Note: The events of this story are real, but the names have been changed.
This is the third installment of a three-part series, in which I illustrate why half of all Americans live near the poverty line by using my life as a case study.
Case in point, medical bills are the most common cause of bankruptcy in America. In 2016 I became part of that statistic, and having gone through the process, I shudder to think how normal it is. Nobody should have to go through what I did, because getting health care in America is as frustrating and overpriced as buying real estate.
I started learning this four months ago. One morning, as I was brushing my teeth, I looked in the mirror and noticed a white pustule on my gums. At first I thought I had cancer. After suffering an existential crisis, I collected myself and recalled that I’d had two root canals done on one of my bottom, front teeth by a military dentist eight years ago. The most reasonable explanation was the root canal had failed, and the tooth got infected.
Since I no longer had access to the military’s socialized medical system, I’d have to pay a civilian dentist. Knowing they charge an arm and a leg, I looked up cheap insurance on the internet and spent several evenings slogging through mind bogglingly complicated insurance websites. Unable to make sense of all the terms and restrictions, I decided to take another approach.
I searched for a dentist office with good reviews in my area and found out which insurance they accepted. Then I paid $125 for the insurance and waited for it to activate… hoping the pustule didn’t become life threatening in the meantime. In case you’re wondering, the reason there’s a waiting period for insurance to activate, is so you can’t wait until an emergency happens to sign up.
When I finally got my insurance card, I took it to the dentist’s office, which we’ll call Negan Family Dentistry. The secretary at the front desk told me they accept my insurance company, but not my plan. FML.
Afraid to leave the pustule untreated any longer, I paid $50 for a checkup, which lasted about 15 minutes.
A dental technician led me down a long hallway lined with booths like a hair salon. Walking down the assembly line I started to worry I’d be treated less like a family member and more like a fast food order. My suspicions were confirmed when the technician X-rayed the one tooth with the pustule under it. Then a dentist came in and told me it needed to be replaced and left.I don’t even know what the dentist looked like, because he or she stood over my shoulder wearing a mask for the entire forty five seconds they spoke before dashing back to the salt mines.
After the dental apparition vanished, the tech sent me to the front desk, where the secretary gave me a bill for $250 and the phone number for Negan Family Periodontics, two towns away. Everything happened so fast it made my head spin.
In a daze, I asked what the bill was for, and she said, “It’s for a temporary tooth we put in after the real one is taken out.” I asked why I was paying her when she was sending me somewhere else. She said, “We put that part in.”
I told her I’d think about it and threw the bill away. A few hours later I called Negan Family Periodontics and told them I needed a tooth replaced before I died of blood poisoning. The secretary told me their next available appointment was two weeks away, but she promised to call me if they had any cancellations. She never called.
After fourteen days of worrying I was about to die, I drove to the place “my” dentist referred me to. The secretary who greeted me was an older woman with white skin but Hispanic facial features. She spoke warmly, until I told her I didn’t have insurance. Then she snapped into full aggression mode, basically accusing me of not intending to pay my bill. I gave her my credit card and driver’s license, which she copied angrily and pushed back at me.
Afterwards, a nicer lady handed me a bill for $3.5k. By the time I saw my periodontist, Dr. Simon, my head was spinning again. Dr. Simon’s cheerful personality put me a little at ease. He laughed and joked like he didn’t have a care in the world. I wanted to like him, and I tried to act happy but couldn’t stop thinking about how I just paid him six more months of all my disposable income for what would amount to less than half a day’s work on his part.
I offered to barter my professional services in exchange for reducing my fees, which is legal, but he responded with a long speech about how he always follows the rules to a fault. As the overpriced laughing gas kicked in, I wanted to say, “It’s too bad there isn’t a rule about not extorting your customers out of their future life savings every time they have a minor medical emergency.”
An hour later, he’d pulled out my decayed tooth, cut it in half, screwed in a metal foundation for a fake tooth, and glued the top of the old one back in place so I wouldn’t look like a jack-O’-lantern for the next few months while my jaw bone healed around the prosthetic.
The next time I walked into Negan Family Periodontics, was for a cleaning I didn’t ask for and wasn’t necessary for the tooth replacement. As soon as I sat down in the waiting room, The Dragon at the front desk told me I needed to pay another $1k to the dentist from Negan Family Dentistry, who would be putting my fake tooth in. Stunned, I asked why I was paying someone else more money to finish the job I thought I was paying them to do. In response, she ripped some papers out of a folder and waved them in my face, telling me I already signed something agreeing to everything, and I better pay up now, with a tone of voice that clearly said she didn’t believe I would.
