Why is dentistry not part of healthcare services?

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#1298547 5-May-2015 18:00

sidefx:
Jaxson:

Removing the emotion and politics etc, why can we get the same procedures done in Thailand for around 20% of the local cost, if not less?

This is with locally or US trained dentists using state of the art equipment.

I would like to know a real reason a filling costs $300 and the likes of root canals and crowns are in the $1200 - $2000 each category.

Average Thai income seems to be around 6400 NZD per annum, so probably not a very fair comparison.

Last filling I had cost about $220 and took no more than 15 minutes. If I could get that in Thailand for $50 (1/4 of the price), the only difference being cost of labour, that means my dentist is making around $400+ an hour.

My girlfriend had a crown done last year. Cost us about $2000. There was a 30 minute appointment to take a mould and fit a temporary, and another 30 minute appointment to fit. Info online and a program here in Oz on Channel 7 some time ago suggests many dentists order crowns that are made to order overseas (often from china) for around $150. So if a dentist can get a crown for $150 but charge $2000, then that's around $1800+ for an hours work. Apparently a crown can cost up to $750 if made in Australia - but that still means the dentist is charging over $1000 for an hour of their time.

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#1298548 5-May-2015 18:09

ajobbins:

Last filling I had cost about $220 and took no more than 15 minutes. If I could get that in Thailand for $50 (1/4 of the price), the only difference being cost of labour, that means my dentist is making around $400+ an hour.

My girlfriend had a crown done last year. Cost us about $2000. There was a 30 minute appointment to take a mould and fit a temporary, and another 30 minute appointment to fit. Info online and a program here in Oz on Channel 7 some time ago suggests many dentists order crowns that are made to order overseas (often from china) for around $150. So if a dentist can get a crown for $150 but charge $2000, then that's around $1800+ for an hours work. Apparently a crown can cost up to $750 if made in Australia - but that still means the dentist is charging over $1000 for an hour of their time.

It's not only the dentists income you need to consider though. What about the nurse(s) and receptionist? What about the workman who installed the dentists equipment? What about the technician who services said equipment? Based on the average thai income all of those would cost about 1/10 - 1/5th what they do here resulting in a much lower cost to run a dentist practice in Thailand compared to here. Likely suppliers of dentist equipment, etc charge less in Thailand too because they know Thai dentists can't afford to pay as much as a NZ dentist. Not to mentioned other costs of running a practice like rent\mortgage, etc, which are likely also significantly less in Thailand.

I'm not defending how much dentists charge, because I tend to agree it is too much. Just saying that we should probably be comparing dentist costs to a country with similar economic profile to NZ...

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#1298572 5-May-2015 19:06

wasabi2k:
Geektastic:
wasabi2k:
Jaxson: And then we enter into the politics debate...

I think it takes about 5 seconds for this to become a political debate. It is assigning priority to government spending - and then it becomes a tax discussion.

I think everyone would agree full, free healthcare for everyone would be great - but noone wants to pay for it.

The question about offering people lower tax vs medical care when they need it - I believe you are massively underestimating greed. I would say the majority would choose lower tax - immediate benefit vs possible later benefit. I don't agree with that, but it wouldn't surprise me.

You can adjust what you spend money on without increasing the total - but that too will rapidly become political.

It would be interesting to see a model where everyone gets, say, $750 of 'free' dentistry per year or something so at least basic maintenance was covered.

So we just need to reallocate up to $3,353,250,000, based on the 2013 population.

Easy.

Does that include the ones we already pay for?

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#1298654 5-May-2015 21:25

anyone know how much the wellbeing add on costs from southern cross? "Vision and dental" covers 75% of up to $750 per year

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#1298669 5-May-2015 21:45

Well considering that for a start they were talking about 30 billion of transactions in the cash economy, if those people were paying tax, those alone should more than cover it. But we have so much money going offshore, and offshore companies operating in the NZ market who aren't paying tax, or minimal tax, we should be getting harder on those, or not supporting them at all.
But on average dentall treatment in NZ shouldn't cost $750 if people go at least once a year. Really it shouldn't avaerage more than $150-$250. $750 a year average is a significant amount of work.

