Mr. & Mrs. America… You Are Being Ripped Off!

Check this out:  Obamacare pays for dental clinic for uninsured

taj mahalObamacare built a 6,000 sq. ft. clinic to house only 10 dental chairs in New Jersey (big surprise).  And, they’re PROUD of it.  That’s a CRAZY waste of space.  Ten chairs??   Six thousand square feet??   A private office that size (would be a very large group practice) would likely have (by my estimation) at 15 – 20 chairs.  If there are any dental office design experts reading this, feel free to correct me.  I might even be low.

And, then they also proudly tell us they spent $3.4 million dollars to build this 10-chair clinic!!  Holy shit!  Did they line the walls with gold leaf?  Who bid this contract??   Who got kick-backs?

Any dentist who has built an office (me included) will tell you that something is VERY amiss with the amount spent.  It comes to $566 / sq. ft.!!  Good gawd!  Again, someone correct me if I’m wrong, but that’s at least DOUBLE what it costs the rest of us to build a VERY nice office.

“The ERs are overflowing!”  Not.

From the article:  <<The law is trying to put the brakes on the skyrocketing cost of health care in part by changing the habits of consumers who visit expensive hospital emergency departments for maladies that aren’t emergencies.>>

That statement would be funny if it wasn’t such a provably blatant lie. 

Maybe this is the style of bathroom in the New Jersey $3.5MM dental clinic?

Maybe this is the style of bathroom in the New Jersey $3.4MM dental clinic?

The article is full of agenda-driven fallacies.  It implies that ERs are rife with “uninsured” dental emergencies and other non-emergency medical issues.  While I know that years ago, ERs were overwhelmed with head colds and broken pinky-toes, that seems to have changed.  I live in a fairly metropolitan area.  Today, the hospital ERs have roadside billboards advertising their services along with a real-time digital display of their current wait time in minutes (almost always single-digits).  They are hurting for business!  There are plenty of “urgent care” walk-in clinics around to take the non-emergency load off the ER departments.

hospital chairs


A few months ago, I went to the ER for severe abdominal pain.  My wait time:  ZERO minutes.   My individual experience means nothing.  But, I submit the billboards are indicative of the current situation which contradicts the claims of this article and those with an agenda of a government takeover of healthcare.

From the article:  <<“The dental need is so great,” said Marta Silverberg, chief executive officer of Monmouth Family Health Center, a health care organization that serves low-income residents and operates the dental clinic. It has about 13,000 visits a year.>>

Golly… 13,000 visits per year sounds like a lot to the typical layperson.  But, divide that over 250 work days per year (allowing for 2 weeks vacation) and 10 chairs, it comes to 5.2 patients per chair per day.   That’s a pretty slow day for any dentist.  So, taxpayers are footing the bill for a very expensive office full of very expensive employees doing very little.

Hospital Emergency RoomFrom the article:  <<In New Jersey, 32,000 patients a year go to hospital emergency departments for dental problems not caused by trauma, something which costs taxpayers and insurance policyholders $8.5 million, a Rutgers report found.>>

Hmmm….  On the surface, that sounds crazy, eh?  But, it comes to $266 per visit.  That’s actually not bad.  I’d bet the cost per patient visit at the new Obamacare dental clinic will be higher than that.  A lot higher.

“Free” dental treatment!  Hooray!

So, our benevolent leaders are using taxpayer money to provide some VERY expensive treatment to these “non-insured” and “under-served” patients.  I submit it would be a more cost-efficient use of tax revenue to give vouchers to these patients that could be used to pay private care dentists (like myself) their FULL FEE for their care.  It would cost LESS.  And, it would be, no doubt, higher quality care.

The more “free” something reportedly is, the more expensive it really is, especially if the government is involved.

OK…  Chime in below!

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17 Responses to Mr. & Mrs. America… You Are Being Ripped Off!

  1. This does seem to be excessive for just a handful of chairs. It leads me to wonder what the end game strategy is here. Perhaps they are running a test case and plan larger expansion while holding onto the space down the road if it proves ‘successful’. Or perhaps they expect the clinic to be stuffed to the gills, so they want only the 10 chairs, and have a huge waiting room.

