A few days ago, I attended a seminar conducted by the Economics Society of Singapore on the “Contentious issues in Healthcare”. Naturally, rising healthcare cost is a hot topic. Economists look at big picture numbers such as GDP often treat the delivery of healthcare as a single entity, encompassing public and private healthcare. Journalists often highlight the high fees charged by private clinics to exaggerate the rising cost. To be sure, cost is rising but it is cost more by factors other than doctors’ professional fees. So where is the money going to? Let’s use implant dentistry as a model.
The cost of replacing a tooth with a dental implanthas actually dropped significantly over the last twenty years. This is a result of having more dental implant brands available in Singapore and more dentists providing that service. The increased competition has the effect of controlling rising prices. However, this is only possible because of advances in research that has simplified the treatment protocol such that dentists who follow these protocols are able to achieve a high level of success. That in turn generates more confidence amongst patients which results in greater demand.
Today, if you have a missing tooth and the jaw bone is in an ideal condition to receive an implant, the treatment cost is definitely much lower than twenty years ago. However, advances in understanding of dental implantology has also resulted in ever expanding indications. Situations that were deemed unsuitable for dental implant treatment twenty years ago are now routinely treated. This is made possible through advances in tissue engineering to reconstruct lost bone structure to support the implants.
Patients’ expectations has also risen significantly over time. Twenty years ago, patients were happy to have a functional prosthetic replacement for their missing teeth. Today, patients take function for granted and expect a highly aesthetic prosthesis that looks like natural teeth.
If an economist were to look at the total expenditure on dental implants today compared with twenty years ago, the numbers would be staggering. However, it is not an indication of rising cost in per se but rather rising consumption by the public. To an individual patient, it is precisely because of such widespread adoption of dental implants that he can actually pay less for it, provided he is content with the standards of twenty years ago, which is not too bad to start with.
Cost of dental implant treatment has not risen in proportion to the rise in overheads such as rental and staff salaries. This would not have been possible if there was restriction to the use of dental implants in Singapore. Without a widespread acceptance by patients and dentists, cost would remain high and it would have remained a luxury treatment only for the rich.