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Last week I awoke one morning from uneasy dreams to find myself transformed into a dental patient.
A tooth on the right side of my mouth was aching. Had I become a teeth grinder overnight? Had a beetle crawled into my mouth?
The familiar misery followed. Hot drinks sending me through the ceiling; pleading for an emergency appointment with the nice people at my dentist; X-rays, prodding and the lamentable news — a suspected dying tooth. A probable root canal. And — a new experience! A trip to see someone called an endodontist.
Friends made the "ka-ching!" sound of a cash register when I told them my plight. Money. Dentists and all associated specialists mean money. Lots of it.
My metamorphosis was going to be into a mendicant.
Through a series of decisions made over the years, alarmed here and there by government tinkering, levies and disincentives, as well as my husband's bouts of illness, we now pay premiums to a private health fund for their most gold-plated product. To make us feel better about it, I'm sure, they even call it "gold" cover, but I'm afraid claim amounts come to us in tin.
The monthly premiums, which we are lucky to be able to afford, are staggering, and as is well telegraphed each year by an apparently struggling health insurance sector, they increase annually and by an amount never matched by their customers in a wage increase of their own.
But I apparently have the cover for this kind of specialist, so off I went, to a surgery of such impeccable cleanliness and order that we could have given me a quick face lift while I was there.
My endodontist — I hesitate to write "my" given I've only known him for 25 minutes, but he's had his hands all up in my mouth, and I paid him for it, so we must have some kind of relationship — narrowed his eyes at me when I wondered how much I might get back from my fund for the service.
My endodontist — I hesitate to write "my" given I've only known him for 25 minutes, but he's had his hands all up in my mouth, and I paid him for it, so we must have some kind of relationship — narrowed his eyes at me when I wondered how much I might get back from my fund for the service.
He said, almost word for word, what any number of health care professionals and front of office staff have told me for decades: "If you took those monthly premiums and put them under your pillow instead of paying for insurance, you'd could pay for every service that you need and still have money left over."
I'd heard this exact suggestion so many times from the providers who were supposed to be working happily within a system that was balanced — if not equally, then in a teetering stability — between publicly funded health care and the private system. Health care professionals who were openly scornful of the benefits of a health insurance system so symbiotically entwined with the public sector that one would collapse without the other.
One medical assistant told me years ago she stopped her insurance, banked it all, and had money for a family holiday at the end of the year. Medicare looked after the rest.
My endodontist didn't have the set up for me to claim at his office ("Why should I do their work for them?") so it was only from the safe distance at home, where my horror was nowhere near his beleaguered staff, that I realised how I'd been duped.
We have had this insurance cover for more than four decades. In fact, I think I remember receiving some smarmy email about recognising our loyalty and providing us with a special members contact number, on which you wait 45 minutes instead of two hours. The amount of money we have paid this company is appalling. I could calculate it quite quickly in my head — but I won't. I can't say that number out loud.
This was the first time I had ever made a claim on this kind of service. I was surely going to get plenty back… that's how it works, right?
My first appointment with my new tooth man cost me $360, including a scan. My insurance cover included endodontics as "extras" so I opened the app, punched in the item numbers and uploaded the receipt. The screen dissolved to reveal my payout: want to guess?
$25.
There is no zero missing in the figure above.
Twenty-five bucks. I snorted. It was actually funny. What kind of dupe pays thousands of dollars a year in health insurance to a system in which I am most likely to be admitted and very well-cared for publicly if I have an emergency, but tosses me crumbs for all the other medical treatments I have been persuaded must be sought privately?
And what kind of publicly funded health care system still doesn't recognise dental work as foundational to good, general health?
When Medicare first kicked off, dental care was seen as nice-to-have rather than a must-have. It was tagged as preventive and, importantly, not regarded as essential medical treatment. This was a decision rooted deeply in the thinking of the 60s and early 70s — a time when dental health just wasn't on the universal healthcare map. That choice, made to rein in costs, still shapes what Medicare covers today.
Instead, it's left to an individual's ability to cover it with private insurance.
But health insurance is the game of mesmerists and casino operators: a confidence trick daring me to take on the odds of getting through life without the fear of waiting on a list for months to get that knee or hip replacement (median wait time of 265 days) or fix that annoying deviated septum of mine (365 days).
A great deal of experience in the public health system — all of it excellent every time — tempts me to walk away from the gaming table and put my trust in public health: I know the house always wins. I know the insurers aren't doing this altruistically. Yet the tax system will punish me if I drop my insurance, and the entire health architecture relies on a premium-funded private system to ensure that the public system is not overrun. I'm caught.
The dental work I now have to get done will be painful, deeply unsettling as only drills in one's mouth can be, and will be rebated in an amount that will allow me to top up my travel card. Maybe.
Not for the first time I confront the entrenched dilemma of our health care system: do I walk away from private insurance and trust that health challenges will have me seen promptly enough in the public system? Do I roll the dice?
This weekend you can form your own view about whether a controversial girly show of unnaturally thin women wearing undies and angel wings that chucks in a few "normal" sized ones can now be regarded as a vanguard of inclusivity. I have my views.
Have a safe and happy weekend and I hope this favourite song by Neneh Cherry works as much for you as it has for me during a week of intermittent pain and self-pity. Woe is me. |
