There is little doubt that the ongoing economic crisis has had a tremendous impact on the financial health of so many. Spending on things once considered necessities is being curtailed because when faced with financial hardship, priorities change. Unfortunately, one category of personal finances and expenses that has been relegated to the back seat is healthcare including (surprise, surprise) dentistry, resulting in an actual decreased demand for dental care in the United States.
There is an ongoing public debate regarding the inadequacies of our healthcare system and the complexities of medical insurance. Suffice it to say that the cost of having adequate coverage is extremely expensive and only getting more so. Many who were “down-sized” in the Great Recession remain unemployed or underemployed without medical insurance and thus without a financial umbrella to weather a serious illness. Others with insurance are experiencing the financial squeeze of cost shifting i.e., insurance companies (by way of increased co-pays, in and out of network deductibles and increased premiums) are paying a smaller percentage of the cost of medical care. The net result of the economic downturn is that fewer people are seeking healthcare because of greater financial costs and diminished financial resources.
As I already mentioned, the decreased demand for desired and needed dental care has been one of the casualties of a still weakened economy. As hard as it may be to fathom, history indicates that as many as 40% of Americans do not see a dentist regularly. Clearly, there are factors other than economic that come into play to explain this sad fact, but now, even fewer people are seeing a dentist on a routine basis.
Dental insurance has always been considered the stepchild of health benefits. Even patients with good dental coverage are accustomed to out of pocket expenses when receiving other than preventive care. For as long as I have been in practice, there have always been annual maximums and graded degrees of coverage. Many insurance policies exclude entire classes of treatment such as orthodontics, implant dentistry, cosmetic dentistry, crowns, and porcelain veneers. Fortunately, programs such as flexible spending accounts and health savings accounts have helped to defray the cost of dental care by providing certain tax benefits. Unfortunately, these programs have been recently curtailed, effectively increasing the cost of care to patients. And economic pressures have prompted many companies to cut back on the dental benefits package offered to their employees often by reducing reimbursement, limiting access to “in network” dentists only, or eliminating coverage totally.
These factors, on top of reduced discretionary income, have led to an overall decrease in utilization of dental services, and I dare say are a challenge to overall dental health. It’s an unfortunate reality that in these challenging economic times, people are being forced to make difficult choices about how to spend their more limited funds, often making health decisions which may in the long run cost them more than just money. The old adage that an ounce of prevention is worth a pound of cure perhaps rings truer today than ever before.
Emergency Room Visits for Dental Related Problems
Much has been said in recent years about the 15 million or so Americans who do not have medical insurance. But did you know that over 130 million don’t have dental insurance? In 2012 there were over 800,000 visits to hospital emergency rooms for dental related-problems resulting in a price tag that is staggering. The tragedy is that most ER’s don’t have dentists. After the emergency dental patient is seen in the hospital for what usually amounts to a couple of prescriptions for antibiotics and pain medication, a visit to the dentist is still required, thus increasing the financial burden even more. Clearly this is a problem that affects people at all levels of the economic strata. The trend of increased visits to the ER for dental emergencies (up 16% between 2006 and 2009) includes middle class families.
I believe that the economic pendulum will eventually swing back to better times (economists may say the recession ended a couple of years back) but there is still an economic pall that continues to linger Things will get better. And when the job market becomes more robust, there will be a demand for higher salaries and better benefits. We have seen economic cycles before and this jobless recovery will ultimately bear fruit. In the meantime, for those who are struggling, it is important (very important!) to take care of your health and the health of your teeth. Schedule an examination. Get a cleaning. Take care of the small problem before it becomes a large one. In the long run you will be better off.
Dr. Michael Sinkin is a NYC dentist that has been in practice for over two decades. He truly cares about the experience his patients have and takes great pride in making them feel relaxed and comfortable during every visit. Come in for an appointment and experience a different kind of dental practice. To find out more about Dr. Sinkin, please click here.