It's funny because when I moved to Alberta, I saw a massive reduction in my car insurance rates. I payed about half as much in Alberta. However, I now pay double in dental fees. 
http://calgaryherald.com/news/local-news/pain-of-dental-fees-mounts-for-albertans
A visit to the dentist in Alberta may end the discomfort of a toothache, but a Herald investigation shows that appointment is likely to cause more financial pain than just about anywhere else in the country.
As patients in the only province without a suggested fee guide, industry experts say Albertans may be oblivious to the fact that fast-rising charges mean they are paying significantly more than most other Canadians for care.
With little or no advertising of dental fees, consumer advocates believe the public is also unaware that the prices levied by dentists within the province often range widely.
An internal survey conducted by the province’s dental association and college each year reveals how much more Alberta patients commonly pay.
For example, the median price of $77 for an annual recall exam in Alberta in 2014 was more than two times the suggested fee in any of the other three western provinces.
View Checkup Prices in Alberta in a full screen map
Even the survey’s average charge of $47 for a pair of bitewing X-rays is nearly double the guide price in Manitoba, Saskatchewan and B.C. and over 40 per cent higher than the suggested rate at an Ontario dentist.
While Albertans with insurance may find they are now digging deeper in their own pockets as fees have surged and plan coverages have not kept pace, an oral health advocate estimates “tens of thousands” of the province’s working poor are now forgoing essential dental care.
Dental hygienist Denise Kokaram, who works with The Alex’s dental health bus providing care to Calgary’s vulnerable youth, said over half the children her team sees have untreated tooth cavities.
“They have almost full mouth decay in some cases and they’re in terrible pain, but parents are just forced to wait for the teeth to fall out because they can’t afford the $2,000 it will cost to have them filled,” Kokaram said.
“They’re stuck in the middle by not being poor enough to qualify for government health benefits, but with family budgets that are so tight they can’t even afford preventive care.”
The Alberta Dental Association and College, which both lobbies for and regulates the province’s $1.5-billion industry, stopped publishing a suggested fee guide in 1997 in the face of criticism the listing was actually working as a schedule of floor prices that discouraged competition among practitioners.
The move also occurred amid a battle with Alberta Blue Cross over its effort to control the growth in dental costs by negotiating lower charges with designated dentists for its plan members in return for higher patient volumes, plus complaints by large employers that dental fees in the province had skyrocketed.
In the 16 years after a suggested fee guide was abandoned and competition among the province’s dentists was supposed to flourish, the association’s internal survey of members shows the fees levied on patients continued to increase at twice the rate of general inflation in Alberta.
The 93 per cent hike in prices during from 1997 through 2013 also outpaced the 64 per cent rise in dental care costs that Statistics Canada says occurred countrywide during the same period.
RELATED
Meet Alberta's least expensive dentist
Many working poor struggle to pay Alberta's dental fees
Numbers compiled by a Toronto-based human resources adviser show dental prices in Alberta have surged over 25 per cent in the last five years alone, nearly twice as fast as its national index of fees.
When dental plan use was factored in with fee hikes, Buck Consultants warned companies last year that “Alberta stands out as having high expected cost increases, exceeding nine per cent.”
Indeed, even a 2013 internal study for the Alberta dental association, while noting that fees for fillings here were often similar to those in other jurisdictions, found that historically “Alberta dentists have charged higher average fees than dentists in other provinces, and it appears from the recent … surveys that this is still the case.”
Officials with the association declined to be interviewed for this story, but in a written response from its legal counsel the association blamed the rapid rise in fees on larger overheads in dental practices due to the province’s strict infection prevention rules and higher staff salaries.
While the supply of dental hygienists in Alberta actually outpaced population growth between 2000 and 2009, Fred Kozak cited a more recent federal report that showed the median wage in the province for these professionals, who traditionally work alongside dentists, was still 47 per cent higher than the national average.
The same 2012 report also showed dental assistants in Alberta made nearly a third more than the Canadian median rate.
Still, recent listings of dental practices for sale suggest the profession can be quite lucrative.
For example, an established office in Calgary with two dentists and approximately 2,500 patients had gross revenues of nearly $2.2 million a year or about $875 in billings for each active file.
The cash flow of $1.5 million after expenses amounted to an “exceptional” 69 per cent of revenues and placed the unidentified facility in the “top 5 per cent” of general dental practices, according to the ROI Corporation listing.
Another city dentist selling his 16-year-old office through Practice Solutions Inc. had gross revenues last year of nearly $970,000 from about 1,075 active files or about $900 in annual billings per patient.
The listing noted that had yielded a “good” profit margin of 46 per cent or $450,000 after expenses, but before debt service, for working 32 hours a week.
