'How Are You Paying For This?'

The Best of Andy Rooney

(This classic Andy Rooney column was originally published Jan. 6, 1985.)

First, I'll give you some idea of what kind of dentist I have. The last time I went to him he had to remove the old work another dentist had done to get at some decay under it.

"Boy," he said enthusiastically, as he worked away, "you've had some very good dental work done in the past. Whoever did this did a nice job."

How many professional people do you know, in any field, who compliment the work done by anyone else?

It had been at least five years since I'd been to see my dentist. I'm one of those who doesn't go until it hurts, at which point, of course, it's often too late. Many years ago, I'd had a tooth removed toward the back on the left side. A bridge had been fixed to the teeth on either side of the hole and it was so strong and comfortable that I'd forgotten I ever lost the original tooth.

On my first trip, my dentist took X-rays.

"You may have to have root canal work," he said, as he looked at the pictures.

I winced.

He got out his drill, stretched my mouth out of shape and started to clean out the bad stuff. Finally he stopped, inspected the crater he'd dug and said, "You may be lucky. It didn't go down as far as I thought."

He put in a temporary filling and sent me off with a numb mouth and the warning not to bite myself while the Novocain was still working.

Toward the end of the second visit, he was in my mouth with his jackhammer when he said, casually, "How are you paying for this?"

He has a naive, open way about him, and obviously this is standard practice for him. He doesn't just send you a bill when he's finished; he talks to you about it. Medical and dental schools must have classes that address this problem now.

No matter how they do it, I'm always a little put off when doctors mention money. I have such high regard for people in the medical profession that I think of them as being more concerned with my health than their fee.

"The company has a dental insurance plan," I said, trying to speak clearly with the vacuum tube in my mouth. "Do I pay you or do they?"

"Why don't you give me a check," he said, "and they'll pay you."

Sure they will, I thought to myself.

On the third visit, I brought him a check for $1,000, which he estimated would be about half the bill. I forgot to bring the insurance form for him to fill out.

During the periods when his hands or his machinery weren't in my mouth, I talked to him about dentistry and money. I don't think he's getting rich.

"The money's in things like this bridge I'm making for you," he said, true to form. "I see a lot of patients who only have their teeth cleaned. There's no money in that."

On my fourth visit, I brought the insurance form. He said he'd fill it out and mail it. The total bill was $1,972.

Because of Christmas and the time it took the laboratory to make the new bridge, I didn't have another appointment for 10 days.

On about the sixth day, I came home and, much to my surprise and pleasure, found a check from the insurance company. I hadn't even paid the dentist for everything yet and I was getting a check from the dental plan. The bad news was, they were allowing me only $945 of my $1,972 bill. The remaining $1,027 was on me.

It's difficult to put anyone's income in perspective in relation to our own. We expect raises ourselves, but are invariably surprised to find anybody else getting them. This skilled professional saw me a total of six times and did a good, important job for me. I do have the feeling, though, that it must be easier for a doctor or a dentist to charge double knowing someone other than the patient is going to pay half the bill.

Health insurance has probably done more for doctors than for patients. I'm not complaining, just stating a fact.

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