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Comment by cdjk | Hacker News Reader

What I think is really interesting is that my experiences with dental insurance are entirely different. I've gone to the dentist, found I have two cavities, and when I schedule my next appointment on the way out I'm given a detailed treatment plan that includes prices. It even includes details about how some fillings are more expensive because the insurance only covers amalgam fillings in the back but the dentist only uses composite fillings (for example). And it only takes a couple minutes to figure out the prices, and more importantly exactly what the insurance will cover.

I realize that the set of things a dentist deals with is probably smaller than what a doctor does, but it seems like it's a much better model for insurance.

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I think this is partly because dental insurance bears little resemblance to comprehensive medical insurance. In fact, for most people with a generally healthy dental history, it's often not worth paying for dental insurance, since it ends up simply being a pre-payment for services. Expensive procedures & oral surgery are often covered for only 50% of the final cost.

In the US at least, I think dental "insurance" is really just a simplified way for employers to offer an appealing benefit to employees.

I agree in part, but the workflow of "this is what's wrong with you, this is what we charge, this is what insurance pays, and this is what you pay" seems exactly the same, even if what's covered and the reimbursement rates are very different.

My main point is that I've never been to a doctor where I've had to schedule a followup appointment and been presented with a itemized invoice (and the dentist's office can usually prepare it in under 5 minutes).

What's always surprised me is how cheap ophthalmic surgery is. I don't think opthalmic surgeons are exactly slumming it, but the cost of say getting a cataract removed is under $4k per eye with no insurance.

That is interesting. I know the prices for things like LASIK are completely transparent, but that's because insurance isn't involved. I'd assume that insurance generally does cover cataract surgery, however.

Some of the reasons might be that the procedure is fairly quick, the eye is easy to get to, it doesn't require general anesthesia, and doesn't require a full OR in a hospital (I think - correct me if I'm wrong). In that sense its closer to oral surgery than a gall bladder removal, for example.

I wonder if there are a combination of factors at work here. Elderly target market + (mostly) elective procedure + low Medicare payments perhaps?

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