Comment by KGIII | Hacker News Reader

Comment by KGIII | Hacker News Reader

Parent Full thread

It absolutely shouldn't account for such a large discrepancy, but is the level of expertise the same? I would also expect that the US dentist has paid much more for their education.

Did the US dentist go to school longer? As I said, I'm sure they paid more. Is the US dentist more skilled at their job? Are the requirements to practice dentistry lower in India? Are the results better or worse in India?

You also mentioned the lower wealth in India. There is also a lower standard of living cost. Costs for products and services have long-since been decoupled from expenses and people charge what they think the market will bear.

Also, is there a greater supply of dentists? My understanding is that the AMA artificially limits the supply of medical doctors, but I'm not sure about dentistry. I also have no idea what it's like in India.

Given what little I know of the situation, I suspect I'd support the idea of Indian dentists making more money, not US dentists making less money. I believe teachers and medical professionals should be well paid. $150,000/year isn't that much. We have programmers who make larger salaries, and they don't even give me a free toothbrush.

Edit: Google tells me that the average salary in India is $616, so the average Indian dentist makes about 8.5x the average income. That's about $225,000 in the US.

>Did the US dentist go to school longer? As I said, I'm sure they paid more. Is the US dentist more skilled at their job? Are the requirements to practice dentistry lower in India? Are the results better or worse in India?

I assume the phrase "no amount of safety is enough" when it comes to health care is a false statement, it's an economic problem: Am I/is the population willing to pay 1000% (10x) more for say, 2% to 1% (2x) improvement chance in the person fucking up my teeth?

With that in mind, I wonder is going to school for a long time necessary? I think we have a return-on-investment curve (or time in school vs chance that the person fucks up) that plateaus at some point here. Maybe it plateaus where the Indian requirement is, and people in the US stay in school too long for very little returns.

I'd say that safety certainly has a price point where people will change their minds, even if they don't want to admit it.

That's fair but a major problem with US healthcare is that there isn't really many options around cost trade-offs. We have them in every other consumer industry - a loaded luxury car offers different trade-offs than a used subcompact. Why don't we have the same choices in health care?

My grandpa has cancer and is getting chemo, the chemo seems very expensive (at least 100x more expensive than the same molecules but without FDA certification in India). However, the hospital bills each intramuscular injection at $200. An intramuscular injection is the same injection as a flu shot. Now, why can I get a flu shot for $20 at walgreens but a hospital charges $200 to perform the same sort of shot with a different payload?

And why can't we trust people to do it themselves? Diabetics stick themselves with needles routinely with pretty basic training.

I wonder how much my health insurance would be if I could forego check ups, promise not to use insurance to cover on-patent medication, and DIY my healthcare as much as possible. And I'll keep wondering because apparently a lot of that would be illegal.

I believe the only realistic option is single payer. Elsewhere in the thread, I voiced my displeasure at using insurance for regular medical care. I think using insurance for regular care is silly. Doing so and complaining about the prices borders on insanity. It's like expecting your auto insurance to cover a tuneup.

>That's fair but a major problem with US healthcare is that there isn't really many options around cost trade-offs. We have them in every other consumer industry - a loaded luxury car offers different trade-offs than a used subcompact. Why don't we have the same choices in health care?

Plus, the bizarre system of "You can only change once per year and in specific windows or for a major life change".

> Am I/is the population willing to pay 1000% (10x) more for say, 2% to 1% (2x) improvement chance in the person fucking up my teeth?

As someone with permanent nerve damage from having my wisdom teeth removed that makes me look like a fucking stroke victim when I smile...yes, absolutely

Wow.

I've been advised by a dental surgeon to not take off my wisdom teeth because of this.

Did you receive warnings about it before surgery?

This is a tough one -- inferior alveolar nerve damage is the most common long-term complication in third molar extraction -- I advise about 1% of my patients against extraction based on the proximity of their lower molar roots to this nerve. However, there is great anatomic variation in the course of the IAN such that damage to it can occur even when pre-op radiographs show that there is little risk of hitting it. (Which is to say... SURPRISE, there's a nerve where you didn't expect it!) Sorry to hear it, OP, AND I hope you don't have permanent lingual paresthesia -- having a numb tongue is nearly impossible to acclimate to...

Wisdom tooth removal is no different from any other surgery, and as such you are likely to get the same "blah blah you could even die" speech. I did.

Sorry to hear.

We take a risk every time we do something. It doesn't mean that you'll absolutely be guaranteed by paying 10x more that you won't have a botched surgery, it's just less likely. Someone would say they are willing to pay 10x more for 2x less the chance, given they had an accident. The problem with that was I don't think the population will be happy adopting an 80 USD toll road and $25 per gallon for 2x less the chance of a car accident, even if that could be done. I think safety tradeoff is easier said than done.

Where did you have it done?

I ask because you did pay 10x more if you had that dentistry work done here in the US and the outcome is as you've described.

Yep, in the U.S. So I suppose the slightly lower risk didn't work out for me, but if I had to advise anyone else on the hypothetical decision, I'd say pay 10x more and get the slightly lower risk. It's not enough money to save given how shitty the consequences can be.

We know that going to school for a long time isn't necessary , for the most common procedures dontists do: filings and x-rays . We know that because a few western countries, with public healthcare,have dental assistant with a 1-year degree that do those things.

Reply on news.ycombinator.com