I call my most recent medical sting The Tag Team. One of my crowns broke off and I went in to my dentist. He said that, although he could fix it, it probably would not last very long, and for the best results, I should have the stub to which the crown is glued extended. He said that he could not do this, and that I would need to go to a periodontist. He said that after the periodontist did his work, I would come back in to get the crown done. I have had several crowns done and at least one that needed to be fixed, and they seem to cost a bit more than $700 dollars each.
I made a rational, informed decision that I wanted the more permanent fix, and I went in to see the periodontist. He said that he could do the stub extension, but that I might want to consider an implant, which is basically a screw that goes into the bone with a post that eventually supports the crown. He told me EXACTLY what this would cost. He said that after the implant was all healed, I would go back to my own dentist for the crown.
I made a rational, informed decision to have the implant. It was quite expensive, but I decided it would be worth it for me, and at least I knew EXACTLY what it would cost me. So far, so good. I believed that I was making the choice that I wanted for my own care. What he quoted me was indeed EXACTLY what he charged me.
At some point during this whole implant procedure (it takes around six months), I even went in to my dentist for a cleaning, and we discussed how the implant process was going, and that I would make an appointment for the new crown as soon as the periodontist said it was time.
When the implant healed, I went back in to my dentist, and he took impressions for the crown and when it came in, he installed it. I like the result.
THE STING: I got a bit of a sticker shock when the bill for the crown came a few days after it was installed. It was almost $1000 MORE than the usual price that I have paid for a crown or a crown repair. The reason? Well, I'm not sure. What I am sure of is that I was NEVER told that the price of gluing a piece of porcelain on to a metal post is $1000 more than gluing the same piece of porcelain on to the stub of a tooth. Surprise!
And consider, how would I have resolved this? It turns out that the cost of the crown is dependent on what kind of implant the periodontist uses; my dentist had never done one of the brand that the periodontist used, so he probably didn't even know himself. Indeed, when I went in to get measured for the new crown, there were two marketing-types hovering around my dentist showing him how to take the impression. I just didn't know enough to realize that there are crowns and crowns, and they are not the same. They preyed on my ignorance.
Friday, April 4, 2008
The Way of the Capitalist
When someone offers a product I want or need at a price that I am willing to pay, that is called capitalism. That is, the seller makes a decision on what product he wants to sell and at what price, and I make an informed, rational decision to purchase that product. If I don't like the price or the policies of the seller, then I can simply walk away and attempt to find a product elsewhere.
For quite a number of years, I have observed that a great deal of effort in the medical industry is going toward destroying the ability for consumers to spend their money in an informed and rational way.
Let me make a couple of definitions of things that are not illegal, but that are being used to extract money from people wanting to purchase medical items or care without their informed consent:
I think that a good example of a sting is my Qwest telephone bill. In their ads and when I call to ask the price, my telephone line costs $14.88 per month. But, when the bill comes, the price is $26.15 per month, an $11.27 difference. The taxes are $2.89 of this difference, and the rest are stings like: "City Occupation" fee, "facility relocation cost recovery" fee, "federal access" charge, etc.
I believe that Comcast Cable TV is another sting, and indeed, it borders on a scam. They advertise a $33 per month price that sounds pretty good. But, unless you absolutely know what questions to ask, when the bill comes you are charged a monthly fee extra for a digital converter, a monthly fee extra for a remote control, etc. In addition, the $33 per month is a short-term come-on price, and very soon, the real price kicks in; however, in their ads, even the real price WITHOUT the converter, remote, and other extras is mentioned in the middle of a very large paragraph of type printed over a multi-color background in a type size that my old eyes just can't read. For my part, if I could make a rational, informed decision, I might decide that Comcast's product is worth it and subscribe, but the way they do it, I am completely unable to get a straight answer from them as to just exactly what the full monthly cost of their product will be, so I forget it.
For quite a number of years, I have observed that a great deal of effort in the medical industry is going toward destroying the ability for consumers to spend their money in an informed and rational way.
Let me make a couple of definitions of things that are not illegal, but that are being used to extract money from people wanting to purchase medical items or care without their informed consent:
- SCAM - A scam is where you make someone believe that they are getting something that they are not. In my opinion, an example of a scam is Proactiv, a widely advertised range of quite expensive skin care products. These are advertised quite expertly as though they have some sort of magical powers of skin care. When I researched the active ingredients, I found that they indeed use chemicals that are commonly found to be effective. However, products with exactly the same ingredients are cheaply available from Rite-Aid and Walgreens. Indeed, Rite-Aid offers their own brand of products with a HIGHER percentage of the active ingredients (10% vs 2%) at about one fifth of the price. To further the scam, if you order from their 1-800 number using a credit card, WITHOUT TELLING YOU they automatically send you more product each month and, of course, bill your credit card each month. They make it REALLY hard to stop this automatic monthly subscription.
- STING - A sting is where you offer a product at one price, but when the bill actually comes, you are charged a slightly higher price. The difference is usually not enough for you to make a big stink about, but when you think about the total amount extra that is being extracted from hundreds, thousands, or perhaps even millions of consumers, it is not a good thing. I'm not talking about taxes here, but "other" charges.
I think that a good example of a sting is my Qwest telephone bill. In their ads and when I call to ask the price, my telephone line costs $14.88 per month. But, when the bill comes, the price is $26.15 per month, an $11.27 difference. The taxes are $2.89 of this difference, and the rest are stings like: "City Occupation" fee, "facility relocation cost recovery" fee, "federal access" charge, etc.
I believe that Comcast Cable TV is another sting, and indeed, it borders on a scam. They advertise a $33 per month price that sounds pretty good. But, unless you absolutely know what questions to ask, when the bill comes you are charged a monthly fee extra for a digital converter, a monthly fee extra for a remote control, etc. In addition, the $33 per month is a short-term come-on price, and very soon, the real price kicks in; however, in their ads, even the real price WITHOUT the converter, remote, and other extras is mentioned in the middle of a very large paragraph of type printed over a multi-color background in a type size that my old eyes just can't read. For my part, if I could make a rational, informed decision, I might decide that Comcast's product is worth it and subscribe, but the way they do it, I am completely unable to get a straight answer from them as to just exactly what the full monthly cost of their product will be, so I forget it.
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