What is the best dental plan in the US? - MEXICO

That’s Mexico the third world country that’s a couple of hours away from here by plane, not a dental company called Mexico Inc.

About a month ago, Frontline (my favorite show on TV) did a special called, Sick Around the World and sent a reporter around the world to compare health-care systems in the world’s leading economies with the US system to try and understand why the US is lagging so far behind in all health indexes when compared to the rest of the developed world.

At the beginning of his interviews with the top doctors in each country, the reporter asked the same set of questions. One of them was, “How many people go bankrupt due to unpaid medical bills in your country?” and as expected each doctor would at first look surprised at the question and then answer that they had never heard of such a thing.

The most interesting response came from Japan when he interviewed the top doctor in that country. The Japanese doctor looked embarrassed because he did not know the answer to the question. In typical Japanese etiquette, he was trying hard to be as polite as possible, but he just seemed puzzled and was not sure if the reporter was asking a real question or a trick question.

Nervously, he referred to his colleagues sitting behind the camera and asked them something in japanese before he answered the reporter - as if to ask, “Is that a real question or a trick question? Have you guys heard of anything like that?”. Assured that he was on the same page with his colleagues, he told the reporter that they had never had of such a thing. It was a classic TV interview moment.

That exchange in a nutshell, clearly highlighted just how deep into the abyss the US healthcare system has fallen. Most observers of the US from outside know that the current doldrums the US economy finds itself in is due largely to the mortgage financing meltdown. Lost in this bigger mess is a slow burning casualty where millions of people are being driven into bankruptcy and poverty due to insurmountable medical bills.

There’s a common saying here that, “you are only a couple of paychecks or a major illness away from the being homeless”.

Apart from being independently wealthy, the cheapest way for most people to get health insurance here is to be lucky enough to be in a job that offers it and to stay employed without breaks. With the current US economy, this is a tall order.

The woes do not end there. Once you have covereage, you are allowed a lapse of not more than 30 days when moving from one coverage to the next. If you fall seriously ill after the 30-day lapse, you are automatically excluded from future coverage and classified as having a “pre-existing” condition. From this point on, getting coverage becomes a mirage.

US Insurance companies run very sophisticated databases. With a pre-existing condition, you might sneak and get coverage, but with time, they will find out and they are brutal. Horror stories are all over local newspapers and on the local 10 o’clock evening news.

The result is that millions of people are left without healthcare or woefully under-insured. This sad situation was graphically portrayed by 60 Minutes, when they did a story a few months ago about a charity called Remote Area Medical, a charity started by former actor, Stan Brock to help people in remote parts of the third world. Like a cruel irony, they set shop up in Knoxville, TN USA - the richest country on earth. Lines started forming as early as midnight even though the temporary clinic would not be open until 5:30am later that morning. Some people drove hundreds of miles in the hope of being seen by a specialist. A lot of these people were not destitute people, but working people.

A friend of mine though, took a different approach. He had been having major issues with his teeth and gums and although he was employed full-time and had a comprehensive dental coverage, he was frustrated by the lack of transparency he was getting when he visited dentists around the Dallas area. He was getting quotes of US$ 10-20,000 perhaps more depending on how bad his situation was. The only way to find out was to have a dentist look at him. The problem is, dentists do not let you window-shop. Instead, they are like a high-powered vacuum machines aimed at your pocket. This has been my experience too.

Most employer-based dental coverage is usually $1,400 a year. So you might think that being frugal and shopping around perhaps might stretch your dental dollars - it does not. Dentists know exactly what your coverage is and have devised devious ways to get that money out of you the moment you step into their offices.

When you walk into a dentist’s office in the US, you will most likely be greeted by a pretty lady at the front desk. She is your first point of contact and usually handles all the money issues. One thing she will never do is tell you precisely how much the work will cost even if you know exactly what you want done. The standard response is that it all depends on the scope of work and they cannot know that until the dentist takes a look at you.

So you walk into the dentist’s chambers, he or she sizes you up, gives you a quick lecture on how ignoring your dental work can lead to plaque in your heart and so on unless he does three or four procedures beyond what you wanted done. When he realises that you are apprehensive about committing yourself until you know the cost, he calls the pretty lady from the front desk to run through the numbers with you. You ponder for a moment and because you are now in an embarrasing situation with all the techs waiting right there for you to make up your mind, you save face and decide to give them the go-ahead.

When the work is done, you are given a run-down of what your treatment plan will be and you walk to the front desk to close out your visit. When you lay your eyes on the final bill, your eyes bulge and she quickly tells you that the figure she quoted was for one quadrant. Now you are looking at 4 times what you were quoted. Your yearly coverage only covers a fifth of the total bill. With her smiling face, she asks you how much you can pay today.

In a couple of hours, you have come from having $1,400 surplus on your dental plan, to owing thousands of dollars.

This is the reality and frustration that drove my friend to fly to a little town south of Mexico city to get his work done. He had bridges, crown caps, fillings, gum disease treatment and some other stuff I don’t even remember all done for US$600.00 and to top it all off, this dentist was educated in the United States. I’m about to take some time off and head down south as well because I think this has to be the best dental plan I have ever come across.

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