In Part 1 of this series we looked at factors surrounding the escalating cost of dental care and its burden on patients without dental insurance (for expensive procedures like implants, most of us).  The focus of Part 2,  presented here, is to provide strategies for saving money when the cost of care goes through the roof,  First, the best thing you can do to save money on expensive dental is to spend it now. Regular dental visits, cleanings and attention to small problems before they become big ones is the best strategy. Still, heredity, lifestyle and disease has made some of us prime candidates for big time dental work. Short of extractions and full dentures, what can the financially-strapped patient do?  Let’s start with the most obvious.

Bargaining and Dental Schools

Many dental practices are slow these days, so your timing is good. Ask your dentist to give you a better price after the Novocaine wears off.  Dentists don’t like to bargain (why would they?)  and their marketing gurus have taught them to counter-offer financing, often with a “no interest” teaser.  Extended payment plans  are not reduced fees. They just pain spread over time, often 12 months. The piper must be paid, and after a set period, finance fees usually kick in. So ask. You may not save thousands, but every little bit helps.

Dental schools can be a great place to receive treatment. Students hone their skills under the watchful eye of experienced teachers. When the work is done correctly the first time,  you have a great experience. The problem is that there is no way to gauge students’ skills until after the fact. Treatment at a dental school is a money saver to be sure, but the time commitment can be deadly. You may wind up having multiple appointments, even for a simple dental.  A hygienist we know describes it, “A basic cleaning took some patients as much as 8-12 hours and three separate visits.  This is not a viable option for most people who could go to their dentists and have the same work done in a one-hour session.  I can only imagine the time involved in having more serious work completed.  You will need to decide if multiple trips to the school and hours in the chair while a dentist-in-training tests his skills is worth the savings.

With the cost of care going up annually, many Americans are pursuing a different alternativee for quality care.  Combining a vacation with a trip to the dentist can save them large sums of money, and might even make a trip to the dentist fun (well, almost fun).

Dental tourism

Traveling abroad for care is part of a growing trend called “medical tourism.” Whether leaving the US for a hip replacement or a dental implant, the patient leaves the U.S. to receive care from qualified practitioners abroad at substantial savings.

Of all the different medical tourism procedures available, dental tourism is the most popular because:

• quality dental care is widely available around the world
• most patients pay for dentistry largely or completely out-of-pocket in the US
• savings will be substantial
• dental procedures are generally minor compared to many medical  procedures.

After treatment, dental patients can be true “tourists”, and can enjoy a relaxing post-treatment vacation. A patient who goes to India for a joint replacement is unlikely to be touring for some time.

Quality dental care is available outside the US

The “American-centric” myth that quality care is only available in the States is exactly that.

“Every year we bring to NYU 110 dentists from 33 countries, train them in advanced procedures, and then they go home. There is no reason to assume the quality of care is any lower overseas.” Dr. Stewart Hirsch, associate dean of New York University College of Dentistry “

Schools outside the US produce their quotas of qualified dentists as well. Practitioners around the world have access to the same information, the same training and the same equipment. As in so many areas of science and medicine, the global economy has leveled the playing field.

The American Dental Association (ADA) has a vested interest in protecting their US-based members, and has recognized that the global economy poses a threat. Still,  they do not dispute that quality care is available abroad.  How could they? Large numbers of international dentists belong to the Association, attend its meetings and receive training through their member institutions. Of approximately 15,000 dental professionals attending the annual ADA meeting, about 1,800 are from outside the US.

Americans traveling for dental care

More and more Americans are going outside our borders for dental care. A recent New York Times article quoted a source that said 40% of all medical tourists are traveling for dental care. When the total number of all medical procedures is considered, that percent becomes even more impressive.  The total number of dental travelers is difficult to pinpoint but estimates range from approximately 200,00 to 750,000 annually. Most reports (including those of the ADA) project that number to be on the rise. The think tank Deloitte Center for Health Solutions projects a 35% annual growth rate despite, or perhaps because of, the current economy.

