Now that we’ve solved the problems with America’s medical care so beautifully, it’s time to turn our attention to the biggest health care circus in town, dental insurance and dentistry in general. David and I were setting up appointments for spending out the last of this year’s benefits and calculating how much to put aside in my flex spending plan for next year, when I thought that it might be a good idea to see exactly how much I was paying in premiums in order to get a paltry $1,000 each in benefits each year. It turns out that I am paying $540.00 annually for both of us. That’s more than a quarter of the benefit! I swear, I spent more out-of-pocket on my last crown ($1200) than I did when I gave birth and stayed in the hospital for five days ($36). Gone are the good old days when you could walk down to the corner dentist and pay him with a chicken.
When I was a child, I had a long-term illness that wreaked havoc on my permanent teeth, so I spent most of my childhood in a dentist’s chair. It’s not my favorite place to be, so I spend lots of time brushing and even flossing, since my hygienist sister shamed me into it almost 30 years ago. No one could tell that by looking in my mouth, of course, and I’m sure most dentists think of me as a slacker. I comfort myself that dentists all over the world are not so judgmental. David Sedaris relates in Let’s Explore Diabetes with Owls that his French dentist laughingly asked him why in the world a man his age would be considering braces, and he replied that perhaps it was because he could floss his teeth with his bathrobe belt. She scoffed that surely he could find better things to do with his time than flossing.*
This past year of “care” at my dentist’s office has been less than stellar. I think the average age of the staff is about 16, and, no doubt, they all go to the gym and spa together after work. At my last complete exam, the tiny little blond hygienist had the personality of a cardboard cutout and could not seem to make any conversation that did not come directly from the manual of How to Talk to Your Patients. Although I told her exactly what I wanted, she silently went about her work and, at the end, presented me with a $4,000 treatment plan that I was supposed to sign. “But,” I protested, “I really do want to replace that filling that fell out!” She looked offended at my dismissal of her masterpiece, but agreed to set up an appointment.
Earlier in the year, I had a new crown put in to replace a temporary crown that I’d had for… um, ever. I mentioned that I had been having trouble with the last crown that I’d received there, and the new dentist, who resembles a tall version of Joey on Friends—which does not inspire confidence— looked at the computer screen and told me that I did not have a crown on that tooth. I had to convince him to turn around and look into my mouth, at which he nearly jumped and exclaimed, “Oh, you do have a crown there!” He then proceeded to cheerfully take $1,200 for putting in the next one. At least I didn’t need a root canal this time, for another $1,000.
Why does dental care cost so much? I admit that I yell at the television when those ads come on celebrating the fact that a local group of dentists spends one day a year fixing the teeth of homeless people for free. Sure, that’s great, and I am all for it. But, I yell, “That’s because you spend 364 days a year robbing the rest of us blind!” We use one third of our annual benefit on a normal cleaning and exam. We’re supposed to go twice, but then we can’t get anything actually fixed. It’s not that I don’t think American dentistry is the best in the world. It is. After all, we could have the British system, with results shown here.
What to do? Surely we can hire some crackerjack programmers to set up a great system to keep track of every molar in the nation. If it got too complicated, the entire flowchart could point to dentures if the patient is above 60. Citizens might not be too thrilled with that, but then the denture lobby would get involved, and it would all go smoothly from there. Even white teeth and healthy pink gums for all. In the meantime, I think I’ll have to set my flex spending plan to max and just assume that we won’t pay the electric bills next year.
*Very loosely paraphrased with apologies to Mr. Sedaris.