Tuesday, July 29, 2008

Dental Insurance, Yes or No?

Question: Does anyone know of a good dental coverage plan??...asked by:hope0806 on centralvalleymoms.com health forum

Answer: Unfortunately, a "good" dental plan does not exist for individuals. The best value is those plans bundled together with medical plan premiums (usually only found through large employee groups like school districts, large companies, etc.)which are paid for with "pre-tax" dollars and are not overly restrictive of your choice of dentists. I am really not being self-serving when I inform people that you may want to reconsider plans that only pay a benefit when you use their doctors...how soon will you be seen? Will the doctor be reachable after hours? Will the plan require that your doctor use the 'least expensive treatment' (not necessarily the best). I really dislike that interference in the doctor-patient relationship and decision making. What happens if you are out-of-town...will the plan still pay a "non-participating doctor"?

I once was a "provider" in a pre-paid discount plan. It was too frustrating for me and my patients. The limitations for treatment and the expectations of what was to be provided were not realistic. The lists of doctors and specialists look extensive, until patients try to see if the office is still accepting new patients on their plan. I quit the plan because there were no specialists within 45 miles on the plan, and people did not understand how little the plan actually benefited them. Plus, I could not ethically allow my patients to receive sub-standard treatment just because it was cheaper.

Rule of thumb that I tell my patients is if you have to pay more than $600 aftertax premiums a year for so-called dental insurance by itself, then you are are better off just paying for routine exams, xrays, and healthy gum cleanings on your own. You won't go over $600. Even with investments in your dental health like root canal nerve therapy or crowns, most plans will max out after $1000-$1500 is used.( The maximum benefit hasn't changed in over 40 years. If benefits kept up with equal value of medical benefits, dental benefits would be about $6400 annually) Dental insurance is useful, but the way it's structured, it will never pay for someone to be brought back to total dental health in a timely manner.

Third party financing, like a separate healthcare credit card (good at ER's, vets, MD's, etc) have really made it affordable for people to get the treatment they need and want. On the interest-free plans, the practice/doctor pays for the finance charges and interest. I know the insurance people don't like me saying this, but: 1. you do get what you pay for, and 2. almost 87 cents for every healthcare dollar(that includes medical plans) goes to the insurance company (its administrators,claims delayers, oops! I mean claims processors, executives, shareholders and commissioned salespeople), only 13 cents actually goes to pay for actual care (labs, hospitals, doctors, nurses, therapists, etc.)

If I ruled the world, we would truly provide monetary incentives for people to stay healthy and figure out ways to make doing preventive stuff profitable. The way healthcare is right now, the more procedures and treatment that is done, the more profitable it is for the providers. By helping my patients stay healthy, I actually "hurt" the profitability of my business. Something's wrong with that business model.

Treva D. Lee, DDS, MAGDhttp://www.drtrevalee.com/
Help for Smiles of All Ages

Friday, July 25, 2008

Summer Time Memories

I'm searching for our bug spray, sunscreen, Uno playing cards, marshmallow roasting forks. Into stuff sacks the sleeping bags go. How many spiders did it take to make all those cobwebs on our folding chairs? Do we get a 1 day fishing license or a season pass? In 48 hours we'll be able to see the stars, smell the pines and feel the cool mountain air. And my 2 kids will just have to do without any "screen" time, ie, TV screen, computer monitor screen, or DS Nintendo screen. Our mini-van is too old to have a DVD player built in, and my husband and I have held our ground on making it a-portable -DVD- player-free-zone. The only screen they may see in the coming week is the outdoor movie screen at Pinecrest Lake. It's like a pedestrian's version of a drive-in movie theatre.

It's an unwritten rule with the other families that video devices are verboten! MP3 players for music are ok, but not to view video. Use those eyes to really see what's around you.
We might even have some real conversations that will encourage them to actually express an opinion and defend it. Time will slow down where they'll be allowed to have their adventures sloshing around in the creek, telling ghost stories 'round the campfire, paddleboating on the lake, and getting way too sunburned because they ignored mom's advice. Heck, I'll even let them make and eat gooey, sticky, sweet s'mores!

It's old-fashioned and nostalgic to attend Family Camp...where waiting your turn to use the showers and saying "please", "thankyou" and "pass that platter of food" are the rule and not the exception. Where the kids are allowed to figure out their own pecking order free of parental interference and egos. Where the college-aged counselors are role models and they know it and behave accordingly! A place where I first allowed my children to go to the bathroom unaccompanied by me, their dad, or another relative. And where they learn lessons like mosquitos are especially hungry and fierce at dusk! Or ants are much bigger in the mountains. Or the ground squirrels and stellars jays are aggressive foragers and think nothing of rifling through your belongings.

Here's to making summertime memories!