| Jonquilyn Hill is the host of the new Vox podcast Explain It to Me, which sets out to answer your questions about all of life's curiosities. |
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| Jonquilyn Hill is the host of the new Vox podcast Explain it to Me, which sets out to answer your questions about all of life's curiosities. |
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Do dental bills leave you with sticker shock? Here's why. |
If you need something explained, Vox is the place to go. Now, we're bringing that ethos to our latest franchise, Explain It to Me, which launches Wednesday, September 18, and focuses on answering your questions through a weekly podcast, a weekly newsletter, and a video series. Every week, we'll tackle a question from a listener and find the answer. This week, for our podcast, our Today, Explained colleague Matt Collette asks: Why does going to the dentist sometimes feel like a scam? "I feel like every time I go to the dentist, it's like a little bit of a mystery," he says. "Unlike when I'm at my regular doctor's office, there isn't this step where they say, 'Hey, we recommend you do something and here's what it's going to cost.' That just feels so [different from] how I think about health care — having to think about not only do I want this procedure, but do I want to pay for this procedure? And how do I want to pay for this procedure?" |
Matt isn't imagining things. There are major differences between the ways dentistry and medicine operate, including the way dental and medical offices do billing and how patients pay for services. These differences caught the attention of Dr. Lisa Simon. She's an oral health and medicine integration fellow at the Harvard School of Dental Medicine. She's also a dentist and a doctor. After spending time in a community health care center as a dentist, she went to medical school. "I realized that the ways that dental care and medical care were separate was really harming my patients," Simon told Vox, "and I wanted to do something about it." "I think it's this legacy, and maybe partly this dichotomy between medicine and dentistry, where we almost act like dentistry is optional and medicine is obligatory, which is not how our bodies work at all," she said. We sat down with Simon to discuss the history of dentistry, why dental insurance works so differently from medical insurance, and how to leave the dentist not feeling like you were a Fyre Fest victim. Be sure to listen to the whole episode here. Below is an excerpt of our conversation, edited for length and clarity. |
Jonquilyn Hill Why does the dentist feel like a scam? What is Matt picking up on? Lisa Simon There is a fundamental tension in the way dentistry is paid for, which is that the average dentist is in private practice, and their income is dependent on providing a procedural service to you. So they are incentivized to offer more services to you, and you are disincentivized from wanting to pay for them. There's this misalignment in terms of what our goal would be, which is to never get a cavity, and what dentists' goals are, which is to make money doing a lot of procedures that they're very skilled at.
Jonquilyn Hill Have you heard dentistry be described as a scam before? Is this sentiment that Matt has common? Lisa Simon I hear it all the time. Even within the field, I've heard it referred to as the mechanic's principle. [If] I bring my car to the mechanic and the mechanic says, "Oh, yeah, pretty bad confubulator you got there, I definitely need to repair it," I have no knowledge or expertise to be able to tell if that is true or if I am being scammed. But the reality is that most dentists are probably not scamming you in this evil, mustache-twirling way, but also there can be legitimate clinical differences in someone's style. You may have a more conservative dentist [who is] going to wait and see if this gets bigger and maybe it doesn't need a filling right now, or you might have a dentist that's more aggressive and wants to treat something earlier just because they have different clinical experiences, and they're legitimately recommending what they think would be best for you.
Jonquilyn Hill So why is it still so expensive to get dental work done? Why does it feel so different from regular health insurance? Lisa Simon In one way, dental insurance is super expensive: For the average person, a dental procedure like an implant is a crazy amount of money out of pocket. In other ways, dentistry is actually super-duper cheap. It's only 4 percent of our average health care expenses as a country. If you think about the single cost of being in an ICU in a hospital for a day — which can easily be $50,000 — that's way more expensive than dental care. The idea behind medical insurance is that if this super-expensive, absolutely horrible nightmare thing happens to you, you are not financially on the hook for it.
Dental insurance isn't actually insurance; it just doesn't work that way. It's a discount plan. It originated in the '40s and '50s with unions that were trying to provide a nice perk for their members.
What it does is it makes the cheapest things — like your cleaning, your exam, or your X-rays that you get every year — free or really cheap. But if you actually need things, you are going to pay progressively more and more of the cost of these more expensive things, which is basically the opposite of how medical insurance was originally designed to work.
