The Best system in the world.
Andrew Cory
Most of you have probably seen this "Falling numbers of state dentists in England has led to some people taking extreme measures, including extracting their own teeth, according to a new study released Monday."
This has lead many of us Americans to pat ourselves on the back, congratulating ourselves on our high quality of dentistry. After all, in our country of pay-for-play dentistry, we have plenty of dentists. And we never have to pull our own teeth...
Well: I got an Email this morning, from a friend here in the US: "I just saved myself about $300 last night, albeit painfully. I pulled a good chunk of my own wisdom tooth out, by hand. Yep. I'm that stupid. Or rather, I was that desperate to break off the shard that kept cutting my tongue and mouth up all night, and happened to have some prescription motrin laying around still, to dull the massive pain that came afterwards."
Does she have insurance? Of course she does. Can she afford to use it? Not even a little. Still: Good to know that we Americans have the best health care in the world!
Is there some other explanation for the rather desparate course of action your friend took?
I am not parsing that correctly, for some reason. How can she not afford to use what she already has?
Also, things do happen a dentist is not available (nights / weekends). This is not necessarily a market or insurance failure.
Co-pays. Deductible. When the first of the year rolls around, she can afford to use her insurance again.
Anyways, the difference here is that the U.S. doesn't pretend to offer "free" health care, tax you to pay for it, and then force you into DIY dentistry with rationing. If she wants to save $300, more power to her. At least here she has the choice.
Bah
Andrew, the fact that your friend decided to forgo the co-pay and instead pull her own tooth just to save-a-buck, has no bearing on the rest of us. Her need - or her perception of need - has absolutely no claim on the resources of those of us who are taxpayers.
As several have already said. There are thousands of dentists in this country who would have gladly done the work and gave her generous payment terms on the deductable/co-pay. They do it all the time.
And as others have also said, I would much rather pay a few hundred dollars - OF MY OWN MONEY - to get proper dental or medical care, rather than have to rely on a government system paid for by - OTHER PEOPLES MONEY - and not be able to get care at all.
My oral surgeon only charged $225 to extract a broken molar, and the only thing my dental "insurance" paid for was the $30 anesthesia charge. Now the "insurance" says that if I had a dentist pull the tooth, they would have paid, but they do not pay for oral surgery, even though the dentist recommended the surgeon remove the tooth so that the bone would not be destroyed. Such is life with the insurance we have.
I prefer the pay as you go method, over any Government run subsidized medical program.
Oh the poor, poor, pitiful poor. Again, I call bullshit.
A person can get 2000 calories on less than $2.00 - and that's from the grocery store. And there are already programs in place that will supply the speech therapy for a child from a household as poor as you let on to be.
But wait! You have a computer! Must not be as bad as all that.
Regardless, your need still does not have command of my resources.
I didn't like not having money. I decided I should go to college and earn a couple degrees in fields that paid well, so I would have more money. It was hard, but now I have skills that are valuable and produce income. That's how "incentive" works.
It's sad that so many people choose not to acquire marketable skills, and have children without being financially prepared. But decisions have consequences.
My income in college was about $12,000/year before taxes (mostly FICA), and I was paying about $3,500 in tuition and fees. I was able to get along just fine on $8500/year for rent, food, utilities, etc (no car, and I had very basic health insurance through school) with careful budgeting.
You may have been poorer than I was, but you also might have had higher expenses (perhaps through misfortune, prioritization (choosing a higher tuition school, for example), or insufficiently careful budgeting) that exhausted your cash reserves, and I think it's important not to confuse low income with high expenses.
------
Roy, Andrew is saying that at some point in the past he couldn't afford 2000 calories a day. I saw that sort of thing happen to some of my friends in college occasionally, when they overspent early in a budget cycle and didn't have enough money left over for even basic food late in the cycle. He's not saying he's that poor now.
BTW: she owns her own home. Granted, it's a mobile home, but perhaps she should sell that and live on the streets in order to afford her dental work?
I would not though force somebody else give my friend $300.
Did she enquire as to what alternatives she may have had? Did she ask any dentists if they had ways to help her out, or if any friends, family, neighbors, religious congregations, or whatever might be willing and able to help?
I can understand that she might not have considered these options. However, if she did have them then it's my belief (FWIW) that it's better to have your community voluntarily help you out than to have government tax people who are strangers to you under threat of law and force.
And yes, the Body of Christ definitely needs to do a better job of making itself available for such needs.
And sure, you say 'it's just a tooth, why can't everyone chip in and help out with that'. But then it expands, and expands, and expands. But we already know that the supply doesn't expand.
Basically, your friend made choices that turned out bad. Using her dental benefit earlier in the year. Not having savings to allow her to afford an extraction when insurance wouldn't cover it. Complaining to you about it.
However, you, as you are wont to do, are presenting us with that all distilled to a false choice: Having to extract the tooth with string and a doorknob or live with it cutting up her tongue. You know very well that that's not the only choice this person had, yet you build your argument that the rest of us should be all compassionate and be chastised.
I've also busted my ass to make sure I had enough money to do that, even when it meant foregoing a new car or thing I just had to have. If my budget says I shop at K-Mart, I shop at K-Mart. If I can swing Brooks Bros., then that's where I'll shop.
Be true to your teeth or they will be false to you.
And its corollary:
Your government or dental insurance plan isn't going to save you from protracted neglect and
profound dental ignorance.
BTW: she owns her own home. Granted, it's a mobile home, but perhaps she should sell that and live on the streets in order to afford her dental work?
