Here’s a good answer that tracks with what my parents, who are dentists, told me: https://www.reddit.com/r/explainlikeimfive/s/H4MsnWKatM

> For the longest time, surgeons, dentists and optometrists weren't part of the medical profession. You'd have a barber who could give you a shave or pull your teeth, or a butcher who could cut up a hog, or cut off your gangrenous leg. Optometrists were craftsmen who made the spectacles in their shop. Doctors were University educated in Latin and Greek to read ancient medical texts and despised the uncouth yokels.

> Surgeons muscled their way into the medical profession, originally with the help of the Royal Navy, who only had space for one or two people in charge of both cutting off legs and looking after crew health on their ships.

> Dentists and optometrists never did, so they started their own universities, certification boards, etc. By the time they became respectable enough for people to try to merge them with the medical establishment, in the 1920s, they had no desire to give up their independence.

> The first insurance policies were private contracts with groups of doctors and the system developed from there.

Details vary from country to country of course, but the gist of it generally holds true.

A friend of mine is an orthopedic surgeon and says he's basically a carpenter.

Doc here. They are basically carpenters. They us drills and saws and hammers and stuff.

Image removing somebody's leg without a saw. You just gunna twist it like thumbtack or clay until it separate?

I once made the mistake of observing to my dentist that every tool he was using to fill my cavity looked like a smaller version of something I could buy at Home Depot, to which he cheerfully responded: "yup!" and carried on drilling.

For a good time (citation needed) you can find clips online. Jaw surgery was particularly eye opening.

This is a perfect case to illustrate that while knowledge is power, ignorance is bliss.

Note that "optometrist" is distinct from "ophthalmologist", which is the actual eye doctor. The optometrist job is only about fitting glasses and contacts for near/farsightedness, while ophthalmologists can treat all manners of eye diseases.

And the final form of dentists, oral-maxillofacial surgeons are an all in one and have to study general medicine, surgery and dentistry.

An optician fits lenses, an optometrist measures your vision (and can refer you to an ophthalmologist if they spot something unusual).

Not sure about Dutch, but in Germany and many other countries, basic dental care is included in the default public health insurance. But it's basic. So it won't be necessarily beautiful, the color may look less nice, they may pull out teeth that could be saved with more money etc. But indeed since it's part of the body, you can get it fixed to a basic level.

Because socialistic healthcare systems - everywhere in EU - do just the bare minimum you need to survive. Anything above that is not covered, not even partially, because equality - apparently in the social utopia a person's health is a political topic. They will fix your pancreatic cancer by cutting the organ away, even though much less invasive methods are available. Good luck paying more than a US hospital would bill fully out of pocket as an average European earner.

Good luck if the decision tables are not applicable to you - I pay a huge amount of healthcare tax (many times more than the best US health insurance offer) and yet the medication I need every day to survive and function costs me 100 EUR monthly because the system doesn't recognize the existence of my disease. At least I'm top 1% earner, but again - this is unreachable to the average European.

You lost at "European" and "everywhere in EU". The system is different between countries. For example Poland covers free annual review and basic procedures. (even if it's worse quality than on a private insurance) You're just trolling or really misinformed.

You said the same thing I said... You only get basic care to survive, nothing else.

The system is different but this aspect is pretty much the same everywhere around here.

Having a repeating free review and treatment is above basic care to survive. Both compared to many other places in the world now and historically.

I very much disagree, that's the most basic of basics. I don't care much what's happening in low income areas and especially not how it used to be historically. And the point is what happens when an issue is discovered - it's nice that they do checkups, it's not so nice that the treatment available is again only the most basic available and anything above is very expensive and not covered even partially.

You’ve taken your own situation and used it to paint a very very broad, and wrong, generalisation.

I have taken my 3 decades of personal experience - hundreds of situations - and combined it with what my family, friends and acquaintances experienced. It's really not just me. And the national news say the exact same thing - healthcare is expensive, inadequate and unavailable (you wait for months - if you find a doctor that would take you, which is definitely not guaranteed).

In the US it is the same. The result is many people do not have dental insurance, and even if you do it often doesn't pay for much. Even our medicare (for old people) doesn't cover it. Thus some people cynically refer to teeth as "luxury bones".

In my experience (average teeth), dental insurance doesn't pay out enough to cover the premiums, and it's not worth the bother.

For private dental insurance yes. It almost never makes sense to get private dental insurance and it’s almost always better to pay out of pocket.

I mean think about it from the insurer’s point of view. The only reason you’d ever get “the platinum” dental plan is if you were planning to use it. And it isn’t like you have that many “dental emergencies” if you have healthy teeth. If you don’t have healthy teeth you’d already know it when you pick out the insurance plan, so of course you’d get the upper tier.

The only scenario where it makes sense is if your employer picks up a healthy portion of the premium, in which case you are basically getting dental care subsidized by your employer. In that case you’ll likely come out ahead because you knew in advance pretty much how much dental care you’d need.

The same goes for vision care, really. You know in advance how many contacts, glasses and eye exams you’ll need. It isn’t really an insurable thing. If your employer pays for most of the premium, it’s employer subsidized eyewear & contacts for you!

…of course the math does change a bit when you have to pick the same type of plan for a family. In that case it’s time to bust out a spreadsheet and do the math to see the optimal course.

It's also tax-payer subsidized (i.e. regressive, because it's mostly higher-income people that get dental insurance) because it's money from your employer that you or your employer don't have to pay taxes on.

Canada too. Some rumblings about it at the Federal level, but we'll see if that changes.

Apparently teeth are luxury bones

It’s an interesting case study in the US. Want to see a doctor for a minor issue? Good luck knowing the price in advance. Want to see a dentist? Ask for pricing on the phone, and you’ll get it.

Not my experience in Canada. I went around to dentists and asked for their rates and none of them gave me the equivalent of a take-out menu for basic procedures. Why not?

What's extra fun is that that insurance only covers treatments to a fairly low amount, just slightly higher than the price of your regular checkups.

(That said, I believe dental issues that are the result of e.g. accidents do get covered by the default care package.)

I've been self-employed for years now (USA), and never buy dental insurance, because it's not really insurance, it's basically a non-taxable way for companies to give their employees extra money. Buying it as self-employed persons is basically just giving the "insurance" companies your own money.

Isn't medical insurance the same? On average, the sum benefit you get from insurance is less than the total amount you pay.