The following is a reprint from the ADA News August 20, 2012 issue written by Stephen P. Blank, D.D.S. in Port Lucie, Florida.
“I just wanted to help clarify dentistry’s relationship with insurance as I see it after 30 years in practice…The real problem for dentistry that many dentists are unknowingly training their patients to think of insurance as their friend. Some go as far as signing contracts with the very insurance companies that tell them what to do.
Insurance companies care about taking in as many dollars as possible and paying out as few dollars as possible to maximize profit. They are some of the most profitable businesses in the USA, at your expense. Insurance companies don’t diagnose, treatment plan or render care. They just want patients (and some doctors ) to think they are looking out for the patient. They confuse patients with TV commercials that suggest that they are health care companies. They are looking out for their own bottom line.
Insurance companies have limited payments to about $1000 – $1500 for decades, while costs to purchase benefits have gone up. Benefits have been resrticted to crazy concepts (no tooth colored fillings or crowns on back teeth, no fixed bridge if a removable appliance will do, etc.).
Insurance companies routinely down code procedures to their own benefit. The insurance company costs have not gone up; they set their maximum risk up front. It doesn’t matter if your crown fee is $500 or $2000; they will quit paying when the patient’s limit is reached.
The reality is that dental insurance doesn’t exist. By definition, patients cannot insure against the need for hygiene care or X rays. They can only pre-pay some third party and then hope to get their own money back. Insurance does not cover catasrophic problems; only a very small part until the limits are reached, often not enough to fix even one tooth. …That third party then tries to dictate what doctors can do, contracted or not, what the patients are entitled to based on some contract, and then reduce the payment based on some hidden usual, customary and resonable tables that they create themselves. …
Insurance – based care is fragmented socialized medicine managed by many private companies. Insurance is a failed method of money management.”