your citation is worthless through no fault of your own.
This is sort of embarrassing to admit publicly, but I had a fear of going to the dentist for several years and decided to go recently. After a 10 year hiatus, I was shocked to learn that I didn't have a single cavity or any other apparent issue! The dentist and hygienists were as astonished as I was. In my hiatus, I would brush every single day and occasionally pick plaque off myself with a tool similar to what the hygienists use at the dentist office. Needless to say, I bucked my irrational fear of the dentist and I'll be going back in a few months for another regular cleaning. This isn't to say that going to the dentist for regular cleanings isn't worth it, but maybe it isn't as required for some people as we think granted they keep up with a regular at home regimen?
Dental Care is just like everything else related to your health: it's complicated.
If you're eating healthy and have good hygiene, doctors ain't gonna help whatsoever unless you're unlucky and get a rare disease that they can actually diagnose and treat correctly. The likelihood of that is probably around 0.0%, rounded.
The average person drinks soda, eats lots of sugar, drinks alcohol etc. That adds up over the years. especially soda in the context of dental care, as that's an acid and destroys the enamel over the years. once that's damaged, things get worse.
Kinda relevant: is the 92 in your username your birth year? If it is, you not having any issues is to be expected. Most people develop their Dental issues in their late 30 and later
That all makes a lot of sense, and yes your assumption is correct regarding my username. I’m glad to have corrected this behavior of mine before it got too late.
I also use the little $10-15 kit off amazon. Like you I did that for a long time as well as brushing. Unfortunately when I went back to the dentist I had a single cavity but a bunch of calcified plaque between my teeth that I had to pay like $800 to get cleaned out. Obviously I’m a big flosser and picker now.
I must have had some pretty bad halitosis with that calcified plaque because now I’m not habituated to the smell. For those in my family that are clearly not flossing and have shit breath i thought about buying them dental kits and floss for Christmas stocking stuffers. My SO said no and it’s their wives and dentists who should tell them. I kinda disagree but I’ll leave it alone. Someone had to tell me - what if no one ever tells them their breath is horrid because of the calcified plaque? They’ll just wander through life like that?
And some people who smoke live to be 100 years old, but if you go by actual statistics and data and not just some random anecdote off the internet, people get cavities. If cavities are untreated the tooth rots, infections occur, teeth need to be pulled and there are lots of negative consequences.
Sinusitis has odontogenic origins like 20% of the time iirc. I suspect a lot of heart disease results from the bifurcation of dental from general practice, eg periodontal disease being seen as a dental problem not a cardiovascular risk factor that doctors should be on the watch for.
It is not? The lack of healthcare in US is always astonishing. Here in Brazil, since about 2000, dentistry is supported by public healthcare. Sure, for some services it may take a lot of time to be attended and treated, so who can afford usually pay for private healthcare, but nonetheless the public and free service exists. It is common that US tourists, when became sick or if they suffer some accident here, they resist to being sent to the hospital arguing that they cannot pay. And for some of them, it takes some time to make them understand that they do not need to pay for such a basic human right.
Brazil also has an interesting relationship with teeth.
When I was there, I noticed people brushing teeth after lunch. This happens even at corporate offices -- the restrooms would be full of people brushing and flossing after meals. People brought toothbrushes to work. There was even a floss (fio dental) dispenser.
Funny though, if it was considered primary medical in the US I bet it would be a lot more expensive. I'm always surprised that dental care prices seem justifiable based on the services I received.
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It could make sense for some categories of routine care to be included in insurance because they reduce risk or are cheap enough to be affordable perks of the insurance product. I just wouldn't call those features insurance.
If you're unconcerned about health insurance compared to health care as such, that's also OK. But the US healthcare system is mostly not a single payer healthcare system, at least not right now.
Maybe insurance isn't the right word for what our medical plans are, but this feels like some serious mental gymnastics to avoid seeing what obviously is.
It seems to me that "It makes sense to include them with insurance but I wouldn't call them insurance" is needlessly pedantic
This isn't really the whole picture though, is it? I pay £25.80 for a dental check-up thanks to the NHS. If I wanted to do that on a private basis I'd probably be paying double.
