Health care prices and competition

My teeth are rotten. It is my own fault. I didn’t care for them when I was young. As a result, I have a big investment in crowns and fillings. Much of this work was done decades ago and it is getting old. I also chipped two front teeth a while back. I decided to get it all fixed, in Brazil. Getting three crowns and four filling replaced, as well as two cavities fixed and my chipped front teeth capped will cost $2553. Lots of money, but only about a quarter of the U.S. price.

In addition, this dentist can get all of that done in about two weeks. It is different in the U.S.

A few months ago, I needed blood work to test for cholesterol, sugar etc. That cost me only about thirty dollars. And it didn't take much time.

This was all done by private firms/doctors. Brazil has a public system, but it is used only by those who cannot avoid it. People pay the private doctors themselves, which keeps the costs down. And the medical system in Brazil is still not as lawyer infected as ours.

I am not saying that I prefer the Brazilian system. American medical care is still the best in the world, but it is expensive. We sometimes get more than we would want to pay for. And we don't pay attention because somebody else is paying.

There are a few lessons here. First, medical care can become more of an internationally trade commodity. Chrissy had ONE crown replaced in the U.S. It cost her around $2500. She could have flown to Brazil, had the work done here and still saved money after paying for the airfare.

A second lesson has to do with delivery. If people pay out of their own pockets, prices remain lower. Brazil is NOT an inexpensive country generally. It costs MORE to maintain an American level of living in Brazil than in the U.S. Restaurants and food cost more. Cars cost more. Electronics costs a lot more. But medical care is cheaper. Maybe a system that insures against big things but makes people pay out of their own pockets for other things is a good way to go. It is no coincidence that the only medical treatments to come DOWN in price have been things like laser and plastic surgeries generally not covered by insurance.

ObamaCare is in the process of collapsing. By this time next year, the Obama folks will be talking about the necessity of bailing out the insurance companies. They will be pumping adrenaline into a dying horse. It might be better to make the big necessary changes, that bring in more choice and discipline.

I don't expect this will be easy. Our liberal friends are ideologically committed to delivery of health care paid mostly by others (taxpayers or young people) instead of the consumer. But this has a way of raising prices and lowering innovation.

And if you need some dental work done, or maybe some elective surgery, you might consider international travel. Just make sure you are in the private system, since the public systems suck.

Posted by Christine & John at January 16, 2014 5:59 PM
Comment #375699

You need a new dentist. Seriously. A crown costs $1200. Fillings cost $250. You are getting ripped off.

Blood testing without Obamacare cost between $150 to $250; with Obamacare, it is free if it is preventative, otherwise it costs a nominal co-pay.

Why would you think Obamacare is paid for by anyone other than consumers? I am paying @ $600/month for myself and my wife. My 24 year old daughter is paying @ $167/month. For those who are eligible, federal subsidies are covered by a phased-in tax on health care companies, a tax on makers of medical devices, and @ 3% surcharge on Medicaid for people with incomes over $250,000.

Health care costs showed their lowest rate of increase between 2010 - 2012 since records for that began. Some argue that the only reason health care costs stopped skyrocketing was because of a slow economy; in any event, they did not increase, and it seems more likely than not that the answer is right in front of our faces. Obamacare is working. It is achieving one of its primary goals, namely, controlling rising medical costs.

Posted by: phx8 at January 17, 2014 7:35 PM
Comment #375701

C&J, YOU BLEETING LIBERALS! Is Brazil the conservative Toronto? Brazil is an impoverished country previously under despotic rule with street dentistry, aaaaaaand we should have the same system here? Whaaaaaaaa..?

WHAT I SEE IS THUS A PHASE AMONGST THE MOD YUPPY—A country or nation that had or currently has a feurer or regime is ultimately a better country with more economic “FREEDOMS”—MOVE THERE YOU INSIPID COMMUNIST AND STOP POSTING AMONGST OUR QUALITATIVE CIVIL LIBERTIES HERE.




Posted by: simpleheaded at January 17, 2014 8:20 PM
Comment #375702


I probably am getting ripped off in the U.S. I go to dentists in the Washington area. I have considered going back to Wisconsin for the treatment, but it takes too long. But you cannot beat the Brazilian price. Seven teeth plus fixing the chipped teeth, plus the regular cleaning for around $2500 is a good deal. Even at your less expensive price, you are looking at $3600 for the crowns alone.

Re Obamacare - nothing is free. Somebody pays. The only real way to make things cheaper is to improve technologies or processes. Everything else is just moving around the one who pays.

Re subsidies - I just don’t like the idea of somebody else paying. Just because someone earns more than I do, it doesn’t mean that they should pay for me. It also seems silly to tax medical devices. That is a kind of tax on innovation.

BTW - it is not always good to have others pay. When I was a kid, my father worked as a longshoreman. His insurance covered almost everything. Almost. It included dental and I got some of my teeth filled. But it didn’t cover cosmetic. My dentist at the time told me that my smile was “gummy” and wanted to - believe it or not - trim back my gums to show more tooth. Fortunately, the insurance wouldn’t cover it and my father wouldn’t pay. Today, like many old people, my gums are NOT too big.

BTW 2 - Kids don’t get cavities anymore. None of my three kids has even one cavity. Toothpastes have vastly improved in recent decades. I actually don’t have “new” cavities, but I am still suffering from the effects of the old ones.