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#1298717 5-May-2015 23:09

mattwnz: Well considering that for a start they were talking about 30 billion of transactions in the cash economy, if those people were paying tax, those alone should more than cover it. But we have so much money going offshore, and offshore companies operating in the NZ market who aren't paying tax, or minimal tax, we should be getting harder on those, or not supporting them at all.
But on average dentall treatment in NZ shouldn't cost $750 if people go at least once a year. Really it shouldn't avaerage more than $150-$250. $750 a year average is a significant amount of work.

I wonder how much 10c on every can (pro rata for bigger bottles) of sugar filled drinks would raise. And yes, I would include beersies in that.

I saw something on TV a while back (I forget what) and they had a nutrition scientist who placed the equivalent amount of sugar from a 2l pop bottle in a pile on the table. Scary.

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#1298849 6-May-2015 09:50

SepticSceptic:
Athlonite: I asked my dentist why he charges so much and this is what he told me: by the time he'd done 5 years dentistry school and set up his practice he owed a whopping 1 million bucks. well really that's alot of money so how come you can go to Queenstown every year for a ski trip then and to Hawaii for two weeks a year with the whole family

What was his answer to that ?

nothing he just smiled and kept on drilling (bloody sadist)

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#1298877 6-May-2015 10:27

tardtasticx: When I was 20 my wisdoms came through in the middle of a semester. Was gonna start around 2.5K to get them out at my local dentist with basic sedation, strongly advised against by everyone I knew. Even then, what kind of 20 year old can afford that on such short notice?

Fortunately a well off family member paid for me to get it done under GA, 6-7K all up. Mind boggling amount of money. Not everyone can afford that, and few will be as lucky.

Essential dental care should be covered, cosmetic stuff like teeth whitening or false teeth (unless you're missing so many you cannot eat or talk properly) should not. It's such an integral part of the body I don't understand why it's not paid for under the health system.

I had wisdoms and to molars out last year under a GA and it was about $7000 at a private hospital. However if you look closely at the bill, it's a bit absurd. They charge stupid amounts like $20 for gauze pads and $30 for Panadol. I suspect they do this because the insurance company is footing the bill.

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#1298902 6-May-2015 10:51

I don't know what the markup is, but if you look at the medical equipment and supplies, they are astronomical. Some blame should be on the pharmaceuticals and the medical equipment companies for charging to much too.

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#1298930 6-May-2015 11:26

A guy I know in Vietnam (Kiwi married to a Vietnamese lady) had a good example. His wife (also NZ citizen) needed a pacemaker and they happened to be in NZ at the time, so he took her to see a specialist. Told it would be many months of waiting or $15,000 private.

He returned to Vietnam and saw a western-trained specialist there. Same pacemaker, same surgery, similar big shiny new hospital: $3500.

He asked why the big difference.

Apparently the makers of the pacemaker charge different amounts for the equipment in different countries, depending on what they think they can get! NZ is 'rich' so the unit is expensive. Vietnam is 'poor' so it isn't as much.

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#1298998 6-May-2015 12:46

Maybe Pharmac Should set up shop in Vietnam or India?

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#1300037 7-May-2015 17:11

Can't even add mal-practice insurance overheads, as that would be covered by ACC

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#1301511 10-May-2015 17:13

this might be of interest RE the cost of healthcare http://www.stuff.co.nz/national/health/68324546/big-pharma-has-the-upper-hand-and-they-know-it

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#1301542 10-May-2015 18:19

joker97: this might be of interest RE the cost of healthcare http://www.stuff.co.nz/national/health/68324546/big-pharma-has-the-upper-hand-and-they-know-it

Yes

My wife had a breast cancer op, and two series of chemo, the first cost $60k plus the second $80k. That involved a number of 2 hour sit-downs while it was dripped into her system. I assume 90%+ of the cost was medicine, something is not right

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#1301558 10-May-2015 18:57

Did u pay out of pocket?

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