Examples of Savings

Savings on dental work depend upon a number of factors including the country visited, the procedure, materials used and the dentist performing the procedure. Dental implants are the most frequently requested procedure by dental travelers because of their costliness in the US.  As Figure 1 demonstrates savings on dentistry can be considerable for extensive work.

Fig 1: Implants

In Fig 1, an implant and crown in the US are estimated to cost $ 4,000 (this can be more or less depending on location).  Travel expenses are variable and include the flight and a week with moderate accommodations in Panama City, a top location for dental work. An implant patient will make 2 trips, the first for surgery and again for the crowns placed on the implant.

For patients needing less work, savings of even one or two thousand dollars may pay for treatment and a vacation, as in Fig 2. Taking care of a couple of root canals and spending the rest of the week touring can be pretty nice.

Fig 2: Root Canals

Are patients satisfied with care abroad?

This survey by the leading non-profit group in the medical tourism field, the Medical Tourism Association, looked willingness of patients to consider repeat care overseas. The percentage who said they would, 88%,  speaks highly for their level of satisfaction. A  dental-specific survey, revealed high levels of satisfaction among the thousands of dental tourists questioned. Patients who traveled abroad to receive treatment had a average satisfaction rating of 84%, a similar percentage to the general medical tourist surveyed by the MTA.

Part 3: What you need to know (coming soon)

Interested in knowing more about dental travel?  In the third and final part, we will share tips and secrets: where to go for treatment, locating the best dentists, and how to save time and money.

Entrepreneurs will find the following to be most useful:

“Knowing yourself is the beginning of all wisdom.” Aristotle said this about 2,500 years ago and it seemed to work for his prized pupil, Alexander the Great.

More and more Baby Boomers are looking at starting their own business. Whether their motivation is to boost a flagging 401-K or to fulfill a lifetime dream, you need to know that a successful business is more than a good idea.

In my six years as, I have no clients whose ideas conquered the world…yet . Whatever the merits of the business, the “big idea” often has less bearing on future success than the personality of the person starting the business. Like the stars that guided the ships of Ancient Athens, there are 10 personal questions the would be entrepreneur should ask him or herself before launching their business. Knowing yourself will help you rise above the competition.

1. Can you afford financial risk?

Because: Many new ventures do not succeed, and you may lose much of whatever money you have.  This may affect your financial goals, such as children’s college expenses, or retirement savings.

2. Are you ready to  give  up your current lifestyle for potentially a number of years?

Because: Unlike working for others, your own business may require longer workweeks, fewer or no vacations and maybe years of scrimping and saving before things take off.

3. Are you good at speaking and persuading others?

Because: In any new business, explaining your ideas—to investors, customers and employees—is a good part of what you will need to do.  You will be selling your idea and product all the time.

4. Are you prepared to run all aspects of your business?

Because: In the beginning you may need to do everything, from sales to marketing to bookkeeping.  You may not like, or feel comfortable, with some of the tasks you will need to do.

5. Are you comfortable with a lack of structure?

Because: In a new business, you will need to feel comfortable making all decisions, without any existing structure or guidance (actually SCORE can help provide guidance).

6. Are you a self-starter?

Because: Entrepreneurs need to be able to take rejection and keep going.

7. Does your “significant other” agree to your plan?

Because: Marriages and relationships can be tested by the time and money a new business requires.

8. Are you passionate about your business idea?

Because: You need to be totally motivated about your business,  and know about what you are getting into (going into a field you are not familiar with makes success more difficult).

9. Do you have a history of executing your ideas?

Because: Successful entrepreneurs usually have a history of coming up with ideas and seeing them through. A past with leadership roles may be an indication.

10. Do you need a business partner?

Because: If you don’t have all the skills you need, you may need a partner who can make up for your shortcomings.

If you cannot comfortably answer “yes” to most of these questions,  you need to think about how  you can overcome your weaknesses (you can change).  Your SCORE counselor can help with free counseling. For an online If you cannot comfortably answer “yes” to most of them,  you need to think about how  you can overcome your weaknesses or whether going into you own business is right for you.  Your SCORE counselor can help.

