Dr. Julie Kellogg: It's Time to Ask - Is Dental Insurance Serving Society?

It would have been so easy to bump that steaming cup of coffee into his lap.

I’ll admit the thought crossed my mind as I boarded the plane at 5:30 a.m.

As I turned the corner from the boarding door into the main aisle, there he sat, comfortably leaning back in his spacious first-class seat and sipping his morning brew. His hair was meticulously slicked back, and his eyes seemed smug as he watched “the commoners” board the plane. Emblazoned on his crisp polo shirt were those two words that make every dentist’s blood boil, “Delta Dental.”

I gritted my teeth as I made my way back to my seat in coach. Being the hero of resistance who gets hauled off a flight for malicious behavior would not move the needle of the dental insurance industry, even if most dentists would secretly have cheered the public action.

I thought of this encounter when I heard about the assassination of the United Health CEO and read the disturbingly unsympathetic comments pouring onto social media.

It begs the question: Is health (dental) insurance serving society?

We’ve seen political actions to change health insurance largely fail on the national stage in the past few decades, even as we continue to complain about the middleman interfering in our medical care. But why?

Because most Americans actually like their employer-sponsored health and dental insurance. They are scared of the unknown alternative a change might bring.

And yet, we still like to hate the gatekeepers, the ones who regulate who gets in and who receives what services.

As medical and dental innovation has increased the treatment options available, the ethical line between life-saving and elective gets wider and murkier. So, who should decide how benefits get paid out? Let’s be honest, at the end of the day, taxpayers like you and me are footing a large portion of the bills.

Dentistry still has a price problem too, especially for mid-life adults.

According to the Health Policy Institute at the ADA, “Compared to other types of health care services, cost barriers are most severe for dental care services. In 2023, 13% of the population reported cost barriers to dental care, compared to 4-5% for other health care services.”

Those with private insurance have the fewest cost barriers to dental care.

Here is where we dentists can feel mired in a paradox. We don’t like the labyrinth of rules or the inadequate reimbursement rates, but perhaps our patients treat their employer-sponsored insurance as their only viable pathway into our offices.

Change doesn’t happen if you don’t start. Instead of indulging in bitterness and fantasies of coffee-fueled revenge, consider taking some beginner action steps.

Instead of being silent, start a curious conversation with your patients:

1. Ask them to do the math. Are they receiving a reasonable amount of benefits for the premium they pay?
2. If they are frustrated with their insurance, request that they talk to their employer or HR department about what insurance benefits would make the most difference for them.
3. Gently explain to your patients that benefits in raw dollars haven’t changed in decades while the cost of providing the excellent care they expect in your office has risen astronomically.

Americans like their private health insurance AND they like systems to be fair.

The ratio of benefits given to costs involved is distorted. The frustration we all feel is rooted in an unfair and exploitive system.

When you take the time to run the numbers, the exploitation becomes clear, and our sense of fairness demands we take action.

Our association has been exemplary at advocating for dentists in Washington through recent difficult years. But I believe that the murder of the United Health CEO indicates that the voices of professional associations are not enough. We need to add the voices of the people and the HR departments of small businesses and large companies to the chorus – but in a constructive way.

We must act now to grow a movement to a critical mass of voices — slowly, strategically, and peacefully. Bottling up our silent bitterness and fantasies of revenge are neither healthy nor effective.