Alan Kaluta, president of Practice Solutions, said Calgary is by far the “most profitable area” to practise in Canada because it is not as oversupplied with dentists as “more competitive” markets like Toronto and Vancouver with “different fee guides.”
Kaluta said the city also has an affluent population that is able and willing to spend money on their mouths, including cosmetic procedures.
“There’s a lot of insurance money, there’s a lot of money floating around,” he said.
“You have your sales staff and executives all walking around with the pearly white teeth.”
Ken Fraser, a Toronto-based consultant who tracks dental costs for health insurers, said he’s watched fees surge in Alberta in recent years such that the average claim paid is now 15 per cent higher than in Ontario and 30 per cent higher than in B.C.
“It may be in part because overhead and staff costs are higher, but I think it’s also fundamentally about a lack of competition and price transparency,” Fraser said.
“Raise your prices in Cape Breton and people will stop coming, but in a buoyant economy there isn’t a lot of pushback and I think people in Alberta have gotten accustomed over the years to shelling out for what insurance won’t cover.”
Claims data provided to the Herald by a major insurer shows fees also vary widely within Alberta.
For example, an annual checkup, including a dental exam and one unit each of scaling and polishing, averages out to about $202 across the province, but can cost as little as $119 in Edmonton and up to $394 in Fort McMurray.
Within Calgary, the price for the same checkup varies from as little as $151 in the city’s northeast to over $265 at a downtown office.
Even among Albertans with generous plans that aim to provide “100 per cent reimbursement,” comparisons between price lists developed and updated each year by major insurers such as Sun Life Assurance and Manulife Financial and the dental association survey show fully half of those people will still need to dig into their own wallets to cover at least some of the cost of their annual appointment with the dentist.
“I’ve seen lots of people who are paying into dental plans at work, but who don’t use them because they can’t afford the out of pocket charges because dental costs are so high,” Kokaram said. “It’s so sad that proper care is unaffordable to so many.”
Prices for endodontic procedures in the province are literally all over the map.
For example, while the dental association’s 2014 survey shows the median charge for a root canal with three roots is about $1,140, claims data obtained from Sun Life shows patients have been billed as little as $300 in Edmonton and nearly $1,700 in Calgary last year for that work.
Richard Plain, an Edmonton-based health economist and a former board member of the Consumers’ Association of Canada’s provincial wing, said price variations of over 500 per cent for the same procedure are a sure sign the dental market in Alberta has decayed.
“There ought to be a requirement that the association’s survey of prices be made public and dentists should be required to provide basic information online about their fees for common procedures,” Plain said.
“We may want to trust in the invisible hand of competition, but that only works if consumers have comparative information on pricing before they’re in the dentist’s chair with their mouth open.”
Nova Scotia’s dental association makes an abbreviated version of its suggested fee guide available on its website to help “curious” consumers with fee questions, but Kozak said the Alberta association won’t be making its annual review of prices for about 30 of the most common procedures in Alberta available to the public.
“The annual survey of fees has always been information gathered from members on the understanding that it will not be available to the public,” he said. “The survey of fees would generally not inform an individual of the cost for specific services they may be receiving.”
Faced with mounting concerns from customers in Alberta about rising fees and larger out of pocket payments for care, Sun Life started offering an online tool two years ago that uses the company’s own claims data to show the maximum and minimum charges levied by dentists in different postal codes around the province.
Wayne Millar, the insurer’s associate vice-president of product development, said the fee finder attracts thousands of views each year.
“Many of the employers have indicated they are aware that dental fees for commonly performed services are generally higher in Alberta … and the range of fees for the same service really vary from dentist to dentist within the province,” Millar said.
“We wanted to harness our data to empower employees of our plan members to make an informed decision.”
The federal Competition Bureau, which had launched a study of dentistry in 2008 after expressing “unease” about whether suggested fee schedules were facilitating price collusion, is now expecting to release another review early this year that looks at the profession’s “restrictions on advertising.”
“The bureau will continue to advocate for increased competition to regulators, policy-makers and stakeholders,” said commissioner of competition John Pecman, “and will do so in areas where the impact is greatest to Canadians.”
The Alberta dental association says individual dentists are free to promote their fees, so long as the advertising is only intended as “information for the public,” contains “objectively verifiable statements” and doesn’t “tend to harm the dignity and honour of the profession.”
But a Herald search of dental websites was only able to find one practice in Calgary that listed the rates it charged patients.
Plain said the province should legislate the health professions that it oversees to freely provide price information to prospective patients.
“There’s a reluctance among these professionals to have any price competition,” he said.