I reminded her she already had my credit card number. So any time she needed another $1k from me, she could just keep charging my card, and I’d just keep being bankrupt. Snidely, she replied, “Great.”
When I asked Dr. Simon about the charges, he explained he would only mount a screw in my jaw, and the original dentist who referred him, would take a mold of the mounting plate, send it to a lab to make a fake tooth from, and then screw it in. I asked why he couldn’t do it, and he lectured me about how he specializes in his field, and other dentists specialize in theirs. So it’s best that someone else screws the prosthetic tooth in. The process sounded illogical to me, but he assured me it was normal. So I let the issue go.
On my way out of the building, The Dragon gave me an appointment date a few weeks later to remove the half-tooth and install a screw into the plate. She also said she would schedule an appointment with Negan Family Dentistry for the same day so Dr. Negan could take a mold of the screw to make the final fake tooth from. However, after calling three times and getting a busy signal, she said she’d try again later and relay my appointment time to me. I never heard back from her.
Two weeks later, the secretary at Negan Family Dentistry called and informed me they double booked my appointment and needed to change it, which turned out to be convenient, not only because I didn’t know what my appointment date was, but because The Dragon scheduled my appointment at Negan Family Periodontics one hour before the appointment at Negan Family Dentistry, two towns away, which would have been impossible to reach in time. So I rescheduled the second appointment for the next morning.
The reason the appointments were supposed to be for the same day is because, after Dr. Negan made a mold of the screw, he normally would have installed the temporary tooth I never paid $250 for. However, I didn’t pay for it because I couldn’t afford to waste money on a cosmetic enhancement I’d wear for two weeks. My only option was to leave the screw exposed while the third-party dental lab Dr. Negan subcontracts his work to, made my fake tooth and shipped it back to Negan Family Dentistry.
So, the morning after Dr. Simon installed the screw, I showed up at Negan Family Dentistry looking like a James Bond villain. After checking in, I sat down and happily thumbed through an uninteresting magazine. After months of racking up debt, driving all over the Houston area and being treated like an asshole for being poor, the ordeal was almost over. My life was finally looking up.
Then the kind, attractive, secretary politely called me to her desk and asked for another $916. I explained I’d already paid that bill through Negan Family Periodontics. Confused, she said they don’t do that. At my urging, she called The Dragon, who told her they didn’t do that. I thought I already paid this bill, but I knew it would be pointless to argue with The Dragon, and I was already mad enough to say things to her I’d regret.
I don’t know where the miscommunication came from. Maybe The Dragon and Dr. Simon did a terrible job of explaining my fees. Maybe I didn’t understand what they were saying because my head was spinning from getting hit with a baseball bat named, “Debt.” Maybe I’m just stupid, but there is one thing I’m absolutely sure of. Nobody ever said anything about me having to pay another $916 for the appointment in question.
If I had known I’d have to pay more after the initial $3.5k, I might not have agreed to it. If Negan Family Dentistry had given me an itemized breakdown of every step and fee involved in their tooth-replacement process the first day I walked in their office, I probably wouldn’t have ever called Negan Family Periodontics. Now I have to wonder if they consciously chose not to be transparent so they could surprise me with outrageous bills after I’d already committed.
Their surprise worked. I didn’t see the debt bat coming until it hit me between the eyes, sending me into that familiar punch drunk feeling again. Clumsily, I used my cell phone to check my account balances to see if I even had $916. I didn’t, but was able to cover the bill by maxing out my credit card and draining all my checking and savings accounts, including money I’d set aside to renew my vehicle registration.
By the time the technician sat me in the exam chair, my net worth equaled $23 in cash and $6k in debt. Financially, it was the lowest point in my life. My body’s fight or flight response flooded my veins with adrenaline causing me to shake as the technician put the bib around my neck. She may as well have injected me with 10 milligrams of fear and charged me $100 for it.
I had a few minutes to close my eyes and try to breathe the nausea away before Dr. Negan casually sauntered in.
Without looking in my direction, he asked the wall in a rote, disinterested tone of voice, how my Thanksgiving had been. I said, “Pretty good,” which was a lie. The truth is, I had broken up with my girlfriend that week and moved into a cheap trailer next to a railroad track with my brother, who spent Thanksgiving with his ex-girlfriend while I sat alone at our new “home” writing and wearing ear plugs to block the sound of the train horns. Part of me was happy for the solitude, but I couldn’t stop thinking about the fact that the only reason I had to live in a shitty trailer by a railroad track was because my dental bills had erased all my other options in life.
