Ombudsman gnashes teeth over dental costs

The sound of the dentist’s drill is not the only concern of the federal price ombudsman Keystone Archive

The federal price ombudsman has expressed concern about the cost of dental treatment in Switzerland and called for greater price transparency from the country's 3,500 registered dental practices.

Werner Marti, director of the price surveillance office, has issued a public warning that dentists are not making the cost of treatment easily available to the public.

“In our opinion, every patient should have the possibility to look into the prices before he sees a dentist,” Marti said in an interview with swissinfo.

The Swiss Dental Association agrees that every patient has the right to an estimate of costs before signing up for a course of treatment, but it rejects the suggestion that a nationwide list of dental prices will make the prices more readily available.

Alexander Weber, secretary-general of the association, told swissinfo he accepted the principle of transparency but rejected the method chosen by the ombudsman.

“Of course it’s important for people to know how much they are going to have to pay out of their wallet,” Weber said, “but publishing a general price list is not helpful because the circumstances of each individual patient have to be taken into account.”

The problem with creating a nationwide database of treatment costs, argues the association, is that Swiss dentists offer flexible price structures which vary according to the needs of the individual.

Prices can change

“The dentist works for himself, so he or she can decide at any time to change the price,” Weber commented, “and he may offer you a discount if, for example, you are on a low income.”

“All of this means that there is no rigid price structure,” he added.

Marti insists he will carry out a survey of dental prices with or without the association’s help. His office maintains it will publish the information it compiles from dental practices on the Internet.

“I simply don’t understand the attitude of the association,” Marti said.

“Our original intention was to ask them to prove that there is competition in Switzerland by showing us the rates and prices of individual dentists. They were not willing to do this, so it would appear that the association has no interest in making the market more transparent.”

But the association denies it is content to keep a cloak of secrecy over the cost of dental treatment.

“We are not against transparency per se,” Weber argues, “we’re just saying that it must be a form of transparency which is in the interests of the patient.”

“We believe that a published price which does not give you the full idea of the individual situation does not help the patient.”

In a survey conducted last year by German researchers, the cost of dental treatment in Switzerland was found to be at least two or three times more than in many other European countries.

But Weber says the difference in price is due to what he describes as the ‘Big Mac’ factor.

“If you compare the price of a Big Mac, in Germany it costs about two-thirds less than in Switzerland. Why? Swiss costs for things like personnel and building rental are much more expensive than in Germany, so naturally this brings up the cost a little more.”

Dental treatment abroad

The Swiss spend in excess of SFr2.7 billion annually on dental treatment at home, but a growing number of people are avoiding the high costs by travelling to Hungary for major dental treatment.

Weber warns that though prices may be cheaper in Budapest than they are in Zurich, any patient who seeks treatment outside Switzerland is likely to be making a false economy.

“For sure dentists in Hungary are a lot cheaper than their Swiss counterparts,” Weber admitted, “but there is a big difference in quality.”

“A survey carried out by Bern University indicated that more than 50 per cent of patients who are treated in Hungary later develop complications, so it turns out to be much more costly in the long run.”

The dental association recommends that anybody in need of a major course of treatment should consult at least two dentists to compare price estimates before signing any agreement.

“It’s always worth going to another dentist to seek a second opinion, since he or she might offer not just a different price but a completely different treatment method.”

by Ramsey Zarifeh