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I'm in my mid 30s and have left fixing up some damaged teeth and my large wisdom teeth impacted for 17 years too long, this Monday I'm going to get them removed

I'm in my mid 30s and have left fixing up some damaged teeth and my large wisdom teeth impacted for 17 years too long, this Monday I'm going to get them removed under general anaesthetic at a private hospital. The Australian government covers hardly any dental unless your teeth have completely rotted through and are chasing other issues. So far my costs are: - $4500 in fillings and general dental. - $1800 for a crown (gold). - $350 consultation with surgeon (via zoom). - $1100 for 30-40 minutes (max) of a theatre room for the initial operation. - $4000 for the surgeon for 30-40 minutes. - $450 for the anaesthetist. - $0 for X-rays (covered under Medicare). - $150 transport. - $YTD medication post surgery. - $YTD follow up dental work. - $YTD additional surgery to cavities from the top teeth into the sinuses - this is only a maybe, it's a risk. Total so far in the last 3 months has been over $12,000 What stand out for me is how can the surgeon charge $4000 for 30-40mins of active work, and I'm assuming a little paperwork. Having said all that, I admitted myself to the ER earlier this year and spent the day there having a bunch of tests, didn't cost anything at all and no insurance required. While healthcare in Australia is generally pretty decent,dental is significantly lagging behind and expensive.

sen 5y ago
I have no idea on the reasons or specifics but I needed pretty serious dental work here (AU), dental quotes were around $7-8k (“maybe more” they said), went to my GP and he wrote the referrals etc and it cost me $200 out of pocket, mostly for the prescriptions. Sure you wait a while for our public health stuff if it’s not life threatening, and if you’ve got the cash available then private is faster/fancier, but the public system does work.
- smcleod 5y ago
  Did you have to get major surgery under general anaesthetic? This was after I had referrals from my dentist and a second opinion. I do have some complications with a major nerve running about 1mm from one of the largest tooth's roots and I was told when there's some risk of damage to facial nerves you should make sure you get a good surgeon.
jiggawatts 5y ago
It's not all roses and butterflies down under. My missus needed highly specialised but relatively quick and low-risk surgery. Maybe 3 surgeons in the whole country do this particular procedure. Think 30 minutes in the OR, a couple of hours to wake up from the anaesthesia, and then you go home. $4,000. And then the anaesthetist sent a separate bill. What does Medicare + Private Hospital cover out of this? A grand total of $130. It turns out that this particular procedure has no specific "code", so it's lumped in with a routine day surgery billing code. Which is something like $270, with $130 covered by Medicare. Now, if you ask me, $270 is too low, $4K is a tad high, and 100% of both should be covered by Medicare. I looked into it, and it turned out that the Medicare refunds are based on "fixed prices" determined by the government decades ago, and haven't changed since then. Private insurance "goes by the government pricing" because it lets them get away with paying you pennies on the dollar. Realistically, you're not getting any kind of surgery with general anaesthesia for under $1K. Don't worry though, the government and your insurance company will give you maybe a bit over 10% of that back! They have you "covered".
pid-1 5y ago
For those prices, odds are one could save money by traveling to Brazil and getting dental care in a top clinic in São Paulo or Rio de Janeiro. There must be other countries with cheap care. Someone should make a startup for that.
- smcleod 5y ago
  Travel during a global pandemic where we've had almost two years where we can't leave our houses for more than an hour I doubt that'd fly (no pun intended).
- vishnugupta 5y ago
  Medical tourism is a good business in India to cater to exactly such cases. They also advertise these all inclusive prices.
  - smcleod 5y ago
    Yeah but there's a global pandemic right now and India isn't exactly doing well...
vishnugupta 5y ago
For comparison, I got my wisdom tooth extracted for INR 3500 (AUD 65) in India a few weeks ago.
amelius 5y ago
> What stand out for me is how can the surgeon charge $4000 for 30-40mins of active work, and I'm assuming a little paperwork. Is there any other profession with this kind of pay?
Semaphor 5y ago
Ouch. Germany is pretty bad with dental for public health insurance, but at least necessary basics are covered. So you’d have had to pay for general anesthesia (only local is covered unless deemed necessary), and for the gold crowns (only some cheap and ugly material is covered, same for fillings)

sen 5y ago

I have no idea on the reasons or specifics but I needed pretty serious dental work here (AU), dental quotes were around $7-8k (“maybe more” they said), went to my GP and he wrote the referrals etc and it cost me $200 out of pocket, mostly for the prescriptions. Sure you wait a while for our public health stuff if it’s not life threatening, and if you’ve got the cash available then private is faster/fancier, but the public system does work.

smcleod 5y ago
Did you have to get major surgery under general anaesthetic? This was after I had referrals from my dentist and a second opinion. I do have some complications with a major nerve running about 1mm from one of the largest tooth's roots and I was told when there's some risk of damage to facial nerves you should make sure you get a good surgeon.

jiggawatts 5y ago

It's not all roses and butterflies down under. My missus needed highly specialised but relatively quick and low-risk surgery. Maybe 3 surgeons in the whole country do this particular procedure. Think 30 minutes in the OR, a couple of hours to wake up from the anaesthesia, and then you go home. $4,000. And then the anaesthetist sent a separate bill. What does Medicare + Private Hospital cover out of this? A grand total of $130. It turns out that this particular procedure has no specific "code", so it's lumped in with a routine day surgery billing code. Which is something like $270, with $130 covered by Medicare. Now, if you ask me, $270 is too low, $4K is a tad high, and 100% of both should be covered by Medicare. I looked into it, and it turned out that the Medicare refunds are based on "fixed prices" determined by the government decades ago, and haven't changed since then. Private insurance "goes by the government pricing" because it lets them get away with paying you pennies on the dollar. Realistically, you're not getting any kind of surgery with general anaesthesia for under $1K. Don't worry though, the government and your insurance company will give you maybe a bit over 10% of that back! They have you "covered".

pid-1 5y ago

For those prices, odds are one could save money by traveling to Brazil and getting dental care in a top clinic in São Paulo or Rio de Janeiro. There must be other countries with cheap care. Someone should make a startup for that.

smcleod 5y ago
Travel during a global pandemic where we've had almost two years where we can't leave our houses for more than an hour I doubt that'd fly (no pun intended).
vishnugupta 5y ago
Medical tourism is a good business in India to cater to exactly such cases. They also advertise these all inclusive prices.
- smcleod 5y ago
  Yeah but there's a global pandemic right now and India isn't exactly doing well...

vishnugupta 5y ago

For comparison, I got my wisdom tooth extracted for INR 3500 (AUD 65) in India a few weeks ago.

amelius 5y ago

> What stand out for me is how can the surgeon charge $4000 for 30-40mins of active work, and I'm assuming a little paperwork. Is there any other profession with this kind of pay?

Semaphor 5y ago

Ouch. Germany is pretty bad with dental for public health insurance, but at least necessary basics are covered. So you’d have had to pay for general anesthesia (only local is covered unless deemed necessary), and for the gold crowns (only some cheap and ugly material is covered, same for fillings)