> The idea is most people can scrouge up 3k but not a million bucks.
The reality is far from that, though. Roughly a third of the citizens of the US would have to go into debt to secure $3K on the spot, they don't just have that laying around in the bank. Doing so could easily cause a downward spiral where one would have to choose between basic necessities or moving back in with family for months or even years to pay back the debt (I know because I've been there).
Hell, our household income is nearly $70k and while we do have enough in savings to cover such an emergency, it would still be painful and it would take us months to recover the money. Thankfully we both work for local government and have decent dental coverage, but it's a far cry from the much better health insurance we enjoy.
Also, the idea that major dental surgery is "just" $3K is amusing. My bill for removing my wisdom teeth came to nearly $12K, of which my insurance paid all but $800 thankfully. That wasn't even the total cost either; I developed a severe infection and when I called my dental surgeon he told me to go to the emergency room (another $1200) to have it drained and get an antibiotic prescribed. The emergency room gave me the antibiotic but told me to go to the dental surgeon for anything else. It's a total clusterfuck.
> Roughly a third of the citizens of the US would have to go into debt to secure $3K on the spot, they don't just have that laying around in the bank.
That doesn't change the nature of the problem.
With catastrophic events, one person in 250 will incur a million dollar expense in a given year, so everyone pays four thousand dollars a year for insurance and that person gets covered.
With dentistry, one person in five will incur a $3000 expense in a given year, so insurance would have to be $600/year. It's completely useless. If you couldn't afford the loan payment then you couldn't afford the insurance.
Insurance only works for things rare enough that most people in the pool will never incur the expense. If the event is common then it isn't insurance, it's just a prepayment plan.
I really doubt that multi-thousand-dollar dental events are as common as once every five years.
Insurance doesn't have to be for things where most people will never incur the expense. The average time between car accidents in the US, for example, is a bit over a decade, yet car insurance is very much a thing (and not just the legally mandated liability insurance, either).
> I really doubt that multi-thousand-dollar dental events are as common as once every five years.
I don't have the actual numbers, but even if they were once in ten or twenty years, nothing really changes.
> Insurance doesn't have to be for things where most people will never incur the expense. The average time between car accidents in the US, for example, is a bit over a decade, yet car insurance is very much a thing (and not just the legally mandated liability insurance, either).
That isn't the average time between major car accidents. Most accidents are little fender benders that often don't even reach the deductible. What comprehensive insurance is really for is when some drunk totals your car while there is still a five figure car note on it -- and having that insurance is required by the lender. Or for liability if you maim someone and owe a million dollars. But neither of those ever happen to most people.
Typical deductibles are $500-1000. It's nearly impossible to cause more than zero but less than $500 in damage to a modern car. Those little fender benders generally have price tags similar to what you'd pay for oral surgery.
Sure, but the little fender benders aren't what the insurance is for.
You can save a bit of money on car insurance by having a $5000 deductible, because the average claim amount is <$3500 but you'll save more than the difference in insurance premiums over the years with the higher deductible.
> My bill for removing my wisdom teeth came to nearly $12K
Seriously? You could fly to Thailand or central Europe and get your dental work performed there for a fraction of the price. You could probably fly business class, stay at a swanky hotel, and absorb the loss of two weeks work and still come out ahead. I'm serious. Dental tourism is a thing.
I was an accidental dental tourist a few years ago while travelling around Europe. I had just arrived in Budapest, Hungary when a tooth I knew required root canal suddenly started hurting intensely. Wife found a local dentist, booked me in, the procedure was done over a couple of sessions and the total cost came in well under $1k AUD.
(Your bill seems excessive even by affluent Australian standards. I had four wisdom teeth removed – one of them impacted, requiring a dental surgeon – and the total cost was under $3k AUD at my local dentist. I bet it only "cost" $12k because it was covered by insurance rather than priced by the free market.)
> Your bill seems excessive even by affluent Australian standards. I had four wisdom teeth removed – one of them impacted, requiring a dental surgeon – and the total cost was under $3k AUD at my local dentist. I bet it only "cost" $12k because it was covered by insurance rather than priced by the free market.
It's expensive by US standards as well. In NYC, which is a high COL area, the price I've seen quoted is around $200-250 per tooth.
$12K must mean that they were complications that are being included - insurance will always be more expensive than a free market self-paying system, but not that much more.
I'm going next week to have one removed, and it's about $500, plus some extra costs that are covered by my medical insurance rather than the dental insurance whose deductible I haven't hit yet.
> I'm going next week to have one removed, and it's about $500, plus some extra costs that are covered by my medical insurance rather than the dental insurance whose deductible I haven't hit yet.
Yeah, I'm quoting a lower end of the range, but the point is that OP was literally paying more than ten times that amount.
> Preventative dental work is dirt cheap and corrective dental work is relatively rare, and costs rarely spiral out of control. That sounds like a much better deal to me, as an insurer, than insuring any other body part.
When costs are easily predictable, that's actually a terrible case for an insurance model. Insurance is about smoothing risk, not making things cheaper. In fact, for services that are relatively cheap and predictable, insuring against those events will always be more expensive than paying for them out of pocket, because of the additional overhead.
Financially, the expected value of insurance is negative (the sum of all expected payouts is less than the sum of all future premiums). The reason it's valuable is because it reduces the variance in the month-to-month payments, which is a useful product for some people.
One thing with dental care is that it is likely financially reasonable to charge someone less for insurance if they are receiving preventative care. A small filling costs much less than a root canal.
I think the issue with dentistry is that half-assed dental treatment is affordable, you just pull the teeth; if you want decent work to save the teeth -- then it gets expensive.
Which is presumably one of the reasons why some more expensive dental treatments like crowns are only covered at 50% or so by most insurance. They're considered at least partly cosmetic.
Sometimes extractions make sense in any case, but they're always going to be cheaper than multi-visit restorations of various sorts.
That may be true as to why the insurance is separated, but unfortunately the idea that most people can scrounge up 3K is not accurate (at least in the U.S.).
The reality is far from that, though. Roughly a third of the citizens of the US would have to go into debt to secure $3K on the spot, they don't just have that laying around in the bank. Doing so could easily cause a downward spiral where one would have to choose between basic necessities or moving back in with family for months or even years to pay back the debt (I know because I've been there).
Hell, our household income is nearly $70k and while we do have enough in savings to cover such an emergency, it would still be painful and it would take us months to recover the money. Thankfully we both work for local government and have decent dental coverage, but it's a far cry from the much better health insurance we enjoy.
Also, the idea that major dental surgery is "just" $3K is amusing. My bill for removing my wisdom teeth came to nearly $12K, of which my insurance paid all but $800 thankfully. That wasn't even the total cost either; I developed a severe infection and when I called my dental surgeon he told me to go to the emergency room (another $1200) to have it drained and get an antibiotic prescribed. The emergency room gave me the antibiotic but told me to go to the dental surgeon for anything else. It's a total clusterfuck.