If you would like a free PowerPoint presentation that covers the 10 Questions in more depth, leave a comment here or send an email to me at japton@panamdentaltours.com.

Calling someone a Boomer is a polite way of avoiding the fact that they are aging. One of the most defining traits of the generation born between 1946 and 1964 may be the inability to acknowledge that they may actually be getting old. So I think eventually those of a certain age will either remain Boomers, which will define their social/political philosophy. Those who opt to be called Seniors will be considered to have a different set of views. Like Liberals vs Conservatives.

In olden days they called you a pensioner, elderly, or just plain old. You were a Senior if you were really really old.

For example, this piece from the Canadian newspaper The Manitoba Free Press, October 1930:

“Today, friends of ‘Dad’ Quick, Vancouver’s senior citizen, congratulated him on the attainment of his 110th birthday.”

Then in 1938, it all changed. Several newspapers reported the ‘Thirty Thursday’ plan by the Commonwealth Party’s candidate for governor, Robert Noble:

“On Nov. 8, the people of California will vote on the scheme as a proposed amendment to the state constitution. If passed, the retirement life payment plan, as it is called, promises to pay $30 a week for life in state script to every “senior” citizen, man or woman, 50 years of age or over.”

When life expectancy was 61, of course, anyone who made it to 50 was a Senior.

What does any of this have to do with quality dental care and saving money in Panama (www.panamdentaltours.com)? They have a a pensionado program there, open to all residents (including ex-pats).

Now, you may be thinking: “Pensioner? Retiree? That leaves me out.”

Not necessarily. The rules for becoming a “pensioner” and qualifying for this visa program in Panama are probably not what you’d expect.

Anyone over the age of 18 may apply and can qualify as a pensionado in Panama. Another defiunition of pensioner! All you need is a guaranteed pension income. And look at the goodies you get:

* 50% off entertainment anywhere in the country (movies, theaters, concerts, sporting events, etc.)
* 30% off bus, boat, and train fares
* 25% off airline tickets
* 50% off hotel stays Monday through Thursday, 30% off Friday through Sunday
* 25% off restaurant meals
* 15% off at fast-food restaurants
* 15% off hospital bills (if no insurance applies)
* 10% off prescription medicines
* 20% off doctors’ consultations
* 15% off dental and eye exams
* 20% off professional and technical services
* 50% off closing costs for home loans and more

Panama has the best of both worlds: being a pensioner and young enough to enjoy it.

I certainly don’t want to be the one who encouraged another boomer to jump into the deep end only for them to nearly drown and never enjoy the pool again. However, in our ever changing economic climate, most of us need to consider some form of second career to maintain our life-style and provide us with the ability to give back in the second half of our lives.

In light of these thoughts, I would suggest three things to look at in choosing your second career:

1. First, and in my opinion foremost, find something to do that you love. If more than 80% of working people don’t like their jobs, then way would you spend your second career doing the same thing? What would you do if money were not an issue? Find a way to do that AND find a way to get paid to do it.
2. Look for something that allows you to begin with minimal risk. Many, if not most, boomers don’t enter their retirement years with “deep pockets.” Most of us are ordinary people who want our second careers to count while minimizing any risk to our hard earned funds. Be careful to consider all the costs in both money and time. Find a way to get started without spending more of either than you can afford.
3. Look for something that can produce high rewards. Now, like success, the definition of “high rewards” varies greatly. You must define what “high rewards” means to you and then align your second career with that definition. When you let someone else define for you what is reward and how much you should have, you become enslaved by their definition rather than liberated by yours.

Many baby boomers spent their first career living out the dreams of those they worked for. We created success for others while putting ours off until later. Well, later has just shown up and now it is time for us to establish our own definition of success and follow after our dreams. Find what you love, work hard and with low risks, and gain the high rewards you deserve!

Talk more later ….