    Doesn’t make much sense to me, as FFS dentistry provides better outcomes and results in almost all cases except the MOST basic services. Now, I’ll definitely be annoyed if they start offering free ‘cosmetic’ work…

    • The Dental Warrior says:

      Even if they plan to “expand,” the cost to build the clinic is crazy-high.

      Thanks for visiting my blog and your comments!

      • ram deshmukh says:

        Why the picture of the Taj Mahal? What does that have to do with the construction of the dental clinic?

        • The Dental Warrior says:

          Hi Ram,

          Here in the U.S., “Taj Mahal” is a euphemism for an overly-ostentatious building. In other words, a building that is very fancy and very expensive.

          • ram deshmukh says:

            Ok.. i had a feeling that was the case. There would be more meaning if you put up the Kremlin. It would represent big government, socialism and big control. The taj mahal is a converted Hindu temple. It is now a supposed burial chamber for one of the Mughal elite. It used to be Tejo Mahalaya, a Hindu temple before it was converted by the Mughals. It’s representation is completely different with Indians. Thank you.

  2. jason says:

    we built a 12 op “high end” practice in 5000 sq ft for under a million dollars. Its a fee for service practice.

    I built a medicaid practice right next door. It has 5 ops in 1500 sq ft for 100K.

    Its easy to watch expenses when its your own money. When its the tax payers money, no one (government) cares.

  3. Dr. Doug Johnson says:

    1. Obamacare does not build anything. It is a law, not a government agency or organization.

    2. “They are proud of it”…with respect to Obamacare, there is no “they”. If anyone is proud of it, it is the owners of Monmouth Family Health Center, which appears to be privately owned.

    3. The Affordable Care Act does not contain provisions for building any government-owned dental facilities. It does offer increased grant opportunities for general, pediatric and public health dentists, yourself included. The article implies that the entire project was funded by such a grant; the reality may be that the grant only covered a portion of the total expense of moving the clinic to less cramped quarters.

    • The Dental Warrior says:

      From the article (did you read it?):

      Money for the expansion comes from a grant through the Affordable Care Act.

      Was the article incorrect (certainly possible)? If so, where did the money come from?

  4. sue rockwell says:

    That is all just for show. They can say look what we do for the poor.

    We sure don’t have anything like that in Florida. If you are poor where I live, and have a dental emergency all you can get is an extraction via a “lottery selection” and pay 148 bucks for it–at the University of Florida. I kid you not, it is right there on the website:

    What few other resources there are that I have been able to find, also only do extractions. Otherwise it is full price at a private practice.

    The entire insurance system is wasteful. The government system is designed for people to work at justifying their jobs.

  5. Dr. Ryan says:

    Monmouth is a FQHC (Federally Qualified Health Center). I worked at one in a small town for five years. They charge based on income. It is a non-profit, not privately owned. With the grant, likely what happened was the government gave $3.4mil, and the FQHC had to spend it on dental. Then when they planned it, the CEO and COO/building manager who aren’t dental people, hired out their good buddies at their favorite architecture firm who have never designed a dental clinic, to design and build it. At least this was my experience. And BTW if you go check out their website, their executive director is not an MD nor their dental director a dentist.

    • The Dental Warrior says:

      And BTW if you go check out their website, their executive director is not an MD nor their dental director a dentist.

      Gee…. what a surprise! 🙁

  6. Dennis says:

    Interesting article. I know it is anecdotal, but the ER I work in continues to have increasing numbers of patients and long wait times.

    What I’m more interested in though is your take on Dentistry and the ACA. I used to think it was smarter to go into dentistry over medicine. The Feds have basically regulated medical doctor’s pay for years and imposed tons and tons of regulatory burdens. On the other hand, it seemed to me that they had pretty much left dental doctors alone for the most part (perhaps debatable).

    However, it appears that the ACA is requiring pediatric dental coverage. Do you see that as a foot in the door for more burdensome regulation of the dental industry and the doctor’s who practice dentristy?

    • The Dental Warrior says:

      Hi Dennis,

      Thanks for visiting my blog and posting a comment.

