[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.

[AnthonyMouse]

> The problem is that poor people need cash for lots of things.

That isn't the problem, it's the reason why giving them cash is better. Because if they can't afford to put gas in their car to get to work, using that money will keep them from borrowing it from the credit card company. And then in six months they'll still have $500 less credit card debt plus having not paid 25% APR for six months.

[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.

[AnthonyMouse]

Salary isn't margin, it's cost. You have to pay the market rate to convince your dentist to be a dentist instead of a psychiatrist or lawyer or bank manager.

What are you proposing, price controls? Then what do you do when your dentist quits to become a real estate broker?

[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.