Jeff Jardine

December 30, 2007

Brace yourself for dental care bidding war

From casual conversations come great ideas. Or not.

A few weeks ago, Merrill Balassone, The Bee's K-12 education reporter, decided to get braces.

She's a loyal University of Southern California alum, and I suspect she knocked her canines out of alignment by gnashing them during the Trojans' painful football losses to Stanford and Oregon. She denies it -- at least the part about Troy's stunning upset by Stanford in October.

"I didn't watch the Stanford game," she said.

Like many of us, she has a tooth that, over the years, has caused issues with her other teeth. Better to get it fixed now than wait. So she asked a few of us newsroom dwellers if we knew a good orthodontist.

Having never worn braces -- I can spit a stream of water about 12 feet through the gap between my front teeth -- I didn't, but my dentist does. So I called his office and they recommended one.

She got names from a couple of other co-workers as well.

Then it hit me: Why not put the job out to bid?

After all, governments do this for public projects, and what is more public than your smile?

It's pretty simple. You put out a request for proposals, detailing the work you want done. You set a deadline and wait for the bids to roll in.

I don't know anyone -- even with the best benefit plan -- who doesn't cringe at soaring health care costs. Several times a year, readers will call The Bee to complain about the amount of the bill they got for a short stay in the hospital or for a surgical procedure, covered or not.

Anything that deludes you into thinking you have some control over runaway health costs makes you feel better, even if that smugness is nothing more than a placebo.

When you're paying all costs out of pocket, as Merrill will, it's important to get the best quality work for the lowest price. Many dental plans cover a portion of the cost of braces, but only for an employee's children who are 19 years old or younger.

Merrill is 25. You're on your own, kid.

She contacted three orthodontists to set up free exams and get the estimates. You can do this with something such as braces with a reasonable expectation that taking the lowest bid probably won't be fatal or maim you for life.

No guarantees, though.

My wife once needed a root canal and went to an oral surgeon. Afterward, the pain only got worse, and she returned to his office the next day. The problem? He'd gutted the wrong tooth.

Oops, sorry.

Still, while I'm sure some folks have been upset with their orthodontist, I've never heard of anyone filing a malpractice lawsuit over braces.

In our capitalist system, competition is supposed to help keep prices in check. But it doesn't always work that way. Unfortunately, there aren't many areas of health care in which the bidding process might apply. There's too much at risk.

Would you really want the lowest bidder performing your heart, liver or kidney transplant?

Do you want your brain surgeon cutting corners?

Would you want an Earl Scheib-like approach to your eye surgery?

"I can laser any eye for $59.95."

It's all akin to what one of the astronauts -- John Glenn, maybe -- said a while back, and I paraphrase: You never want to go into outer space in something that came in under budget.

Undaunted, Merrill put her braces work out for bids and received offers for varying types of chomper correction.

One doctor proposed Invisalign -- invisible plastic braces -- for $5,650, with an alternative bid of $5,250 for traditional metal braces.

The second doctor came in at $6,497 for Invisalign and $5,697 for metal braces.

The third bid $5,375 for a combination of ceramic and metal braces, which are less obvious than the old-style full metal bracket.

She chose Dr. No. 3. It wasn't the rock-bottom bid, but the product is more what she envisioned because she'll be wearing the braces for about two years.

"I definitely wanted the clear on top with the porcelain," she said.

Soliciting bids like this won't revolutionize the way we approach health care. But while Merrill's victory might be Pyrrhic, at least she controls her own dental destiny.

These days, that's worth a smile.

Jeff Jardine's column appears Sundays, Tuesdays and Thursdays in Local News. He can be reached at or 578-2383.

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