      The ACA pediatric dentistry provision is a joke… a cruel joke on the public. My understanding is that the pediatric part of the plans tie into the MEDICAL DEDUCTIBLE. So, policy holders have to satisfy their medical deductible, often thousands of dollars, before any coverage kicks in. That means they effectively get no pediatric dental benefits… but, they PAY the premiums.

      The reality is that dental care is not “insurable” like medical care. Actuarial tables cannot be applied to dental care like they can be in medical care, hurricanes, floods, earthquakes, etc. That’s why dental “insurance” is not insurance. It’s a prepaid dental BENEFIT. It’s a gift card from a control freak, as my friend, Dr. Alan Mead calls it. The typical dental benefit plan maxes out at $1000 per year, which is the same max benefit that they offered in the mid 1960s. The benefits have not changed AT ALL for 50 years.

      I’m not particularly concerned about socialized dentistry. However, if the day ever comes that I’m forced to participate in any sort of entitlement or government program… It will be the day I walk away… literally walk away. I will not do it. Period.

  7. Dennis says:

    Hello Dental Warrior,

    I appreciate your take and certainly you’d know better than me about this subject. Having said that, there are a lot of studies that link poor dental hygiene to heart disease. If the current political thinking is that health care is a right, then couldn’t you imagine someone in D.C. saying that dental care should be a right as well? It doesn’t seem like that big of a stretch to me.

    After all, it seems clear that poor dental health has medical consequences.

    I’m certainly not advocating for socialized dentistry, but I do wonder if it is inevitable. I don’t see a lot of worry from Dentists I know, but I can’t help but wonder just how safe you guys/gals really are. Once those third parties insert themselves between you and your patient it seems like there is no going back.

    Medical doctors have very little control. Will that become the fate of Dentists?

    I certainly can appreciate your stance on walking away. However, I wonder how many doctors whether in dentistry or medicine can take out $175K – $300K in student loans, buy a house, purchase a practice, service and buy new equipment, raise a family and still afford to walk away from it when and if it all goes south.

    Thank you for your insights, it is a fascinating topic.

    • The Dental Warrior says:

      Hi Dennis,

      I’m aware of the correlation of dental disease to systemic medical disease. But, causation has not been proven. If anything happens, I expect it will be a two-tiered system. That’s what has happened in the UK. They’ve had socialized dentistry for a long time. And, the results are… well… a reputation for being a nation of toothless grins. Subjects in England find it VERY difficult to get their “free” dentistry now. And, what they get is arguably of the lowest level of dental care. Meanwhile, private care dentistry is growing in the UK.

      If I am forced to participate, I will walk. Most new dental graduates today (AVERAGING $300,000 in educational debt) will not likely ever buy a practice. They can’t. The money isn’t available. Banks won’t make the loans to them. They’re already in too deep. And, people walk away from loans quite frequently. And, currently, I believe there are government programs in place whereas they can reduce their payments to a small percentage of their income, and after so many years, whatever is left (debt) is forgiven. Crazy.

      Medical doctors have very little control, because they GAVE UP control. You guys jumped into insurance with both feet. Then, as third parties took over, consumers gave up control, too. Costs spiraled upwards, naturally. When the consumer no longer cares about the cost, they can’t be surprised when the costs skyrocket. So, the government felt it HAD to step in. When a patient gets charged $100 / bag of saline (ask me how I know)… that’s out of control.

      For that matter, there was a survey of physicians a while back that showed 40%-ish of them planned to get out of medicine or retire early if / when the government takes over.

      My own brother is a newly-minted neurosurgeon (finished residency a year ago and 1-year fellowship just this summer) and has just started his new job. His contract is 3 years. He got in “just under the wire.” He expects his compensation offer to PLUMMET at contract renewal due to Obamacare. And, if that happens, he’s OUT. Yep… after 16 years of training, he’ll quit after just 3 years of working. He’s brilliant, and he loves his work. But, he won’t do it for arbitrarily and extremely low compensation.

      If the government takes over, I see is as not being able to afford to STAY in it. I didn’t sacrifice and work to get to this point to just become a government employee.

      Good conversation.

  8. James says:

    The full extent to which this law will continue to impact dentists (as well as other medical professionals) is yet to be seen. Makes it hard to know how to do business on a day by day basis.

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