Remember Colton?  He was the young man who lost his girlfriend and job the same week and was likely to face foreclosure.  He now has another problem—a really painful tooth.  It hurt so badly he almost went to the ED, but he owed the hospital $2000, so instead he took aspirin and eventually got better.  But we know he’s headed for big problems and costs, with no insurance or medical friends who will cut him a break.

Yes, Colton’s life would have been easier had he been better educated.  I saw first hand how he and his sister lost ground when they were home schooled, which requires both special students and special parents.  As the son of a public school superintendent and a sociology teacher, I admit my bias favoring public education, because with 300 million people, it is the only viable approach – unless, of course, one believes that the poor and people of color shouldn’t be educated.  We need volunteers in the schools and the schools need to put them to work.  I’m now an on-call volunteer math teacher, math being the biggest need, but I’m only one guy trying to put his money where his mouth is.  Congress bickers about the cost of health care, but I’ve heard few discuss the cost of Iraq, for years deliberately hidden from the budget.  I don’t buy regime change, otherwise we’d clean out Zimbabwe, Burma, North Korea and Sudan just for starters.  Iraq has oil.  America has poor and sick people.  For 8 years, I heard deficits didn’t matter, when I thought they did.  Funny thing how the other side has now decided deficits do matter.

 But back to teeth.  Dentistry is the forgotten part of medical care and few have dental insurance.  I had braces for 8 years.  I was so sick of them, I didn’t go to a dentist for decades after, until my wife pointed out my bad breath; I’ve since had a root canal and a couple of cracked teeth needing capping.  I’m lucky; I can afford preventive dental care which makes my problems minor.

 Yes, Colton should have taken better care of his teeth when he was a teenager.  I ask:  when you were a teenager, did you brush twice a day, floss at least once and use a Water Pik?  I sure didn’t.  So, I’m not about to throw the first stone.

 There was an excellent article in Slate about the difference between British and American approaches to dental care.  In the UK, it is expected one gets dentures early.  Here, bad teeth labels one a hillbilly.  Don’t believe me?  Recall patients or others you’ve seen who had poor dentition.  Didn’t you think of them a little differently?  I label people differently if they misuse grammar.  They label me differently by how I look, dress or the odd things I like to do.  We all pre-judge.

 But it’s more than prejudice; it’s health, and we know it.  SBE and bad teeth.  Heart disease and bad teeth.  Facial abscesses and bad teeth.  Bad breath and bad teeth.  Caries give rise to what some call world stopping pain, and if you’ve ever had such pain you can’t function.  Poor people tend to eat the wrong food, don’t know much about dental care, can’t afford the time or money to fix their teeth, often lose work and can be miserable.  Having suffered from miserable conditions, I counted my blessings I didn’t have to work at the time.  How do these people put up with it?  Same way Colton did—aspirin, somebody’s codeine and a lot of hope.

 Let’s not forget dental care in our discussion of basic medical care, for prevention saves money.  A simple root canal is $1100.  Aren’t we supposed to help people relieve misery?  So why aren’t we doing it?  We’re talking teeth here, not Roux-en-y surgery.

 Colton needs to get on AHCCCS, but that won’t get his teeth fixed.  He’s 22 and headed for dentures before he’s half my age.  This was once the richest country in the world, and we could have dealt with these problems if we hadn’t decided upon socialized world policing and socialized nation building with our socialized military.  It’s time to admit we can’t afford our overseas commitments.  But even the Blue Dogs are silent on that one.

 Once again, here are 4 things we could afford that would help:

  1. Cover all children’s medical and dental care until they are 18.
  2. Limit the maximal debt people can have for medical/dental conditions.  I propose $50K but I’m flexible.
  3. Put in an error reporting system, which I predict will decrease bad outcomes and malpractice case filing through learning.  Make it anonymous and non-discoverable.  And get it running in 6 months.  I know how to do it.
  4. Tie any cuts in physician reimbursement to liability reform and a reporting system. 

I’ve been saying this for years.  Let’s try it.  If you disagree, then I recommend Oscar Rogers’ two step approach from Update Thursday.  It’s on my blog, under 2009 Reality Check, so you can click the link below:

Step 1:  Identify the problem.  We’ve done that, so we’re half way there.

Step 2:  FIX IT!!


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