American Dental Care Bites

In WaPo:

As the distance between rich and poor grows in the United States, few consequences are so overlooked as the humiliating divide in dental care. High-end cosmetic dentistry is soaring, and better-off Americans spend well over $1 billion each year just to make their teeth a few shades whiter.

Millions of others rely on charity clinics and hospital emergency rooms to treat painful and neglected teeth. Unable to afford expensive root canals and crowns, many simply have them pulled. Nearly 1 in 5 Americans older than 65 do not have a single real tooth left.

This is the problem with “free market” capitalism, in a nutshell. According to “free market” ideology, as long as government doesn’t interfere the Holy Free Market naturally finds the most cost-effective and efficient way to provide what people need. It’s like a natural law; water flows downhill, flowers bloom in the spring, free markets create abundance for everybody. But in the real world, that’s now how it works. Without government intervention, free markets let some people sink into genuine deprivation in favor of providing boutique, luxury services for the wealthy.

This is particularly true where it comes to health care. There are some things that can’t be done on the cheap, no matter how free the markets are. And I believe we are the only developed nation still trying to provide health care through a mostly private system, and which has little to no controls in place to stop price gouging.

The Affordable Care Act amounted to a system of regulations and subsidies designed to make the existing system fairer, which it did, although not perfectly so. It had several cost-control measures in place that seemed to be having some effect to slow the increase in health care cost, although that is disputed.

But the Republican plan primarily seems to be to lower insurance costs allowing companies to cover fewer medical problems, without doing anything to tackle the factors that are driving up medical cost. This is like driving down the cost of home owners insurance by selling policies that don’t cover fires.

But getting back to dental work — modern dentistry is not going to make itself more affordable to the poor in the same way that consumer electronics companies might find ways to lower the prices on their gizmos. (See Why Your Dentist Costs So Much.)

The WaPo article describes a two-day clinic “event” in which a bunch of dentists volunteered to see people for free. Mostly they pulled teeth that were too far gone to save. People who hadn’t seen dentists for many years drove there from five states. Many people had jobs, but they had no dental insurance and no “leftover” cash to take care of dental problems as they came up.

Matello had both problems, adding to her frustration about being cut off from a world that many wealthier Americans take for granted.

“The country is way too divided between well-off people and people struggling for everything — even to see the dentist,” she said. “And the worst part is, I don’t see a bridge to cross over to be one of those rich people.”

Matello voted for Barack Obama in 2008, thinking he offered the best option for working people, but she sat out the 2012 election. Last year, she rallied behind Trump after listening to him talk about “the forgotten men and women of our country, people who work hard but don’t have a voice.”

“I’m running to be their voice,” Trump said repeatedly.

What Matello heard was a promise “to restore pride to the working poor.”

A big part of that promise was Trump’s assurance that he would build a “beautiful” health-care system to serve every American, a system that would cost less and do more. But nearly four months into Trump’s presidency, Matello sees Trump backing a Republican health care plan that appears to leave low-income people and the elderly worse off.

“I am hearing about a number of people who will lose their coverage under the new plan,” Matello said. “Is Trump the wolf in grandma’s clothes? My husband and I are are now saying to each other: ‘Did we really vote for him?’ ”

We might argue that Ms. Matello and others like her were hopelessly naive to believe anything Trump said, but television news media were normalizing him way too much. Nobody on tee vee ever explained why Trump couldn’t possibly deliver what he was promising.

And here’s why we should be more concerned about dental problems:

George Acs, director of the dental department at Chesapeake Health Care, a clinic near Salisbury, said people with oral pain and infections are inundating hospitals. Last year, more than 2 million U.S. emergency room visits were attributed to neglected teeth.

“What I am seeing is absolutely horrifying,” said Acs, who recently testified about the problem before the Maryland state legislature.

Although those hospital visits cost an estimated $1.6 billion a year, the ER is generally not equipped to fix dental problems, Acs told lawmakers. So ER doctors just medicate people with “a perpetual cycle of antibiotics and opioids.”

That cycle is feeding a nationwide epidemic of opioid addiction.

The business of keeping dentistry separate from other medical problems is stupid to begin with and needs to stop. But as some of the people interviewed in the article say, having bad teeth is a real social and economic impediment as well as a medical problem.

Over two days, 116 dentists treated 1,165 patients, providing $1 million worth of fillings and other care, according to the Mission of Mercy. Matello was grateful. She was told her panoramic X-ray and extraction would have cost $600 to $800 in a regular office.

She looked at some of the others who had come here, despite working for a living cutting down trees, building homes, minding a town library, running small businesses.

“We are not staying home, not sleeping and living off the government,” she said.

She wondered why there wasn’t a better system for people like her. She tried not to look at the 51-year-old truck driver lying next to her who had three teeth pulled, his mouth stuffed with bloody gauze.

“I am trying to think that this is not demeaning,” she said as she cleared the chair for the next person in line. “But it is. It’s like a Third World country.”

Yes, and it’s maddening that people like Ms. Matello support politicians who are making things worse for her, but in the recent elections, what did Democrats offer to do for her? If anything?

7 thoughts on “American Dental Care Bites

  1. Actually, if I remember right, maha, Hillary DID have plans on her website about her solution(s) to medical/mental/dental issues.
    t-RUMPLE-thin-sKKKin did not.