I’d completely run out of fakeness when Dr. Negan asked how I was doing. Exasperated, I replied, “Not good, since you bankrupted me.”
Without missing a beat, he launched into a bitter, condescending tirade, saying, “Oh!? So, you don’t think dentists deserve to get paid? You don’t think ten years of school is worth any compensation? We rack up a lot of debt in medical school, and it’s not cheap to run a dentist office, but hey, if you think our prices are unfair, you can just go to Mexico.”
He actually said that. I couldn’t believe it. After taking everything from me, he was bitching me out for not saying thank you.
Ironically, he was right about one thing. I had a friend who’d recently returned from a medical tourism resort in Mexico where he spent $4k to fix everything wrong with all his teeth. Plus, he got a two week vacation at an all-inclusive resort. He wasn’t treated by the dirty, filthy Mexican dentists Dr. Negan was so prejudiced against. He saw American doctors who had moved to Mexico so they could help people without having to charge an arm and a leg and a dream to replace one tooth.
My life would be profoundly better on multiple levels if I had the foresight to go to Mexico. For the same price I could have even flown to a medical resort in Thailand, where the doctors and staff would have treated me like a god instead of a cockroach.
My appointment with Dr. Negan lasted 30 minutes, most of which he spent bitching me out. The rest of the time he made a mold of my tooth space using the same process Dr. Simon used when he took his mold, which makes me wonder if both of these guys were referring me back and forth to each other to rack up referral charges.
If my final appointment took the same amount of time, I would be paying both my dentists an average of $1k per hour. I’ll have to work 40 hours to pay off one of theirs. If I made minimum wage, then one easy hour of their life would be worth 140 grueling hours of mine. That’s a narcissistic, psychopathic assessment of the value of life, based on a lie.
No human being is so much better than another, that an hour of their life is worth 40-140 times anyone else’s. Plus, if they’re charging $1k per hour and work 8 hours per day, that’s $40k per week. Even if half the money goes to expenses, it doesn’t cost $20k per week to run a dentist office. Even if Dr. Negan only pocketed $200 per hour, that doesn’t make it any less painful for me to pay $1k per hour.
In the end, the truest measure of Dr. Negan and Dr. Simon’s morality is the size of their retirement accounts. They might have taken on a lot of debt in school, but they’re not going to lower their prices after paying it off. They’re going to charge as much as they can get away with for as long as their career lasts. In the end, they’re going to retire in mansions surrounded by space-age luxury that would make a medieval king jealous, and the only reason they’ll get to do that is because their vaults will be full of peasant’s gold.
I’ll spend the rest of my life living in a trailer next to a train track, wearing ear plugs in bed and getting stomach ulcers from lying awake, worrying about how long I can put off getting extorted by family friendly medical professionals.
The last thing the Dr. Negan said to me before he ejected me from the dental assembly line was, “Hey, man. Everything’s going to be fine. Everything is going to work out.” If he truly believes that, then living in a gated community must have disconnected him from reality. In the America where I live, I’ll never be free. Perpetual debt will always force me to work for a boss who underpays me, just to pay off the businesses who overcharge me and add on extra fees for not having any money.
If medical school, rent and medical equipment are so extortionately priced that dentists are struggling to keep their practices open, there must be better solutions than passing on the extortion to customers. If medical professionals truly cared about their clients, which Dr. Negan assured me he did, then they would be doing something to fix the problem.
As it stands, they’re just shrugging their shoulders and saying, “If I can pass this problem onto the customer, then it’s not my problem. Fuck em…” just like I metaphorically said to the single mother who rented my duplex unit in Austin.
The simplest solution is, stop fucking your customers in the ass with a friendly smile, but if you can’t afford to do that, then try to imagine how angry and dejected bankruptcy must make all your customers feel. Then take that anger and shout it in the face of the people who are overcharging you. Unionize and boycott those people. Write blogs and give speeches about how you have to double the cost of your products to pay rent or a mortgage that’s twice as expensive as the property is worth.
The least you could do is not be silent, but if you’re smart enough to earn a PhD, then you should be able to think of at least one solution to high operating costs other than raping your customers and bitching them out when they say, “Ouch. You’re killing me,” instead of, “Thank you, sir. May I have another?”
If you’ve read this far, you may be thinking, “Hey, Travis. Wake up. The common denominator in all your problems is you. If you were better at adulting, and less angry about life, then you wouldn’t have dug yourself into a pit of debt and made enemies with people who just wanted to help you.”
