Monday, December 24, 2007

Reality Bites: or, Kentucky Bootleg

Not long ago, I had an emergency root canal, which was interesting in the sense that the tooth that had been throbbing sprouted from the lower jaw but the one that needed the procedure descended from the upper. The periodontist found this out through a few simple and ingenious tests involving the application of cold air to different teeth. I wonder if periodontists' kids perform this trick for their science classes. My father was a scientist, and I offered emulsification. (Hollandaise came much later).

So anyway, he was a very nice young man with a small office on the UES, and in the exam room were 3 framed photos of himself with 3 different patients (or at least that was the suggestion), arm on shoulder kind of thing. One was a woman I didn't recognize and one was a man I definitely did but now can't remember (was it Al Pacino?) because I was so involved in considering the idea that the man in the middle, Philip Seymour Hoffman, and I, had reclined in the same chair and spit blood and saliva into the same basin. I trust that Mr. Hoffman is receiving sufficient remuneration from his tremendous body of work (I'd see anything on the strength of his performance, and Laura Linney's too. The Savages is as good as it gets)not to have needed to avail himself of CareCredit on his way out of the office to the pharmacy to retrieve his vicodin reward. And what is CareCredit? 'CareCredit is a convenient, low minimum monthly payment program for your entire family specifically designed to pay or healthcare and elective treatment not covered by insurance"'. This might have been the perfect answer to the call to blepharoplasty my mirror has been submitting to my drooping, swollen, crepey lids, but an $1,800 root canal bill gets there first.

So on the way downtown the gold crown around which the periodontist has maneouvred falls out, leaving an interesting stump. So I'm back to the dentist in a few days, where for another $295 (thanks, CareCredit!) they install a 'temporary crown', because my insurance won't contemplate the sort of elective nonsense of a real crown for a year following initiation of coverage. So my plaster tooth crumbles at first floss and I'm wondering how much I paid for the fleeting play dough reassurance of tooth against tooth. My tongue finds comfort now in the gap between the stump of my back molar and its semi-detached neighbor that I understand will be next in line for reconstruction.

So CareCredit. CareCredit is great because it offers a limited time, no interest payment plan. I'm on track to pay off my bill well in advance of the deadline. But if something should happen and come spring I've got an outstanding balance, it looks like CareCredit could start assessing a hefty (22.98%) interest charge, which goes up to '28.99% for all accounts in default'. (I don't know what CareCredit considers default).

I'm also facing 2 real crowns, one to replace my temporary and one for the adjacent, as well as a strong recommendation for grafting in an area I've had unsuccessfully grafted twice before. My dentist will charge $2,000 per tooth for a crown, and my insurance, which won't cover such procedures until one year after enrollment (18 January) will cover only 50 per cent of what they assess as 'customary'. So I am looking at an additional $2,000-- at best-- out of pocket. (Forget grafting; I'll invest in saran wrap). My dental coverage is provided by AIG by the way. I have to say that Maurice Greenberg may have been the lucky one. Go Martin.

So anyway, I've been looking into getting the work done in another country, a 'developing' country, where there are more qualified medical professionals per capita (still trying to figure out the dental situation) than in most parts of the world. So far I'm getting a price that's 25 per cent less than I'd pay in NYC. If my insurance covers it, then I'd be paying a total of $500 versus $2,000 (or more) out of pocket for two crowns.

And maybe I could use some of the 'extra' money to help people in my own country who are still waiting for for 'development'.

“Not much has changed over the years here, really,” said Glen D. Anderson, who for two decades has made dentures in Corbin, Ky. He sells a pair of dentures for $400 that many dentists sell for more than $1,200. Like his brother, father and grandfather, he makes them without a license.

"Bootleggers exist here for a reason,” Mr. Anderson said. “People need teeth, but they can’t afford to go to dentists for dentures.” ....

...Dr. [Edwin D.] Smith [who paid $150,000 of his own money to set up a free mobile dental clinic] said, “the only choice a person with a severe infection has is to have the tooth pulled, even if she’s 25 years old and the tooth is right in the middle of her face.” He added that "the [Medicare] program does not pay for root canals or dentures, though it does help pay for a liquid diet for those without teeth."

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