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It blows my mind that it costs $400k to become a quality dentist in the USA these days. No wonder I see people train overseas and then just get a license here.
by ck2 13y ago
It blows my mind that it costs $400k to become a quality dentist in the USA these days.
No wonder I see people train overseas and then just get a license here.
How is health care ever going to be affordable in this country if the doctors and dentists have to carry so much debt?
- SixSigma 13y agoIt boggles the mind. By the time I graduate I will owe about 1 year's projected income (about $70k) and I think that's a pretty good return. If a dentist can make back nearly half a million then something needs to be done about the cost of dentristry, something doesn't add up.
- ck2 13y agoI think that is the point, they cannot easily make back the $400k I have to go to the dental college because I do not have insurance, it is impossible to go to a dentist without insurance these days. I usually am seated among many other people at the college who actually have insurance, it is just their deductible is far too high unless they go to the dental school for work.
- jjoonathan 13y agoI don't know how it works for dentists, but my understanding is that for doctors we've essentially given the doctors' guild the ability to legally dictate how many medical graduates they will allow, making them the envy of unions around the world (and schools, who are very happy with an arrangement that allows them to auction off a restricted supply of meal tickets). Sometimes you'll hear the AMA blame congress because they've gotten congress to pay for part of the education process and it hesitates to periodically increase the handout, but the reality is that they could change things tomorrow if they wanted to. Which they don't, because they rather enjoy the sky-high salaries that come from the artificial scarcity they've created. The market is slowly working around this constraint by allowing nurses to train and take on some of the responsibilities that were previously subject to the artificial labor scarcity. Unfortunately this only represents about ~1/3 of the problem with our medical industry by market share. The other two thirds come from drug price overruns (US drug buyers pay twice as much as single-payer countries which have much more size = bargaining power) and the medical insurance industry (a textbook case of "costs of competition" dramatically exceeding the benefits in a measurable way).
- carbocation 13y ago> The other two thirds come from drug price overruns (US drug buyers pay twice as much as single-payer countries which have much more size = bargaining power) As an infuriating elaboration on your point, the United States has a huge single payer in Medicare that is by law prevented from effectively negotiating drug price.
- jjoonathan 13y agoYes! It's insanity! Well, I wish it was insanity. It's actually cold and calculated exploitation. This is why we need campaign finance reform. Under the current system, politicians don't have the freedom to reject bribe money even if they want to. What a mess.
- refurb 13y agoMedicare isn't allowed to negotiate, but it automatically gets the average selling price, inclusive of all discounts. Disproportionate share hospitals get 23.1% discount. It's not like the US gov't isn't extracting it's share. Medicaid IS allow to negotiate and has federally mandated discounts. Medicaid covers more people in the US than ANY of the Canadian provinces who do negotiate. What does that tell you?
- jjoonathan 13y agoMethodology is important. See here: http://www.law.cornell.edu/uscode/text/42/1395w-3a http://www.law.cornell.edu/uscode/text/42/1395w-3a > the manufacturer’s “average sales price” means ... sales to all purchasers ... in the United States ... divided by the total number of such units So it looks like the ASP is fixed to the shit price that results from fragmented bargaining by US companies. A 23% discount on a 100% markup = drug companies laughing all the way to the bank. As for Medicaid, I'm not familiar enough to answer. Do they get decent prices or is there similar corruption at play?
- msellout 13y agoMedicaid does get decent prices, but providers may refuse to accept Medicaid. So some people have no access to affordable care, despite having Medicaid, because none of the providers within a reasonable distance accept Medicaid.
- will_work4tears 13y agoYeah, apparently the median salary of a dentist is ~145k with the highest earners making almost 190k and the lowest earners making ~75k. More of a relative hit than a CS type for sure.
- yashg 13y agoExactly my thought when I read that. $400,000 for dentist? Heck some people don't even give them as much respect as they give to other kind of doctors. Some say they aren't even doctors. No wonder people go to India or Eastern Europe to get their teeth replaced.
- falsestprophet 13y agoThey are literally not medical doctors.
- tostitos1979 13y agoYes, they aren't MDs. But they are Doctors. Personally, I have more respect for the average dentist than for the average GP. They put in tons of physical effort in their work. Lawsuits (or the threat thereof) are constant. Their board exams cover a lot of the same material as MDs. My personal experience is that the average dentist brings more relief to humanity (ever had dental pain?) than the average GP.
- mesaaz 13y agoModern dental care is truly one of the wonders of industrial civilization. Anesthetized basic dentistry adds more to our quality of life than much of the modern "healthcare" industry.
- javajosh 13y agoTo further support your point, I read somewhere that dental pain was the leading cause of suicide, pre-1900 or so, which I find very easy to believe. Dentistry (along with sewage systems) is responsible for more quality of life than almost anything else.
- tostitos1979 13y agoWow. I did not know this statistic. With bit of googling, I saw this: http://en.wikipedia.org/wiki/Trigeminal_neuralgia http://en.wikipedia.org/wiki/Trigeminal_neuralgia Apparently, Salman Khan has this. Painful :(
- sjg007 13y agoAmericans could do the same, go abroad, get a degree and come back.
- ck2 13y agoSo basically outsource college. We're not going to have anything left. Heck why even send people for education, why not go overseas for dental work (I bet it already happens).
- enraged_camel 13y agoAbsolutely. Health tourism is a very real thing. Heck, I was born overseas and go back to visit twice a year. That's when I get my health-related stuff done. Not only is it ridiculously cheap (sometimes even fully covered by my parent's insurance, even though I'm almost 30), but it's also very high quality. Healthcare in the US is an absolute joke. It makes me sad.
- FLUX-YOU 13y agoIvy and tech will probably remain. Frankly, some Americans could do with experiencing other cultures (myself included).
- delucain 13y agoOne of my wife's friends is attending a college in Ireland. The cost of flying to Ireland and back twice a year, room and board, books, and tuition is roughly the same as they would have paid for tuition at their local state university.
- msellout 13y agoYou can't train overseas and "just" get a license in the USA. Even if you've been practicing as a dentist in another country, to practice in the USA one must attend dental school in the US and pass the board licensing exams. It may be that some states allow taking only 2 years of dental school instead of the normal 4 if one has been a dentist elsewhere. I've found that many people are surprised when they discover that dentists in the USA are medical doctors and have a similar education.