If you’re underwhelmed with my plight enough to leave a comment telling me what an irresponsible, whiner I am, then you need to take to the streets and shout the exact same speech in the face of the other 6 billion people in the world who live below the poverty line. Maybe I am whiney, but if everybody stopped complaining about normalized extortion, the only thing it would change is how much longer the majority of humanity stays in poverty.
If you believe I can’t blame anyone except myself for my bankruptcy because I didn’t have insurance, then you’ve either never used insurance, or you’ve accepted insanity as normal.
The reason I needed insurance in the first place is the exact same reason why medical tourism resorts exist: because the cost of medical care in America is inflated beyond reason by insurance companies.
If you’ll recall, I did buy the insurance Negan Family Dentistry advertised they accepted. If they’d been more transparent, I would have known the right policy to buy. If they didn’t pick and choose which policies they accepted, I could have just used any insurance.
It wouldn’t have mattered much if I did, because all policies are designed to be as useless and difficult to use as possible. The company I work for offers medical insurance for $124 per month, but it has a $6k deductible, which wouldn’t have covered the cost anyway.
If I had paid $124 for medical insurance every month since I separated from the military in 2007, I would have paid $13k by 2016. Even if insurance would have covered the entire cost of my tooth replacement, I still would have saved $8k in the long run by not having insurance since 2007.
Doctors don’t even like insurance even though it pays so well, because they have to hire an otherwise unnecessary employee just to file all the paperwork. Since doctors don’t want the extra cost to impact their salary, they pass the cost onto the customers by raising prices accordingly, which I’m sure they feel terrible about.
To make matters worse, doctors have to wait months for insurance claims to be processed and pay out. As much of a nightmare as insurance companies are to work with, doctors should know better than anyone, bitching customers out for not having insurance is blaming the victim.
The problem is that the insurance companies have rigged the system to require everyone to buy extortion protection in the first place, and doctors have chosen to go along with it. I wouldn’t have lost the game if it wasn’t rigged.
I can’t afford anything, because everyone gives me the “fuck you” price instead of “the friend discount,” and you don’t have more nice things, because you get treated the same way. So if you’re mad at me for getting extorted, then be mad at yourself too, and be mad that someone convinced you to accept this sadistic system as normal.
My story ends with me going back to Negan Family Dentistry to get my fake tooth put in. Before leaving the house I checked my bank account to see how much money wasn’t in it, just in case I got surprised me with another bill. There was no need to check how much wiggle room was left on my credit card, because it was already maxed out. Luckily, the secretary surprised me by informing me they wouldn’t be hitting me in the head with a baseball bat wrapped in barbed wire again.
The whole appointment took about fifteen minutes, and most of that was done by a tech who makes as little as supply and demand will allow Dr. Negan to get away with underpaying her. The tech put some kind of clip on the screw sticking out of my gums. Then Dr. Negan came in and snapped the crown on. The procedure didn’t even require any cementing or heating, which proves everything Dr. Simon told me about me needing to see Dr. Negan for the final procedure because he was a specialist, was a complete lie. I could have done the final step myself.
At the end of the appointment I gave Dr. Negan a slip of paper with the address to this blog on it. I told him I didn’t use his real name. I just needed to tell my customer service story, and that it wasn’t glowing, but he could use it to fix the holes in his process.
He didn’t understand what a blog is. So I had to explain it to him. His eyes told me he still didn’t understand. So I wasn’t surprised when he pressed me to just tell him what the essay said.
I told him, the biggest issue, and the reason I was so upset the last time we met, was because his prices were deceptive, and I wasn’t given the total cost at the beginning. When I said that, his eyes bulged out, and he blurted, “You’re a liar!”
Experience has taught me that trying to give someone advice who doesn’t want to admit when they’re wrong, will only result in them attacking you until they’ve said something ugly enough to convince them-self you’re the problem. So I just turned on my heel and walked out the door. Dr. Negan chased me down in the lobby and tried to bitch me out some more. I’d already said everything I had to say in the blog, and I didn’t want him to ruin my day any more than he already had. So I continued walking, right out the front door.
As I exited the building, he shouted, “Have a merry Christmas!” His attempt to take the high road didn’t impress me after calling me a liar for trying to point out the metaphorical broccoli stuck in his teeth. It just reinforced my perception that he’s a delusional ass hole.
I don’t even believe in Christmas, and he obviously doesn’t believe in Christian values.
The worst part of the story is that, even though I’ll never go back to Negan Family Dentistry or Negan Family Periodontics, I won’t get a better price anywhere else in America. I’ll just keep getting my head bashed in and my savings looted, just like you… unless something drastic changes.
Before the world can change, people like Dr. Negan and Dr. Simon need to change the way they justify their predatory business practices to themselves.
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