“We have Gasbuddy.com, but I think we may also need to have a Toothbuddy.com.”
mmcclure@calgaryherald.com
http://calgaryherald.com/news/local-news/pain-of-dental-fees-mounts-for-albertans
A visit to the dentist in Alberta may end the discomfort of a toothache, but a Herald investigation shows that appointment is likely to cause more financial pain than just about anywhere else in the country.
As patients in the only province without a suggested fee guide, industry experts say Albertans may be oblivious to the fact that fast-rising charges mean they are paying significantly more than most other Canadians for care.
With little or no advertising of dental fees, consumer advocates believe the public is also unaware that the prices levied by dentists within the province often range widely.
An internal survey conducted by the province’s dental association and college each year reveals how much more Alberta patients commonly pay.
For example, the median price of $77 for an annual recall exam in Alberta in 2014 was more than two times the suggested fee in any of the other three western provinces.
View Checkup Prices in Alberta in a full screen map
Even the survey’s average charge of $47 for a pair of bitewing X-rays is nearly double the guide price in Manitoba, Saskatchewan and B.C. and over 40 per cent higher than the suggested rate at an Ontario dentist.
While Albertans with insurance may find they are now digging deeper in their own pockets as fees have surged and plan coverages have not kept pace, an oral health advocate estimates “tens of thousands” of the province’s working poor are now forgoing essential dental care.
Dental hygienist Denise Kokaram, who works with The Alex’s dental health bus providing care to Calgary’s vulnerable youth, said over half the children her team sees have untreated tooth cavities.
“They have almost full mouth decay in some cases and they’re in terrible pain, but parents are just forced to wait for the teeth to fall out because they can’t afford the $2,000 it will cost to have them filled,” Kokaram said.
“They’re stuck in the middle by not being poor enough to qualify for government health benefits, but with family budgets that are so tight they can’t even afford preventive care.”
The Alberta Dental Association and College, which both lobbies for and regulates the province’s $1.5-billion industry, stopped publishing a suggested fee guide in 1997 in the face of criticism the listing was actually working as a schedule of floor prices that discouraged competition among practitioners.
The move also occurred amid a battle with Alberta Blue Cross over its effort to control the growth in dental costs by negotiating lower charges with designated dentists for its plan members in return for higher patient volumes, plus complaints by large employers that dental fees in the province had skyrocketed.
In the 16 years after a suggested fee guide was abandoned and competition among the province’s dentists was supposed to flourish, the association’s internal survey of members shows the fees levied on patients continued to increase at twice the rate of general inflation in Alberta.
The 93 per cent hike in prices during from 1997 through 2013 also outpaced the 64 per cent rise in dental care costs that Statistics Canada says occurred countrywide during the same period.
RELATED
Meet Alberta's least expensive dentist
Many working poor struggle to pay Alberta's dental fees
Numbers compiled by a Toronto-based human resources adviser show dental prices in Alberta have surged over 25 per cent in the last five years alone, nearly twice as fast as its national index of fees.
When dental plan use was factored in with fee hikes, Buck Consultants warned companies last year that “Alberta stands out as having high expected cost increases, exceeding nine per cent.”
Indeed, even a 2013 internal study for the Alberta dental association, while noting that fees for fillings here were often similar to those in other jurisdictions, found that historically “Alberta dentists have charged higher average fees than dentists in other provinces, and it appears from the recent … surveys that this is still the case.”
Officials with the association declined to be interviewed for this story, but in a written response from its legal counsel the association blamed the rapid rise in fees on larger overheads in dental practices due to the province’s strict infection prevention rules and higher staff salaries.
While the supply of dental hygienists in Alberta actually outpaced population growth between 2000 and 2009, Fred Kozak cited a more recent federal report that showed the median wage in the province for these professionals, who traditionally work alongside dentists, was still 47 per cent higher than the national average.
The same 2012 report also showed dental assistants in Alberta made nearly a third more than the Canadian median rate.
Still, recent listings of dental practices for sale suggest the profession can be quite lucrative.
For example, an established office in Calgary with two dentists and approximately 2,500 patients had gross revenues of nearly $2.2 million a year or about $875 in billings for each active file.
The cash flow of $1.5 million after expenses amounted to an “exceptional” 69 per cent of revenues and placed the unidentified facility in the “top 5 per cent” of general dental practices, according to the ROI Corporation listing.
Another city dentist selling his 16-year-old office through Practice Solutions Inc. had gross revenues last year of nearly $970,000 from about 1,075 active files or about $900 in annual billings per patient.
The listing noted that had yielded a “good” profit margin of 46 per cent or $450,000 after expenses, but before debt service, for working 32 hours a week.
