[AnthonyMouse]

> If you want employer-funded healthcare to include dentistry, then that's not going to be solved by medical people but the employment market - industries where workers have market power (e.g. IT) will get such conditions, and industries where worker's don't have market power (e.g. fast food) won't.

And how is that anything useful anyway? It's not like dentistry is any cheaper when your employer pays for it. If anything it will be more expensive because of the added bureaucracy and separation of who pays from who benefits. This is one of the reasons costs have spiraled out of control in the US healthcare market. If you need money for dentistry, ask your employer for a raise, not dental insurance.

[chimeracoder]

> If anything it will be more expensive because of the added bureaucracy and separation of who pays from who benefits.

Yes, real insurance (like car insurance or renter's insurance) will always have an expected value that is negative - the expected sum of all future payouts must be less than the sum of all future premiums paid. So insuring against completely predictable events is never worth it unless someone else pays for it, and even then it's less efficient than if they gave you the extra money directly.

Not all dental and vision benefits are completely predictable and routine, but the overwhelming majority of covered benefits are, unlike health insurance (which isn't really "insurance", despite the fact that we use the term).

[mtdewcmu]

>> So insuring against completely predictable events is never worth it unless someone else pays for it, and even then it's less efficient than if they gave you the extra money directly.

It's worth it if the government guarantees it. Dental insurance might not be a good business to be in, but nevertheless people need it. It's a market failure, and it needs government intervention.

[ghaff]

I don't understand why you think dental EDIT: care is a market failure. There are dentists people can go to and get care. Pricing is mostly not affected by if you have insurance or not. (Most dentists will just charge you if their rates exceed what insurance pays.)

If you're arguing that "someone" ought to pay for dental care that's a different matter that doesn't really have anything to do with insurance per se.

ADDED: And one actually gets into cost discussions about things like crowns and alternative treatments with dentists. It actually seems like a good model of how healthcare spending should work. Yeah, I have insurance that pays some but thats orthogonal to the cost discussion I have with my dentist.

[mtdewcmu]

It's a market failure if people are suffering due to being unable to afford proper care. It's possible that the blame lies elsewhere than the insurers themselves. Maybe dentists charge too much. But the market isn't providing what people need. The ideal solution would be single-payer, but expanding Obamacare and Medicaid to cover adequate dental services would be a big leap forward.

[AnthonyMouse]

The true problem you're identifying is poverty. Dental care isn't outrageously expensive. It doesn't have huge margins or vast inefficiency. The reason people can't afford it is because they're poor.

No bureaucratic solution involving government-subsidized dental services is going to produce a better outcome than taking the same money and giving it to those people in cash.

[deong]

The problem is that poor people need cash for lots of things. If you're poor enough that you can't go to the dentist, you're poor enough to be hurting in any number of ways. If we give you $500 and say, "now this is for the dentist -- save it in case you need it", they're quite rightly going to tell you to fuck off and go buy food and gas for the car to get to work. And then when they need a dentist six months later, we're right back where we started, except with the added shittiness of a bunch of upper middle class conservatives preaching about how they "wasted" the money.

[ghaff]

There are actually already public dental clinics in many cases with reduced fees for people below certain income levels.

[ghaff]

Yeah. Pretty much all the same arguments could be applied to automobile purchase and maintenance, something that many people require to get from where they live to where they work. It doesn't mean that we need to have a government program specifically to cover cars.

[maxerickson]

The margins are healthy enough that many dentists work 4 days a week while earning a fantastic living.

[GrinningFool]

> Pricing is mostly not affected by if you have insurance or not.

Based on the bill breakdown I get from my dentist, it appears negotiated rates are a thing here too. I regularly see a total price, an insurance discount, and paid-by-insurance amount. The 'discount' ranges from 10-50% depending on the service.

[ghaff]

I am not an accountant, but in the US, I'm guessing that there are tax advantages to offering employees dental insurance rather than just paying employees more. This is somewhat mitigated by the fact that employees could just put money for routine teeth care into a flexible spending account. (That said, most bigger ticket dental items like crowns are typically only covered by about 50% anyway because they're often at least partially cosmetic.)

[AnthonyMouse]

> I am not an accountant, but in the US, I'm guessing that there are tax advantages to offering employees dental insurance rather than just paying employees more.

That's just an example of bad policy, not a reason to encourage that as a solution to the problem. If buying dental insurance or dental services is tax deduction when paid by the employer but not the employee, fix your tax code.

[ghaff]

I don't actually disagree. But in the meantime I'll take the dental insurance and the tax benefit that comes with it.

[AnthonyMouse]

That's assuming there is a tax benefit. What does it do to the EITC? Does your state or spouse's employer or school have a dental program you get disqualified from if your employer offers coverage? Maybe there is a way for the employee to claim it as a deduction? The US tax code and welfare system is so convoluted that it's difficult to identify whether a given thing will actually save you money without consulting a tax attorney.