It's striking that balance that is going to be hard due to a lot of harsh(er) realities that dental offices are facing. Patients' disposable income are shrinking with the cost of consumer goods going up, so less discretionary income is used for dental procedures. Insurances are lowering their reimbursements across the board in certain regions. The cost of dental supplies are going up (and so are other variable/fixed costs). There is definitely some pressure for dental offices to cut costs and one of them would be lab costs. I'm not going to say that dentists aren't greedy, but not all of them are. Some have always been penny pinching everywhere even before SHTF. I've cut my own salary just so that I can make sure that my staff's salary goes up in line with COL even though reimbursements haven't really caught up. However, I do still see the value in paying extra in a quality lab that reduces the risks of remakes, back and forths, and maintaining a good line of communication for more complex cases.... there's a big but in there though, but, at certain reimbursement rates for any work that requires a laboratory, there comes a point where we may be losing money per unit. I've heard in some states, medicaid reimburses as low as 250 dollars for a crown, and have onerous requirements such as HN PFM or excessive documentation that make it not worth doing the crown or accepting medicaid.
That gets us then to access to care and the care that people should be getting and the financial realities of delivering dentistry at a loss. There are some medicaid mills out there that do game the system and only do things that would result in a net gain (such as some places that only edentulate and slap on a halfass prosthetic).
I guess the point being is that the financial realities will lead to a demand for lower cost equivalancies, but not always because of greed. Although I'll admit there's a lot of greedy dentists out there, the market pressures on dentists will require us to seek lower cost alternatives. I think it's important to highlight that if you can prove that you are more approachable than a bigbox lab with people who actually know something about dental prosthetics, have a reasonable turnaround time, a fair price (not the cheapest, not the most expensive either),and things that "just fit" with minimal adjustments, then it is easy to sell yourself to dentists and say hey, we may not be the cheapest, but we'll provide good customer service, we're made domestically, we use good materials, and that the time they save from sending a case back (and quick cementation times),they'll come out ahead with a better patient experience, lab experience, and help their local economy too. However, the price premiums will definitely have to go down until the economy recovers.
Anyway, sorry for the long rant, I just feel like dentists are painted with such a broad brush stroke, but I think it's important to know why there might be a race to the bottom. I don't think all dentists are greedy, but some are, some are in a position/bind where they can't afford to go past their breakeven point in delivering a service due to geographical/insurance restrictions, and some will accept ****ty results and deliver whatever they get. Just as dentists are facing a new financial reality of delivering services at X cost, I believe labs may have to do so at some point without compromising on quality. I hope that dental materials manufacturers lower their price points, but with supply chain issues, I doubt that will happen (or just use it as an excuse to raise their price).