Getting Dental Care From the Government Can Be Like Pulling Teeth

David Hogberg writes:

The American Prospect’s Ezra Klein cites a Washington Post article as another reason we need “universal health care.”

The article tells the story of Deamonte Driver, a young boy who apparently died of a brain infection brought on by an untreated abscessed tooth. According to Klein, when he advocates universal health care, he is “implicitly including universal dental care.”

The Driver case certainly seems like a compelling anecdote.

But is it really?

The article makes a pretty strong case against government-provided dental care. As described by the Post, here is what happened when the Driver family tried to get dental care through Medicaid for one of their other children:

By September, several of DaShawn’s teeth had become abscessed. [Alyce] Driver began making calls about the boy’s coverage but grew frustrated. She turned to Norris, who was working with homeless families in Prince George’s.

Norris and her staff also ran into barriers: They said they made more than two dozen calls before reaching an official at the Driver family’s Medicaid provider and a state supervising nurse who helped them find a dentist.

On Oct. 5, DaShawn saw Arthur Fridley, who cleaned the boy’s teeth, took an X-ray and referred him to an oral surgeon. But the surgeon could not see him until Nov. 21, and that would be only for a consultation. Driver said she learned that DaShawn would need six teeth extracted and made an appointment for the earliest date available: Jan. 16.

But she had to cancel after learning Jan. 8 that the children had lost their Medicaid coverage a month earlier. She suspects that the paperwork to confirm their eligibility was mailed to the shelter in Adelphi, where they no longer live.

And here is how the article ends:

Reimbursement rates for dentists remain low nationally, although Maryland, Virginia and the District have increased their rates in recent years.

Dentists also cite administrative frustrations dealing with the Medicaid bureaucracy and the difficulties of serving poor, often transient patients, a study by the state legislatures conference found.

Sounds like government dental care results in underpayment of dentists and bureaucratic hassles for patients.

This comes as no surprise to anyone who examines the experience other nations with government-run health care have had with dental care. There are plenty of anecdotes.

There is this one about one dental office having to quit the British National Health Service (NHS) due to lack of funding and hundreds of people lining up at another dental office that did accept NHS patients.

Here’s one where a retiring dentist blasts the NHS. And here’s another about NHS dentists being hard to find in Ryedale, England. But there’s improvement in Devon – the waiting list for a dentist has dropped from 48,000 to only 11,000.

Then there is this man in Scarborough who got so desperate to find a dentist that he pulled out his own teeth. The officials quoted at the bottom of the story claim he could have gotten same-day treatment if he had called the emergency clinic by 8:30 AM. Fair enough, but then pliers and vodka could have been avoided had he gotten some preventive treatment from a dentist first – something that, by the looks of this story, is pretty hard to do.

It appears that the problem stemmed from a 1990 NHS contract that increased dentists’ workload but didn’t increase pay. It got so bad that by 2002 close to 40% of British dentists would not accept new patients.

Funny, that sounds a lot like the problems endured by Americans under Medicaid – so maybe we Americans should be a bit skeptical when social do-gooders promise us “universal dental care.”

-David Hogberg

Addendum, 3/4/07, also by David Hogberg:

One other thing that struck me about the WaPo article was second line: “A routine, $80 tooth extraction might have saved him.”

If it was only $80, why didn’t Deamonte’s mom, Alyce, just suck it up and find some way to pay for it? Unlike in Britain, dentists are easy to find here and it is easy to get an appointment. Politicians and pundits on the left love to use stories about people who had to pull their own teeth because they couldn’t afford dental care. I called dentists in the area in question, found reasonable prices, and most offices willing to offer payment plans. It seems to me that the problem isn’t that folks like Alyce Driver can’t afford dental care. It’s that they expect someone else to pay for it, and they cling to that expectation in the extreme.

I could have written about that in my blog post above. Yet, since my post was about the effect of universal health insurance on dental care, I didn’t want to get off on a big tangent speculating about the parenting (or lack thereof) of Alyce Driver. And now, thanks to David Frum’s brilliance at reading between the lines, I don’t have to.

-David Hogberg


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