Wednesday, 21 May 2008

This will hurt.

I went to the dentist. I go regularly and have not needed anything major done for years. How I wish I had not even had that thought to tempt the fates. As I squirmed with imagined pain in the plastic lounger chair the dentist snapped on his latex gloves, poked around and said: "You need an inlay, you need some root canal work, there's a cavity under a crown and on the tooth behind it." He drew breath and added: "We'll have to kill a nerve and you may also need a bone graft." So much for regular check-ups. He attempted a joke: "I'll have to see you a few times; perhaps you should take out membership." I tried to laugh but all that came out was a half-strangled gurgling sound. He took his fingers out of my mouth and summoned me to look at the x-rays on his computer. I slid off the clammy plastic. He waved a pointy instrument at the screen: "Look, we have problems here a cavity here and this region here is giving you pain, non?" I made another gurgling sound.

This is going to take months and be very expensive. The dentist explained the inlay has to be handmade and I may have to see a specialist about the root canal work and possible bone graft. It also involves lots of choices, which always throws me because then I have to research everything down to the smallest detail. It has been part of my job for years, now it is a reflex. The dentist says inlays are "very badly reimbursed". This means the French health service will pay very little towards the treatment. He asks if I have a "good mutuelle" (health insurance). I say I think so, but as I'm on the Frenchman's policy and it's arranged through his job I am not certain. He taps at the computer and produces two estimates; I feel like I'm haggling with the plumber again. The first, for a ceramic inlay, is for 440,00 euros (£350) of which the princely sum of 41 euros (£32) will be reimbursed by the health service. The second is for a resin inlay costing 360 euros (£284) of which precisely 0 (£0) is reimbursed. This means the mutuelle is unlikely to pay up anything either. I have no idea how much the bill is going to be for the other work; he didn't say, I didn't ask; but I suspect I am going to need a credit plan. The French health system, known colloquially as the 'Secu' reimburses 70 per cent of what it deems the "official" fee of a particular dental treatment. The problem is dentists can charge up to ten times the official fee, which they consider too low to make a living. I am told that much as the British come to France for medical treatment, the French go to Hungary or Morocco to get their teeth fixed.

I ask the Frenchman what French people do about replacement teeth if they have no health insurance; that means about a third of those on low incomes. He says: "That's the problem. They don't."


Nora said...

The source of all dental problems is the prohibitive cost of it, not to mention the prohibitive cost of the insurance itself. Since the Netherlands doesn't have national health insurance anymore, many people have to do without insurance at all and will get very bad teeth as a result of it.

Cimon said...

It is well known that the French health system is very generous, except for two things : dental care and glasses.