Jonquilyn Hill So should we even be calling it insurance? Should we call it a discount plan or say "Here is your dentist loyalty card"? Lisa Simon Honestly, I feel like that's a great point. It's not insurance. To call it insurance is maybe more of a scam than any other kind of scamming that's being done. And it's not to say that it might not be financially a good idea for an individual person, but as a structure designed to take care of a badly unmet need in our society and to provide health care, it's not the way I think any of us would design it. |
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| About the Explain It to Me franchise |
Explain It to Me is Vox's new series focused on answering your questions through a weekly podcast, a weekly newsletter, and a video series. The podcast is your hotline for all of your unanswered questions, and host Jonquilyn Hill is your friendly guide who will find you the answers you're looking for — and maybe even the ones you don't expect. Call us at 1-800-618-8545 or fill out this form to tell us what's on your mind. You can also sign up for the newsletter here. |
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| The Federal Reserve is set to make its first interest rate cut since the pandemic ended. Marketplace's Kimberly Adams explains how the move could impact the US economy and politics. |
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| Samir Hussein/Getty Images |
Diddy's arrest, explained: On Monday, rapper and mogul Sean "Diddy" Combs was arrested, several months after several sexual assault and violence allegations were made against him. He has been indicted on federal charges of sex trafficking, racketeering, and transportation to engage in prostitution, and is accused of running a "criminal enterprise" that abused women. Here are all of the allegations against Diddy so far. Restrictions for teens on Instagram: Meta has unveiled changes that will make the accounts of millions of teens on Instagram private. Users under the age of 16 will need a parent's approval to change the restricted "Teen Accounts" settings, which will provide screen time reminders, filter out offensive words, and limit unwanted and inappropriate messages. Lawmakers, child safety experts, and parents have long had concerns about the app's effects on children. A real-life Succession story: The real-life media family that was one of the key inspirations for HBO's Succession is currently navigating a messy court case that could determine the future of Fox News and News Corp. In a new court case set to begin this week, Rupert Murdoch is now pushing to amend his previously established trust to give the bulk of power to his son Lachlan, who is seen as the one of his four children who is most politically aligned with his conservative political views. Linkin Park's comeback drama: After a seven-year hiatus, rock band Linkin Park announced its comeback with a new lead vocalist: Emily Armstrong, the lead singer-songwriter of the rock band Dead Sara. However, the band is facing backlash from some fans about alleged ties to disgraced actor Danny Masterson, who was convicted of rape in 2023, as well as the Church of Scientology.
The Jordan Chiles bronze medal saga continues: Jordan Chiles, the Team USA gymnast who had her bronze medal award taken back from her at the 2024 Olympics, is asking Switzerland's Supreme Court to overturn the Court of Arbitration for Sport's ruling. Here's a refresher on the scoring controversy.
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School sweeps in Springfield: On Monday, Ohio Gov. Mike DeWine said that state police will be conducting daily sweeps of Springfield schools after authorities have been forced to investigate "at least 33" bomb threats. While the threats haven't had any validity so far, the safety concerns come after racist Republican claims about Haitian immigrants in the area. [CNBC] Meet Moo Deng: Moo Deng, the viral baby pygmy hippo at Khao Kheow Open Zoo in Thailand, is attracting excited fans, but the zoo's employees have concerns about Moo Deng's safety, as some visitors have thrown water and other objects at her. [Yahoo] |
Lillian Suwanrumpha/AFP via Getty Images |
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That's how many US children who were lifted out of poverty when the expanded child tax credit — which increased the existing child tax credit from $2,000 per child to $3,000-$3,600 — was in effect in 2021. Yet despite support from economists and recipients of the credit, lawmakers failed to reach an agreement to make the expansion permanent, and Congress let it expire at the end of 2021. While economists have varying views about the future of an expanded credit, Democratic presidential nominee Kamala Harris has announced that bringing it back is part of her planned economic agenda. Here's what to know about the research on child tax credit plans. |
Scott Eisen/Getty Images for ParentsTogether |
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Today's edition was produced and edited by senior editor Lavanya Ramanathan, with contributions from staff editor Melinda Fakuade. We'll see you tomorrow! |
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