When Choosing a Dentist, Should Insurance Be a Criteria?
One doctor's perspective on the health insurance industry
Q: Hi, Dr. Goldberg,
I enjoy your comments on dLife – I especially appreciated the article about selecting a dentist. I started with a new dentist just yesterday and the hygienist measured my pockets. Most were 1, 2 and 3, but I had a few 4s but the dental team made suggestions to improve.
As a diabetic, I continue to get frustrated with health insurance. My health insurance will cover visits to the ophthalmologist because I am diabetic (and I do not have separate vision insurance.) However, my health insurance will not cover dental check-ups, even though gum disease and overall mouth health is essential in the treatment of diabetes.
If you have any insight suggestions on this issue, please let me know.
A: Thanks for the thought-provoking question GRS. Congratulations on finding a great dental practice that takes your gum health so seriously. They obviously get the relationship between oral health and overall health as you do. You obviously did your homework and found people you can trust with your most valuable asset – your health.
As for the "insurance" matter, here I'm going to say things that might disappoint many readers. It's the truth as I see it.
Most people who own a car or a home have auto or home owner's insurance. This is usually required by the government (if you want to register a car) or by the mortgage company (if you want to take out a mortgage on your house). Imagine buying auto or home insurance or being given it by your employer and then going to the insurance company and asking them to buy you a home or pay for your new car. Sounds ridiculous doesn't it? And no insurance company, if it were to be required to do such a thing, would want to be in the business.
Yet, that is exactly what many Americans are expecting of their health insurance. I'm here to tell you that from my perspective as a healthcare provider, the thinking most Americans have about health Insurance is not only wrong, it is destructive and threatens our entire healthcare system.
When it comes to health, 'insurance' is a total misnomer. Insurance is supposed to cover something in the event something unfortunate or unforeseen happens. If you, G-d forbid, get into an auto accident, it will pay the cost of repair (usually after a substantial deductible). If your house has a fire, it might pay to rebuild it. What Americans are expecting from their 'health insurance' is not insurance but a care or welfare program. Sorry to use such negative terminology. It's the truth. What you seem to expect from your health insurance provider is for them to pay for improvements to your car or your home.
Don't get me wrong. I'm not a big fan of insurance companies. Frankly, I don't think they belong in the health care business at all. I work in Manhattan and see the names of Insurance companies emblazoned on the tops of the tallest buildings. I don't see doctors' names on any of these buildings! Who's making the money? I also see the statistics and believe that as Americans, we currently spend enough money to GIVE healthcare to every American. The problem is that the money is going to administer these 'plans' and not to provide healthcare.
You think I'm passionate about this? You bet I am because I see the whole culture we've built around this healthcare insurance issue as being destructive.
When my granddaughter was old enough to go to the dentist, my daughter-in-law came to me and asked who she should see. I don't see children, so I referred her to the colleague I trusted most with my beautiful, precious granddaughter.
A week later, my daughter-in-law called me back and asked for another referral. When I asked, "why?" she said that my colleague didn't accept her insurance. I was appalled. My daughter-in-law was using insurance as the most important criteria in choosing someone who was going to take care of her child's most important asset – her health! Not competence, not convenience, not care, skill or judgment but INSURANCE. And, this was a member of MY family! I'm here to say that we, as a nation, have to have a frank discussion about our priorities, a discussion I obviously had with my son and daughter-in-law. Avery now goes to my colleague and loves going to her dental visits.
Every colleague my vintage (I'm a baby boomer) that can, opts out of insurance. Many physicians have stopped taking Medicare because of the recent changes. They, like me, feel that it handcuffs their ability to provide the best care possible. They, like me, don't want to compromise their standards. But it's our fault. We don't have our priorities in the right place.
And, it really is about priorities. I know this because I see the same people using insurance as a criteria for choosing their health providers buying $5 Lattes and sporting the latest cell phone in their hand and tattoo on their shoulder. Where are our priorities?
So GRS, keep going to your new dentist. Rejoice that you've found someone who cares about you as a person and your health and don't bemoan the fact that your insurance isn't paying for it. Good healthcare is the best investment you can possibly make.
To everyone's health and wellness,
Dr. Goldberg loves helping people and is here to answer your questions about diabetes and your mouth. Just submit your Dental Issues questions for the doctor to Ask an Expert or email him at: firstname.lastname@example.org.
Dr. Michael J Goldberg is the former Director of Columbia Presbyterian Hospital's General Practice Residency Program and a principal in Manhattan Dental Health. He is the author of "What The Tooth Fairy Didn't Tell You" (Barber, Cosby).
NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.
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