By contrast trying to do something as simple as buying a new medical device for my wife has been a Kafkaesque nightmare with random charges, wrong billing codes, switching companies, fighting insurance, demonstrating need, etc, etc for something I am willing to purchase. The device is also marked up several thousand percent to boot.
Part of the problem with the healthcare discussion is that we need to clarify what we mean by healthcare. When I hear people complain about healthcare they either are complaining about medicine, or hospital stays with crazy and confusing billing processes, and these 2 problems are completely different than each other and require a whole different set of discussions apporaches and solutions, but everyone just talks about "healthcare" with no nuance and it obscures any possible forward progress.
As a final question for pondering how much healthcare does everyone deserve? I think we'd agree it probably isn't reasonable to say a 96 year old woman should get a multimillion dollar experimental cancer treatment that will extend her life by 6 months before dying, on the other hand simply having access to Ibeprofun and Antibiotics means you have access to better medical care than anyone else at any point in history longer than 40 or 50 years ago?
I am also not impressed with all of these just asking questions it's so complicated asides; there are dozens of existence proofs that demonstrate a diverse set of approaches that more or less solve this problem at the nation level. But that would require a bit of curiosity about how the rest of the world works, I suppose.
The problem with health care/insurance in the US is not because of unanswered economic theories (or lack of half baked econ 101 approaches), rather it's because of hard ideological commitments to maximize rent extraction based on historical contingencies.
Ever wonder why US corporations generally provide health insurance? World War II something something.
Or, it being too confusing. That's a problem with health insurance, and not with money.
That's why some think that a national health care system that is designed primarily around effectiveness of distribution of payment, rather than extracting maximum profit from the flow of money between patient and provider, is the moral and effective solution.
To your last point, rationing low availability health care is nothing new. Alcoholics can't get liver transplants for example. There's a whole field of bioethics that can surely answer some of those questions.
"Health insurance in my country is so obtuse and convoluted I would rather not put my basic medical needs in there, and rather just pay out of pocket for it separately."
Strange approach.
https://youtube.com/watch?v=4d_FvgQ1csE&pp=ygUgcHJlc2lkZW50I...
While I agree that dentistry absolutely has an overtreatment problem, there's enough evidence that some procedures result in pain relief at a minimum that we don't need to insist on double-blind trials -- and in fact performing such trials would be unethical.
But this is simply untrue and it undermines the rest of your point. The actual satirical statement is supposed to be about clinical trials (research studies involving humans), not validated research in general.
The study linked is not simply about clinical trials but rather than dentistry lacks validated research in general.
But if the benefits are subtle or borderline, then it’s an interesting ethical dilemma. Which is the least unethical: withholding a potentially-beneficial treatment from a control group, or giving a potentially-non-beneficial treatment to everyone?
How is this acceptable in academic research? Nobody is citing the primary source and everybody is citing interpretations of some source that I can’t find the text of (probably because I’m on mobile).
tl;dr your citation is worthless through no fault of your own.
If you're eating healthy and have good hygiene, doctors ain't gonna help whatsoever unless you're unlucky and get a rare disease that they can actually diagnose and treat correctly. The likelihood of that is probably around 0.0%, rounded.
The average person drinks soda, eats lots of sugar, drinks alcohol etc. That adds up over the years. especially soda in the context of dental care, as that's an acid and destroys the enamel over the years. once that's damaged, things get worse.
Kinda relevant: is the 92 in your username your birth year? If it is, you not having any issues is to be expected. Most people develop their Dental issues in their late 30 and later
I must have had some pretty bad halitosis with that calcified plaque because now I’m not habituated to the smell. For those in my family that are clearly not flossing and have shit breath i thought about buying them dental kits and floss for Christmas stocking stuffers. My SO said no and it’s their wives and dentists who should tell them. I kinda disagree but I’ll leave it alone. Someone had to tell me - what if no one ever tells them their breath is horrid because of the calcified plaque? They’ll just wander through life like that?
When I was there, I noticed people brushing teeth after lunch. This happens even at corporate offices -- the restrooms would be full of people brushing and flossing after meals. People brought toothbrushes to work. There was even a floss (fio dental) dispenser.
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