Alan Kaluta, president of Practice Solutions, said Calgary is by far the “most profitable area” to practise in Canada because it is not as oversupplied with dentists as “more competitive” markets like Toronto and Vancouver with “different fee guides.”
Kaluta said the city also has an affluent population that is able and willing to spend money on their mouths, including cosmetic procedures.
“There’s a lot of insurance money, there’s a lot of money floating around,” he said.
“You have your sales staff and executives all walking around with the pearly white teeth.”
Ken Fraser, a Toronto-based consultant who tracks dental costs for health insurers, said he’s watched fees surge in Alberta in recent years such that the average claim paid is now 15 per cent higher than in Ontario and 30 per cent higher than in B.C.
“It may be in part because overhead and staff costs are higher, but I think it’s also fundamentally about a lack of competition and price transparency,” Fraser said.
“Raise your prices in Cape Breton and people will stop coming, but in a buoyant economy there isn’t a lot of pushback and I think people in Alberta have gotten accustomed over the years to shelling out for what insurance won’t cover.”
Claims data provided to the Herald by a major insurer shows fees also vary widely within Alberta.
For example, an annual checkup, including a dental exam and one unit each of scaling and polishing, averages out to about $202 across the province, but can cost as little as $119 in Edmonton and up to $394 in Fort McMurray.
Within Calgary, the price for the same checkup varies from as little as $151 in the city’s northeast to over $265 at a downtown office.
Even among Albertans with generous plans that aim to provide “100 per cent reimbursement,” comparisons between price lists developed and updated each year by major insurers such as Sun Life Assurance and Manulife Financial and the dental association survey show fully half of those people will still need to dig into their own wallets to cover at least some of the cost of their annual appointment with the dentist.
“I’ve seen lots of people who are paying into dental plans at work, but who don’t use them because they can’t afford the out of pocket charges because dental costs are so high,” Kokaram said. “It’s so sad that proper care is unaffordable to so many.”
Prices for endodontic procedures in the province are literally all over the map.
For example, while the dental association’s 2014 survey shows the median charge for a root canal with three roots is about $1,140, claims data obtained from Sun Life shows patients have been billed as little as $300 in Edmonton and nearly $1,700 in Calgary last year for that work.
Richard Plain, an Edmonton-based health economist and a former board member of the Consumers’ Association of Canada’s provincial wing, said price variations of over 500 per cent for the same procedure are a sure sign the dental market in Alberta has decayed.
“There ought to be a requirement that the association’s survey of prices be made public and dentists should be required to provide basic information online about their fees for common procedures,” Plain said.
“We may want to trust in the invisible hand of competition, but that only works if consumers have comparative information on pricing before they’re in the dentist’s chair with their mouth open.”
Nova Scotia’s dental association makes an abbreviated version of its suggested fee guide available on its website to help “curious” consumers with fee questions, but Kozak said the Alberta association won’t be making its annual review of prices for about 30 of the most common procedures in Alberta available to the public.
“The annual survey of fees has always been information gathered from members on the understanding that it will not be available to the public,” he said. “The survey of fees would generally not inform an individual of the cost for specific services they may be receiving.”
Faced with mounting concerns from customers in Alberta about rising fees and larger out of pocket payments for care, Sun Life started offering an online tool two years ago that uses the company’s own claims data to show the maximum and minimum charges levied by dentists in different postal codes around the province.
Wayne Millar, the insurer’s associate vice-president of product development, said the fee finder attracts thousands of views each year.
“Many of the employers have indicated they are aware that dental fees for commonly performed services are generally higher in Alberta … and the range of fees for the same service really vary from dentist to dentist within the province,” Millar said.
“We wanted to harness our data to empower employees of our plan members to make an informed decision.”
The federal Competition Bureau, which had launched a study of dentistry in 2008 after expressing “unease” about whether suggested fee schedules were facilitating price collusion, is now expecting to release another review early this year that looks at the profession’s “restrictions on advertising.”
“The bureau will continue to advocate for increased competition to regulators, policy-makers and stakeholders,” said commissioner of competition John Pecman, “and will do so in areas where the impact is greatest to Canadians.”
The Alberta dental association says individual dentists are free to promote their fees, so long as the advertising is only intended as “information for the public,” contains “objectively verifiable statements” and doesn’t “tend to harm the dignity and honour of the profession.”
But a Herald search of dental websites was only able to find one practice in Calgary that listed the rates it charged patients.
Plain said the province should legislate the health professions that it oversees to freely provide price information to prospective patients.
“There’s a reluctance among these professionals to have any price competition,” he said.
“We have Gasbuddy.com, but I think we may also need to have a Toothbuddy.com.”
mmcclure@calgaryherald.com
