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A biting assessment of socialized medicine

By Michael M. Bates
web posted October 22, 2007

Historian Will Durant wrote that first century Romans had access to dentistry, including "gold teeth, wired teeth, false teeth, bridgework, and plates."  Many 21st century Englishmen probably wish they had it so good.

CNN reported last week that some English citizens have resorted to pulling out their own teeth.  In the land of the National Health Service aka socialized medicine, six percent of 5,000 people surveyed confessed to using pliers and glue to treat their own dental needs.  Another three-quarters of those polled said they had been forced to opt for more expensive private treatment.  A culprit is the rapidly decreasing number of dentists willing to participate in the assembly-line mechanism of the NHS.

According to an article in the New York Times last year, 2,000 dentists left for private practice in just one month of 2006.  That might be expected in a system in which providers are required to perform in terms of "units of dental activity."  A former NHS nurse noted she'd worked with a dentist who completed cleanings in five minutes flat.

A problem for the British, as for almost everyone everywhere, is how expensive a dentist is.  Rising to meet a need are companies that offer treatment packages overseas.  One enterprise advertises that a patient, by going to Budapest or Prague, can save up to 70 percent on United Kingdom prices.

It's evocative of foreigners traveling to the United States because their own country's socialized medicine scheme doesn't work as promised.  Rudy Giuliani touched on that in a recent GOP debate: "If we do Hillary care or socialized medicine, Canadians will have no place to go to get their health care."

There's more than a shred of truth in that.  Earlier this year a Liberal Party member of Canada's Parliament journeyed to California for cancer treatment.  Presumably with a straight face, a spokesman for the patient claimed the MP "thinks very highly of the Canadian health-care system, and uses it when needed for herself and her children, as do all Canadians."

Getting back to dental care, members of our own Congress are profitably exploiting an isolated but unarguably heartbreaking incident to justify more government intervention.  A 12-year-old Maryland boy's untreated dental decay spread to his brain and ultimately killed him earlier this year.

Several factors compounded what happened to the child, Deamonte Driver.  For some in Congress and the mainstream media, though, the storyline and conclusion are unambiguous:  More government programs are needed.

Said Congressman Elijah Cummings (D-MD): "In letters and speeches, we all mention Deamonte Driver.  We want to keep the memory of this boy alive.  We want to make sure that life comes out of his death."        

So more legislation's been introduced.  More money's been appropriated.  More hearings have been held.

Lost amidst all this "action" is the pertinent fact that the poor child who died, like other children qualifying for Medicaid, was already eligible for dental treatment under current law. 

The boy's mother, asserts a New York Times writer, "believes their Medicaid coverage lapsed early this year because of a bureaucratic foul-up, perhaps because paperwork was mailed to a homeless shelter after they had left."  A Congressional subcommittee contends the "dental provider network available online was virtually useless to parents and guardians."  The subcommittee's chairman said in May that "Medicaid's inability to provide adequate dental care to children has been known since at least 2000 when the U.S. Surgeon General published his report."

Take your choice:  A bureaucratic foul-up, a worthless online provider network, a system that's simply unable to accomplish what it's charged with, or maybe another reason.

Regardless of how you approach it, the underlying problem is the structure itself.  More legislation, more money, more hearings and more red tape won't substantively improve the situation.  Yet that's exactly the direction in which Congress is moving.

President Bush is widely censured for vetoing the State Children's Health Insurance Program (SCHIP).  This broadly expanded program, which added hundreds of millions of dollars to increase dental services, now covers families with incomes greater than $60,000 per year.  "Children" are individuals up to 21 years of age.  In some instances, funds can be used to cover non-pregnant, childless adults.  Congressman John Shadegg (R-AZ) points out that Wisconsin spends 75 percent of its SCHIP money on adults.  People who already have insurance can drop it and let taxpayers carry the load.  Illegal immigrants could also qualify for coverage.

Naturally, opposition to this careless extension of a program that's already appallingly dysfunctional is portrayed as a cruel, coldhearted attack on children.  In truth, it's fundamentally another big step toward socializing medicine in the U.S.

Keep your pliers handy.  You might need them in the not too distant future. ESR

This Michael Bates column appeared in the October 18, 2007 Reporter Newspapers.


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