Posted by: CJ at January 17, 2014 8:20 PM
Comment #375703


You have never been to Brazil, have you? It has its problems, but it is improving rapidly. If you read carefully, which I am not sure you can, you would see that I did not advocate copying the Brazil system.

I like to be polite and I feel bad for the question, but are you like … nuts or just learning impaired?

Posted by: CJ at January 17, 2014 8:23 PM
Comment #375707

Simples dirigido está ocupado e cheio simples da merda.

Posted by: Hildebrando at January 17, 2014 9:10 PM
Comment #375709
President Obama is “chronically incapable” of military strategy and falls far short of his predecessor George W. Bush, according to one of Britain’s most senior military advisors.

Sir Hew Strachan, an advisor to the Chief of the Defense Staff, told The Daily Beast that the United States and Britain were guilty of total strategic failure in Iraq and Afghanistan, and Obama’s attempts to intervene on behalf of the Syrian rebels “has left them in a far worse position than they were before.”

The extraordinary critique by a leading advisor to the United States’ closest military ally comes days after Obama was undermined by the former Defense Secretary Robert Gates, who questioned the President’s foreign policy decisions and claimed he was deeply suspicious of the military.

Strachan, a current member of the Chief of the Defense Staff’s Strategic Advisory Panel, cited the “crazy” handling of the Syrian crisis as the most egregious example of a fundamental collapse in military planning that began in the aftermath of 9/11. “If anything it’s gone backwards instead of forwards, Obama seems to be almost chronically incapable of doing this. Bush may have had totally fanciful political objectives in terms of trying to fight a global War on Terror, which was inherently astrategic, but at least he had a clear sense of what he wanted to do in the world. Obama has no sense of what he wants to do in the world,” he said.

…The dithering over intervention against President Bashar al-Assad has empowered the Syrian ruler, undermined America’s military reputation and destabilized the Middle East, said Strachan. “What he’s done in talking about Red Lines in relation to Syria has actually devalued the deterrent effect of American military capability and it seems to me that creates an unstable situation, because if he were act it would surprise everybody,” he said. “I think the other issue is that in starting and stopping with Assad, he’s left those who might be his natural allies in Syria with nowhere to go. He’s increased the likelihood that if there is a change of regime in Syria that it will be an Islamic fundamentalist one.”

Posted by: DSP2195 at January 18, 2014 9:33 AM
Comment #375717


interesting post! I wouldn’t respond to ‘simple’ if I were you. He is - well - Simple!

I’ve never been to Brazil (I’d kill to go for the upcoming World Cup)! Nonetheless, I’ve read and saw numerous stories over the past decade about how the majority of Brazilians are addicted to cosmetic surgery. It’s a cultural beauty thing.

I don’t have any problem with that - the world could ALWAYS use more beauty (LOL)!

At any rate, I don’t understand, nor can I fathom why phx8 praises Obamacare. He’ll defend it no matter how horrible it is. He/she always pushes the same liberal talking points when referring to the greatness of the program.

Again, I liked your post!

Posted by: Kevin L. Lagola at January 18, 2014 12:53 PM
Comment #375718

A crown around here (Charlotte)is $1200 insurance price and $900 cash. I’ve got a plastic temp now so that’s how I know. Lots of folks here go to Mexico for a “dental vacation.” If you need a lot of work it’s a good deal and less risk since there is plenty of info published on which dentists you can trust. You’re not just going there blind.

Posted by: George in SC at January 18, 2014 1:10 PM
Comment #375719

I worked for an Amish guy who sent his employees to Mexico for surgery. He was also self insured so he saved money any way he could, including letting employees go if they injure themselves.

Posted by: Weary Willie at January 18, 2014 1:50 PM
Comment #375720

Re the price of crowns - I am including the total price of the crowns plus all the visits etc. I still seem to pay more.

Posted by: CJ at January 18, 2014 2:06 PM
Comment #375724

“There are a few lessons here. First, medical care can become more of an internationally trade commodity.”


Indeed, there already is a substantial and growing business in medical tourism. It is not just for cosmetic surgery but for major surgery (heart, knee, hip replacements, etc. as well as advanced cancer treatments. A report by Deloitt Consulting in 2008 estimated that 750,000 Americans traveled to foreign countries for medical and dental services and that the number would grow substantially in the next decade. There is now international accreditation of foreign medical services by the principal US accreditation body.

One of the principal impediments to medical tourism is the reluctance of US insurers, including Medicare, to reimburse services received outside of the US. In my opinion, this is unfortunate. Foreign competition would be huge factor in reducing US medical costs.

Certainly, there are problems with traveling to a foreign country for major medical care. However, for elective or non-emergency care, it would seem foolish not to develop the opportunities.

Posted by: Rich at January 18, 2014 9:57 PM
Comment #375730


Another reason to have more choice and fewer rules. I suppose organized groups in America will oppose this, however.

I would say that my Brazilian dentist doesn’t have all the stuff you find in the U.S. I am sure they could make up some sort of criteria that would exclude him.

Ironically, lots of the doctors and dentists in the U.S. are foreigners.

Posted by: CJ at January 19, 2014 6:26 AM
Post a comment