OK, but if she owns her own home and she can't figure out how to borrow three hundred bucks, that is not a government problem.
You are willing to reduce everyone's liberty so we can have dental care security?
What was that Franklin quote again?
It is an instructive anecdote, but I don't think it teaches what you think it teaches.
Yours,
Wince
Selling your home so that you can have access to dental care is having liberty. What a strange world you live in, wince...
No, no, no. Everyone being forced into a government run insurance system is a loss of everyone's liberty. Poor people being forced into a government run insurance system is a loss of poor people's liberty. And of course you do not even consider the liberty of the good people who PROVIDE insurance and the good people who PROVIDE dental services.
It's not an argument about taxes. It's an argument about choices.
Selling your home so that you can have access to dental care is having liberty.
It's a much stranger world you live in where "borrow $300" (which I wrote) means "sell your home" (which you wrote, and which is ridiculous hyperbole on your part).
Yours,
Wince
I considered the cost of dental insurance long ago, and figured if I went about 3 years with nothing but cleanings, and put the money I would of spent on dental care into the bank, that I'd be money ahead if I needed some average work done such as a cavity filled or a tooth pulled. That was about 10 years ago, so far I'm certainly money ahead by not having dental coverage.
I also have a high deductible health plan for the same reason, and since I'm in good health I'm money ahead. But as I get older I'll be reconsidering my choice of health insurance.
Of course that's a risky choice to take, but I could always run up a credit card or borrow money to pay for some real dental bills, then wish I had not taken the risk and paid for dental insurance.
Thus far, I'm glad I chose to not get dental insurance and I'm glad I chose a high deductable plan.
Next I will switch to the same medical plan but this time with a Health Savings Account since a HSA can become a 'retirement' account once you reach 65 - you can withdrawal the money for whatever purpose OR pass it on to your heirs. Just because you have money in an HSA doesn't mean you must spend it when you have medical bills, so if all goes well I'll spend my regular money on bills and use the tax deduction by doing so and not touch the HSA money. That's the plan, but life is what happens after making plans, eh?
(* - It gets complicated for service like police and the military, which may make up for the reduction in liberty from their funding, by preventing a greater reduction in liberty from other sources (oppression by criminals or foreign invaders). But that's another debate.)
Take this extreme example as a thought experiment. Suppose that the government taxed everyone in order to provide everyone with not just dental care, but also housing, food, cars, computers, utilities, entertainment, etc. You go to work, your paycheck goes straight to the government, and the government provides you with a decent material lifestyle no matter what. Is that an increase or a decrease in liberty?
I'm not saying that the optimal level of government services is zero -- there are practical considerations like the externalities problem and the public goods problem which make us all better off with a certain amount of government intervention -- but that's a different thing than liberty.
Zach, health care is now a function of the medical insurance industry and hmo's. Physicians and other health care providers are no longer its leader although they may be co-leaders.
The notion, that any federal government law can replace it or provide optimal or even basic cradle to grave healthcare is ludicrous.
it's clearly not ludicrous as several other nations have done so with varying degrees of success. whether any of the existing or proposed flavors are right for america is a different issue.
It's kinda distubing to see people still having DIY dental care (6% is no joke) in the NHS. On the other hand, it sucks when you have dental insurance, and they refuse to help you out completely.
I just wish we would have an honest debate about private vs public health care. As I tell my students, things are rough all over (qte from The Outsiders) so there is no magic wands for health care anywhere
I'll agree with the varying.
In Ireland, an elderly cousin says hip replacement surgery requires a trip to Lourdes by a relative or your priest, a lot of prayers and wait 9 months to a year.
I'm sure most people on this blog have been poor at some time or other in their lives (mostly while young). That's cool, we can swap stories. But, anecdote=>National policy -- not so hot.
HankB
If so, why?
If so, who is to be compelled to provide it, and why?
I agree. And if Andrew's post was a bleg to help his friend raise $300, for example, maybe this thread would be different. I would go to the household chancellor of the exchechequer, and we would convene our two person parliment, and if we had consensus, we would help. But the disconnect starts in Andrew's post, which makes snarky comments about our health care system.
Yours,
Wince
I agree with Maniakes as well. The optimal level of government services is not zero. But I would like people to at least realize they are trading liberty for security when they propose government provided health care and for that decision to be made consciously by this community as a political body. It is important to note that the liberty of insurance providers and health care professionals is much more curtailed than that of the rest of us.
Yours,
Wince
As a counter-example: one of the common "demons" of modern health care is the dreaded Health Maintenance Organization, or HMO. Many people see HMOs as part of what's wrong with US health care today. Senator Kennedy, liberal health care hero, has said:
So where did those evil HMOs come from? Well, they've been around in one form or another for a century; but their modern incarnation was largely enabled by a Senate bill, the author of which said this:
And who was the author of that bill? Senator Kennedy.
Don't take for granted that change is automatically improvement. Remember the law of unintended consequences.
And yes, Andrew, a system can be the best there is -- maybe even the best there can be, though that's far from proven -- and still be imperfect. Welcome to real life.
As I read that, the $300 savings looked like it was being mentioned as a side effect, not the motivating factor.
Viva la capitalism!
Of course we all lose our tempers now and then. Dean freely admits to being imperfect in this regard, which is why regulars to this establishment will generally be cut more slack than people who we don't know very well.
Still: behave like an adult, or go find somewhere else to play. Thanks.