The Dentist Will Be You Now

Say what you like about socialized medicine, it certainly encourages self-care:

"I snapped it out myself," said William Kelly, 43, describing his most recent dental procedure, the autoextraction of one of his upper teeth.

Now it is a jagged black stump, and the pain gnawing at Mr. Kelly's mouth has transferred itself to a different tooth, mottled and rickety, on the other side of his mouth. "I'm in the middle of pulling that one out, too," he said…

Mr. Kelly's predicament is not just a result of cigarettes and possibly indifferent oral hygiene; he is careful to brush once a day, he said. Instead, it is due in large part to the deficiencies in Britain's state-financed dental service, which, stretched beyond its limit, no longer serves everyone and no longer even pretends to try.

Whole thing here.

Big Book of British Smiles here.

Comments

[lunchstealer]

It's a man's life in the British Dental Association!

[The Real Bill]

He brushes only once per day?
Then he deserves tooth decay.
Brush more often,
And maybe even floss.
Even better,
Sonicare will eliminate the dross.

(Yes; I know that I'll never be a poet laureate.)

[Ruthless]

It must be in the water.
The French refuse to brush on religious grounds, yet they are beeyootiful.

Or could it be the tangle of tongues of zee Fwench keese zat doos zee twick?

Sign me ooop!

[NCDan]

I'll bet British politicians and government officials can get all the dental care they need.

[D.A. Ridgely]

I'll bet British politicians and government officials can get all the dental care they need.

As long as flights to the U.S. are cheap.

British dentistry has long been a standing joke. Then again, the omnipresence of Cadbury vending machines probably doesn't help matters.

[crimethink]

NCDan,

Your point would be easy to believe were it not for the counterexample of Prince Charles. The teeth that lunched a thousand chips...

[semm]

From the article

Britain has too few public dentists for too many people. At the beginning of the year, just 49 percent of the adults and 63 percent of the children in England and Wales were registered with public dentists.
And now, discouraged by what they say is the assembly-line nature of the job and by a new contract that pays them to perform a set number of "units of dental activity" per year, even more dentists are abandoning the health service and going into private practice ? some 2,000 in April alone, the British Dental Association says.

Clearly, the only solution is to forbid dentists form entering into private practice.

[Ruthless]

Writhing tingling tangle of tongues.
Fuck Pepsodent.

Help me smacky.

[JD]

Well, looks like I get to start making fun of the Brits again, just as I was ready to admit that yeah, yeah, it's not really like that now. "Dental vacations to Hungary", Jesus H. Hopscotching Christ. Maybe Britain needs some, uh, "Open-wide-easies".

[Mark]

Reminds me of this:
http://www.newyorker.com/fact/content/articles/050829fa_fact

[rm2muv]

Perhaps it's all of that dental self-care that has led to the Brits living longer than Americans, and having fewer cases of heart attacks, dabetes, high blood pressure, cancer...

Or maybe there ARE benefits to providing universal medical care, even if there are waiting periods and the super rich have to go elswhere to be treated in the manner in which they'd like to become accustomed.

I teach school in a rural area of Idaho and see plenty of children and parents in need of severe dental care. My own dental insurance is relatively inexpensive because it provides strong incentives for REGULAR care. They have found that it's a lot cheaper to keep teeth healthy than fix them. Now, if we could just make this kind of care avaiable to everyone...

[Austin Powers]

Oh, behave, baby!

[Rick Barton]

Which reminds me, about three years ago I started with a new dentist who was quite cute, single, and she was one of those gals who just exudes sexuality, ya know, like without the slightest effort. I had had interesting conversations with her and was thinking about how I might ask her out, and of course the male mind does tend to explore all the possibilities in these matters...

So one time while I was waiting for her to work on my teeth, one of the receptionists, who was from Belerus, said; "Rick, Dr.____ will do you now"! As I got up I said; "So how did she read my mind?". But I was too clever by half cuz although the foreign receptionist didn't understand the import of the exchange, the other folks behind the desk certainly did! Damn, I just wanted to be beamed up and outa there.

[JD Jaxson]

I havent been to a dentist in 7-8 years and my teeth are perfect.Is it all genetics? My brushing regimine? Is US water healthier?.. I never cared for the dentist but I used to go every 6 months. Then one time they had to reschedule and asked me to change my appt and it would be 5-6 months until they could fit me in! So I never resceduled and forgot about, insurance ended, etc. I have a lot of friends who see the dentist 2x a year and have yellow crooked teeth. Perfect teeth and perfect health fpr me. JD- Docter Free since 2002 and Dentist-Free since '98

[Rick Barton]

...Oh yeah, I left out that after I asked; "So how did she read my mind?" I then asked; "Does this mean that I don't have to pay for my dental work, or does it mean that I have to pay more?"

[Rick Barton]

...perfect health for me. JD- Docter Free since 2002

Be careful, JD! If you haven't had any med tests since 2002, you don't know if you're in perfect health.

[JD Jax]

Well considering the last few times I went to a doctor when I really WAS sick, he spent abou 3 minutes with me and asked if I smoked pot. I said "no". He said "hmm" and gave me some generic antiobiotic.. Not sure what I would do or say to a doctor now when I am not sick... My Teeth are Bangin' though!

[Joe]

rm2muv,

How exactly does having a socialized healthcare system help the British have fewer cases of cancer than in the US?

Does it work in mysterious ways, through the communal virtue it instills in the people?

[JD Jax]

Never had a hot dentist but did have a GF from Minsk,Belarus- She definitely knew what "Do you" meant...

