Comments on: Cost of Modern Medicine, Insurance Reform, and Death in the Paleolithic

By: peter

peter — Tue, 27 Jul 2010 13:59:43 +0000

The health insurance system in our country and most others is a complete mess. The biggest problems are the laws that allow individuals to sue insurance companies and hospitals for exorbitant sums. We have the attitude that these companies are wealthy and huge so “you owe me”. It’s a welfare state mentality.

The problem this creates; is then the insurance companies reciprocate by taking it out on the rest of us to recoup their losses. Which is why you constantly hear of insurance companies denying claims that are perfectly legitimate.

In fact, that is the insurance company business model today. Deny coverage until the customer throws a fit too big to put up with, then we’ll pay the claim.

What ever happened to the customer is always right? What happened to giving a quality product for services rendered? What happened to doing what you say you will do? What happened to our country?

By: JL

JL — Tue, 20 Apr 2010 07:28:35 +0000

When an insurance company says it will cover “half”, you need to ask “half of what”. Its idea of half may be half of its “allowed amount” which may be far less than the dentist charges. And if the dentist is not in the Delta Dental network, the dentist has the right to collect the half of Delta Dental’s half as well as the difference between this “half” and the dentist’s fee. Using insurance company math, you may well end up paying two of three halves of the total charge.

And don’t forget about the lifetime maximum on the policy. Dental insurance usually has a small lifetime max — typically in the low thousands.

By: Greg Laden

Greg Laden — Mon, 19 Apr 2010 18:01:51 +0000

Kierr, ours is billed like yours. It’s just that the first thing you’d do to put in a bridge is to file down two otherwise perfectly good teeth and part of the process of cleaning out the roots of the other teeth. Then you’d fill the roots, and start bridging. For an implant, you remove the roots of the other teeth. So while insurance does add it all up separately, they are simply not the same procedures.

(The tooth that fell off was a cap on a root canal, and the peg on which the cap sits was reconstructed. For a bridge, it could be just flattened down and filled like a pothole)

By: Kierra

Kierra — Mon, 19 Apr 2010 16:50:08 +0000

I do not assume that an insurance company will agree to pay for something that has already been started … I’ve never, in my entire life, seen an insurance company do something that would make me trust them.

Okay, that makes sense. I guess I was kind of assuming that all dental insurance was billed per procedure like mine is.

By: daedalus2u

daedalus2u — Mon, 19 Apr 2010 16:05:56 +0000

Yes, but in the Paleolithic you didn’t need dentistry because you could have gotten someone to chew your food for you. Try finding that now, or getting insurance to cover it. I don’t think so!

By: Greg Laden UPDATE

Greg Laden UPDATE — Mon, 19 Apr 2010 15:02:07 +0000

Kierra, when the altnernative is a bridge over an existing root canal, the next steps may be different, so it is wise to know what the final procedure will be first, although there is a version of this that could be started. Also, there is another consideration: My preferred dentist does not happen to be in my plan. So, the procedure is still covered, if it is covered, but not to the same extent. And, I do not assume that an insurance company will agree to pay for something that has already been started … I’ve never, in my entire life, seen an insurance company do something that would make me trust them.

The good news: I’ve finally got the word from Delta Dental as to what they cover, the’ll cover half,a nd I have an appointment to start the procedure in just over a week.

By: Kierra

Kierra — Mon, 19 Apr 2010 14:24:23 +0000

While the insurance may not cover much (or any) of the actual implant, they’ll probably cover at least part of the procedure to extract the what’s left of the tooth and to clear the infection away. I’m confused as to why you are waiting to do this, as I’m pretty sure that you’d need to have it done first whether you eventually get an implant or bridge. I know for my implants, I had to wait at least 3 months after having my healthy baby teeth (I’m missing the adult teeth) pulled for the bone to grow back into the extraction sites before the posts could be placed. I can’t imagine that they’d agree to place the implant post into a gaping abscess.

By: Roland

Roland — Mon, 19 Apr 2010 13:30:51 +0000

Lessons: 1)dental problems are serious. Prior to ~1900, dental problems were a leading cause of death. 2)insurance cos. are in the business of ripping people off. They invoke trust in their ads, then betray that trust. 3)much dentistry in the US is still fee-for-service, so costs are not as insane as in the rest of the broken medical system.

By: James Davis

James Davis — Mon, 19 Apr 2010 13:18:25 +0000

Unfortunately, as far as the CEO of that company is concerned, the only thing to worry about is whether or not you will continue to pay them more money than they pay out to you.

By: momkat

momkat — Mon, 19 Apr 2010 13:15:40 +0000

Man, you are not living right. Two major medicals in less than six months. I’d go with the implant, even if you have to pay for it yourself. Corrupting two presumably sound teeth to make a bridge can’t be the best choice. I have an implant and have way fewer gum issues with it than I do around the crowns I have. Good luck.