    He flapped his gums and talked a “good game.” At least, to people who’d never been exposed to this master bullshitter.

    And our media, our “Fourth Estate, which is supposed to be the institution which helps seperate the bullshit polical chaff, from the real policy wheat, failed… I would say say, “miserably,” but that’s inadequate.

    t-RUMP ran around bullshitting people – we NYer’s already knew his imprpovisational and completely heartless act by heart. We’ve heard it since the late 70’s/early 80’s!

    He’ll gladly tell any audience what it wants to hear. And it’s not just that, that makes him a great grifter. No. He can sell something, anything – by lying about it in a convincing manner. It’s that ability to sell rancid bullshit as prime Kobe Beef, that makes him the great grifter that he is.
    And now, this goniff’s the POTUS!

    And he doesn’t care.
    He doesn’t care about anyone outside of him, and Ivanka – I think he’d jettison the rest of his children, and his three wives, in a nano-second, if it got him more power and/or money.

    And the Republican Party doesn’t care.
    They don’t care about anyone but themselves and (maybe) family members, and, of course, the rich folks who donate to elections and reelections.

    t-RUMPLE-thin-sKKKin went from “It’s easy to do ABC. And only I – I! – can get ABC done”, on the campaign trail, to “Who knew ABC could be this hard?!?!”
    Well… Anyone with a half-a-brain could/should have been able to tell him. But, sadly, most of our voting public is too stupid/tired/exhausted to pay attention long enough. And so, they bought the “It’s easy” act.

    As for dental care, t-RUMP probably care less about that, than many other things. All he knows is that his teeth are strong enough and well-taken care of well enough, for him to gnaw on well-done steaks.
    He likes fast food.
    And most fast food is – along with high in sodium/sugar/chemicals/preservatives, and little to no nutritional value – soft.
    So, to update France’s 18th Century’s Marie Antoinette to early 21st Century America, t-RUMP is saying to our poorer people:
    “Let them eat McDonalds/KFC/Dunkin’ Donuts/Subway/Papa John’s, etc… !!!”
    And chocolate cake – if, IF, they can afford it!

    • “Actually, if I remember right, maha, Hillary DID have plans on her website about her solution(s) to medical/mental/dental issues.”

      She had lots of plans on her website. The voters never heard what they were. She didn’t run on those things. If it ain’t on the teevee it might as well not exist.

  2. Well, as for what Democrats offered to do for her – most of what they *can* offer, with honesty and reality, is going to be attacked from a half-dozen different sides.

    There’s something sick about how Trump can say “I’ll bring back coal jobs! I’ll bring back steel jobs!” when everyone knows he can’t, and Clinton can say “I’ll keep working to make the ACA better” and the news is, “Trump is drawing big enthusiastic crowds – and now, more about the lawful use of an e-mail server, and the dishonest partisan hatchet job regarding it possible criminal charges against Hillary Clinton – DID SHE GIVE AWAY OUR NATIONAL SECRETS?

    Mind you, you’re right – Democrats need a message, and really, they should probably just “damn the torpedoes, full speed ahead!” because if you’re going to be vilified as a “big government, tax and spend liberal” for the lamb of saying we shouldn’t cut taxes and repeal the ACA, you might as well call for the sheep of single payer, and a far better social safety net.

  3. As the last American dies in the nuclear conflagration that t-RUMPLE-thin-sKKKin’s policies will have caused, his/her last words will be, “Yes. But HER E-MAILS!!!”

    I hope every punTWIT and reporter who stressed her stupid e-mails over t-RUMPLE-thin-sKKKin’s multiple outright lies and fabrications, has a daily reminder of what they wrought.
    So far, t-RUMP hasn’t disappointed me.
    He gives any number of reasons EVERY FUCKING DAY, for them NOT to forget!

  4. One plus about current dentistry (if there is one) is it’s mostly remained competing small businesses. The bookworking (MBA-ification?) of medical clinics is making them what I’d call, corrupt. In the old days you’d see a real doctor who’d treat your painful condition that day. Lately, I’ve had four lesser conditions start with a nurse practitioner or gateway GP who’d then try to kick me upstairs to a specialist from the same clinic. One long reasonably priced visit has become several expensive quickie visits (to maximize profit, I assume). And no, malpractice only adds 5% to cost. The once good idea of a one-stop shop appears to have ventured into legalized theft. At least where I live…

    • “One plus about current dentistry (if there is one) is it’s mostly remained competing small businesses.” And that’s probably because dentists don’t get the big insurance bucks.

  5. @Bill & maha
    Sadly, I think you’re both wrong. In my experience, Dental Practices have become both more insurance oriented and more Taylorized, just like medical clinics and hospitals. Over 10 years ago, after my old dentist retired, I went for a root canal/crown and in addition to assistants, was worked on by three different dentists (interns?), none of whom had their name on the shingle. I never even met the actual owner of the clinic, though I believe she was still actively practicing.

    On a more recent initial visit to a different clinic, the dentist himself couldn’t be bothered to discuss a rather extensive treatment plan with me. That task was shuffled off to an office staffer. Also I was referred to two outside specialists for part of the work. So for starters, at least three billings for initial visits rather than one, all of which is out-of-pocket for me since I’ve only ever paid cash for dental work.

    As in medical clinics, the default assumption of dental office staff now seems to be that you have some kind of insurance. Perhaps fewer people who don’t can still afford to get treated.

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