Dental insurance companies are causing significant harm to the oral health of Americans through several mechanisms.
The first problem is that dental “insurance” is no longer insurance; it’s a yearly coupon.
The reason? Shrinking yearly maximums.
When dental insurance started on a large scale in the US in 1967, the most common yearly maximum was $1,000, and there were generally no payroll deductions. It was a perk.
Now, in 2023, 95%+ of the dental insurance plans we see patients carry are set at a $1,000 per year maximum.
We must use an inflation calculator in order to make sense of this. $1,000 in 1967 is $8,800 today!
Thus, patients today are getting 1/9 the value of their 1967-era predecessors, and are paying monthly payroll deductions for the privilege.
The second major problem for patients and their employers (who deserve to enjoy a workforce not rendered ill or unproductive by avoidable dental disease) is Denial. Deny, deny, deny; dental insurance companies positively revel in not making payments. And when they can’t deny something, their next go-to strategy is Delay. Delay payment to dentist or patient as long as possible.
Dental insurance companies are corporations, and corporations generally thrive on what economists call Negative Externalities—when the production or consumption of a product results in a cost to a third party—a cost to you and me. Air and noise pollution are iconic examples.
The unjust thing here is, the employer paid for this insurance product, the employee/patient also likely paid via payroll deductions, and far too often, they are cheated out of a benefit that they purchased in good faith.
A third problem with dental insurance companies—one that is downright holding back advances in patient care in the U.S.—is that they don’t raise their payment rates at anything close to the rate of inflation. As an example, Delta Dental’s last fee increase in our region was in 2014, and they absolutely refuse to raise rates at any time in the foreseeable future. Dentists who participate in such plans—who accept their fee schedules—not only cannot afford new technology at these rates. We are now approaching and in many cases passing a “coffin corner” where the cost of providing services is greater than Delta’s payment rates. Participating in such plans means running at a loss, and eventual bankruptcy.
In the interest of brevity, we’ll just mention one other maddening fact about dental insurance companies. That is, they are all 501c non-profit corporations. And yet, they amass tens of millions of dollars in profits every year. How is this fair to employer, employee, patient and dentist?
It is time for dental insurance reform. An excellent first step is the passage in Massachusetts of 2022 Ballot Question 2, which mandates that dental insurance companies operating in the state of Massachusetts apply at least 83% of their premiums collected to patient care.
As a culture, we must start recognizing that dental “insurance” is but a yearly coupon, because of how much less dentistry it covers than it did in years past. And those without dental insurance must be educated and informed that there are other ways to afford care.
The three primary threats to human health in dentistry’s wheelhouse are periodontal disease, cavities and oral cancer. The hard truth is that none of these three diseases ever get better on their own, and they don’t even ever stay the same. They only worsen over time. Relentlessly. It is best for human health, and also always less expensive, to diagnose and treat these diseases early, before infection sets in or worse.
I want to educate folks that dental “insurance” is not insurance at all, but a yearly coupon. There’s a vast portion of the population who does not have dental insurance, and gets the notion in their head that “I can’t go to the dentist because I don’t have insurance.” I want to break down that dangerous myth before yet more harm is done.
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