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Insurance Reform: Dental IS Medical. Vision IS Medical.
I just have to get this off my chest. It has been brewing for a long time.
We talk about health insurance reform. One good thing that has come of that discussion is that mental health is treated like actual health (as it should be). Despite that one logical advancement, it seems like no one has really figured out the point.
Mental health is medical.
Dental health? It is also medical. If you do not treat teeth and gums, infections brew. The infections go into the bloodstream, and then it suddenly becomes medical. Why?
Because as my husband so rightly pointed out, the tooth-bone is connected to the head-bone.
When we finally get enough congressional power to do anything, can we please work on this? The whole body’s health is medical.
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As a Mental Health Therapist, I want less government in my business, and that means less insurance. Despite the fact that there should be parity, there is not.
Once people can use insurance I get paid less for each visit. The long term, most experienced therapists all don’t take insurance. At best, they give you a superbill. I dream of a robust enough practice to not take insurance and be all self pay.
I hate health insurance. It is a game to get paid less than I would make if I could just charge my client.
And I do agree it is all health. I just think the more insurance is involved, the worth the experience.
Agreed. A great post.
I agree, mostly. Your post made me recall, though, what a psychiatrist once told me toward the end of his career. He said that more often than not, at bottom his patients’ problems were spiritual. That may be overly simple but I think there is truth in it.
One of the consequences of NOT having dental included in health insurance, at least from my anecdotal perspective, is that all of the dentists our family has seen over the past 15-20 years have become shameless hucksters. You go into get your teeth cleaned and they come back with recommended treatments that are going to cost 5 figures. I had a long, protracted battle with one (I lost) who quoted my wife $500 for a crown and proceeded to charge $1400 for it in the end. Worse than used car salesmen. But then, I had dental insurance at that time and they didn’t do squat to try and assist in the situation.
Well, it is and it isn’t. [I mean about dental care.] Originally, medical insurance covered medical treatments, and dental covered dental. About ’85 or so, I vaguely remember Diagnostic-related groups (DRGs) coming into being. and in the early 80s Kaiser Permanente began the Health Maintenance Organizations; which from hindsight I would say was that start of the moving of doctors from independent professionals to salaried employees, as well as the beginning of all health practices being lumped together under the heading of Health.
I remember being a little surprised when Chiropractic became reimbursable under medical insurance. As well as massage therapy and some even argued for homeopathy being covered.
So this has changed from something that was at one time, to something new and broader, and continuing to be changing.
For examples, now elective procedures are considered a “right” and doctors are no longer specifically allowed to direct, in consultation with a patient, the patients medical care.
The bottom line is that any company should be allowed to determine what coverage it chooses to cover. But top-down government regulation has captured the industry(-ies) and they will follow the regulatory growth curve how they see fit.
Right now, I can choose to have dental insurance or not. I choose not to. I’m against my premiums going up for medical insurance because dental is added on to it. Why shouldn’t I be allowed the choice?
Be careful what you wish for. This will help push us to single payor, or make insurance even less affordable.
No. Just no. Dental and Vision insurance are still affordable because the government leaves them alone. Just like medical insurance was back in the 1980s before the government “improved” things.
I like my dental and vision care. I suspect I will like it as much as I now like health care once the gummint gets involved.
The first time I was group insured at work it was called group hospitalization insurance and it did not include routine dental and vision needs, for pretty obvious reasons. Could this be why coverage for those services have taken the path they have?
Pretty much. Back in the 1970 someone wrote an SF story about auto insurance covering maintenance and servicing that cause prices to spiral out of control. So they saw it coming before it happened.
If you are adding dental and vision then we need to consider hearing to it.
There is a large number of people that need help with hearing but can not afford the $6000 a year for the hearing aids.
I didn’t enroll in dental this year, because I determined that both my wife and I would need to spend at least 90% of the maximum benefit to break even. I’d rather just pay out of pocket for semi-annual cleanings ant take the gamble that we’re not both going to have to have root canals.
Vision made sense because my wife and I both could get an individual plan via our employer’s a-la-carte offering. The family plan wouldn’t make sense from either employer.
I’m happy being able to make these decisions without having them bundled into “medical insurance” that increases in price by 8-13%/year already.
When these things are covered it is not insurance anymore, it is prepayment for routine matters that occur in a regularly scheduled way. The coverage for medical checkups with no specific complaint falls in the same category. It is bad enough that insurance companies avoid covering things that are actual risks that should be insurable now they are pushed to cover routine matters that don’t have a risk profile at all.
So you pay $1500 a year and get $6000 in hearing aides. Who pays the balance, those who don’t need hearing aides? Or does it come out of tax dollars?
Good question.
Last month I got two shots in my knees that took 15 minutes that the hospital charged me $20,000 for but that the insurance company paid $200 for and I had a $250 copay for. What price you think they actually are? I suspect closer to $200 than the $20,000
Fake numbers made to rape consumers and force them into insurance sort of skews the discussion.
Additional thought. I have a phone in my pocket that can call, use internet, take photos, text, etc. It costs $200-$1000. But a hearing aid that is a much simpler device costs 6x more. Really? Really?
This same thing with Medicare and my insurance company is how I got attuned to fake data and fake news being the standard fare. I don’t think there is any way to know the real cost unless you are in the business, maybe.
Based on the kinds of deals I’ve seen advertised that must be a fake price.
It takes just as much engineering to design a hearing aid as it takes to design a cell phone. Yet the market for hearing aids is about 1/20th the size of the market for cell phones. The design overhead has to be covered somehow.
Most likely true before $30 – $200 earbuds became the norm. I suspect that technology would be applicable.
Beat me to it. The level of design effort is also much closer there than to a complete mobile phone.
Do either of you have hearing aids? I do. They are not ear-buds. They are extremely sophisticated pieces of electronics tuned to an individual’s hearing loss. They have a receiver built in as well as a transmitter. They also communicate with each other and can be programmed to deal with gathering noise in a wide area or a highly focused one. By clicking a setting on mine I can listen only to a single individual in a crowded, noisy room. And all the electronic fit on a chip the size of a child’s fingernail.
You can get older-generation hearing aids for much lower prices than $6K – Around $500-$1000.
I had a chat with a doctor recently about all the ways he is allowed to charge or not charge based on which type of coverage someone has, and I came away with the distinct impression that the laws were forcing him to do things that would be illegal if he did them on his own.
Well yes they are both still affordable. Even buying my own vision insurance now that I am retired is extremely affordable and it gives me a good savings. However I can’t find dental insurance that pays well. We pay 37.50 per month each but the max it pays is $1500. That’s not much when you need crowns and bridges. Sure, I go to an expensive dentist but that’s my choice. The insurance really pays almost nothing.
I think I can pretty well guarantee you that if they hadn’t ever been covered under insurance, all your bills would by now been much, much lower.
Isn’t a big chunk of the increased price to cover the administrative costs of all the processing and attention to billing detail that the insurance requires? The insurance people change everything inside the medical treatment process just like what has happened in our colleges and universities. Neither of these reflects the cost of the product, medical care or education.
Yes, I think so. And like universities, prices go up when third party payers are involved, because they keep their margins no matter what the prices are. And like universities (but probably not as badly), hospitals pay for billing services, and rebilling, and the whole conversation back and forth on each patient’s bill.
That’s a good point. Whenever a man gives you a dollar you’re that man’s employee, to the tune of one dollar. He can impose whatever conditions he likes until that dollar is no longer worth it and you refuse both the restrictions and the pay.
The best example of this right now is the vaccine mandate; while the court stayed the general case it did not for healthcare workers. Why? Because healthcare facilities get Medicare dollars, and the Supreme Court says that means the government can include conditions with the money.
This is also an excellent point. Speaking strictly as a Christian here, we do not take the concept of sin nearly as seriously as we ought to.
Sure. I’m not even going to take the extreme complexity of that particular situation, though.