[Ralph Wiggum]

No, Nooo ! Take it away, take it a-awayy !!

[BarryJV]

rm2muv

Or maybe there ARE benefits to providing universal medical care, even if there are waiting periods and the super rich have to go elswhere to be treated in the manner in which they'd like to become accustomed.

The problem with Health care in the UK is not that the government provides basic health care for all, it's that it controls health care for all, except of course for the very rich that can afford to the costs of private care as well as the tax. Hospitals are owned by the government, so even if you want to pay for the treatment you need, you might find that you can't.

In many areas of the country it is simply impossible to find an NHS dentist, so you have to pay for private care, but you don't get any money from the NHS towards private care and you don't even get any of your tax returned.

[Jersey McJones]

What a crock of shit. I have friends from Britian, and friends from Americans who live there and have been there often, and I regularly work with a pile of Brits, all who have used their healthcare system and say it's just the same if not better than ours.

It's a shame to see this sort of low-brow demogoguery in the name of dogmatic, over-zealous ideology that flies in the face of the proven benefits of national healthcare as seen in 36 countries and every First World nation on Earth except ours.

And why is ours' so behind the times? What's the real "reason?" To profiteer from the system with the lowest of lowest scumbaggery - to profiteer from the uncertainties of mortality.

Makes me sick - and not the healthcare kind.

JMJ

[SY]

I have friends from Britian, and friends from Americans who live there and have been there often

JMJ, I'm just boggled that you've got friends.

[Jersey McJones]

Sy, I'm just boggled that Americans are so insipidly greedy as to profiteer from the healthcare system.

JMJ

[Ironchef]

Those dentists/doctors probably "profiteer" for the same reasons you do Jersey. You know - food, shelter, kids, education. That kind of materialist crap.

[Serafina]

There's a dentist shortage in the U.S., too, pretty severe in a huge swath of the Great Plains, southern Texas, much of Nevada, northern Maine, and poor, rural counties in many other states. The current system in the U.S. isn't all that much better in giving people access to dental care, but for cultural reasons we do so much better with preventive care than the UK.

[Jersey McJones]

Ironchef,

"Those dentists/doctors probably "profiteer" for the same reasons you do Jersey. You know - food, shelter, kids, education. That kind of materialist crap."

Those dentists could make even more if there weren't sleazy profiteers in the way. Ask any dentist what it's like to get the insurance companies to pay their bills and you'll see what I'm talking about.

Only you, Ironchef, would be so off the point as to think that I was referring to the actual service providers. Genius.

JMJ

[the other Mark]

Ah, profit: the dirtiest word in the English language.

[Jersey McJones]

Mark, there's nothing wrong with profit at all, per se. But profiteering, extorting, taking advantage of bad things for money, is disgusting. That you, like so many Americans, lack the insight to see the inherent problem with todays private insurance system shows the world what a bunch of dumb-asses Americans really are.

JMJ

[Dave W.]

In England the healthcare (non-dentistry) is basically socialized and the dentistry is considered as private (notwithstanding the tax for it). I already knew this by frequenting the Unofficial Fall Board.

Weird to see the spin that gets put on these facts here at this board.

My question:
If the gov't gets out of dentistry entirely in the UK, would dental prices for private dentistry there go up or down do you think?

If the answer is up, then maybe those taxes are best seen as a price to pay to keep prices where they are now.

[the other Mark]

You're my favorite troll ever, Jersey. I wuv you.

[Jersey McJones]

I wuv you too. Smmmmmmmmoooch.

JMJ

[Jersey McJones]

Yeah, I suppose I am... Though most people get a kick outta me. Some find me obnoxious, but aat least I care about the world around me, ya' know. That's why I love these sorst of sites. The marketplace of ideas is my favorite place to shop... er, uh, I guess "haggle" is a better word...

😉

Thanks man!

JMJ

[Another Lurker]

Come on how can anyone be against Universal Heathcare? It's free!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

[Jersey McJones]

Al, no one is so stupid as to think that "it's free" though the geniuses on the right would have their debased base think so.

Look, can you show me a cost benefit analisys that shows the value added to the healthcare system by private insurance?

Go ahead. I dare you. I've dared many a debator over the years to show me this. Not one has ever come to the fore. Can you?

JMJ

[Dave W.]

Look, can you show me a cost benefit analisys that shows the value added to the healthcare system by private insurance?

If there was no private insurance system (and no socialized medicine to take its place), then old people would pay more and young people would pay less. The value added is the shifting of the burden from old people to young people. This is valuable because old people are sympathetic and vulnerable, and young people have their entire lives to make more money.

Besides the profiteering that you (correctly in my view) mention, this is the other valuable thing the insurance system provides us.

[The Real Bill]

JMJ,

It's not about value added; it's about freedom. You damn control freak.

The desire to control others is at the root of all evil.

[Dave W.]

It's not about value added; it's about freedom. You damn control freak.

You mean like the freedom to tak your $$$ and opt out of the insurance system and to deal face to face, person to person with your doctor or dentists about things like prices and payment terms?

No. If the US has maintained this important freedom at all, it is only in the theoretical and not the practical sense.

[Jersey McJones]

Bill, your freedom isn't worth a pile of shit if your dead.

JMJ

[the other Mark]

Dave,

How do you figure?

[Dave W.]

Another value for McJersey:

Traditionally, by structuring health insurance as "insurance," rather than as a "amrket" effectively exempted this sector from antitrust scrutiny. In today's climate that may not seem like a big deal. However, historically doctors needed that structure so that they could consolidate to the extent that they are now consolidated.

So another value of the insurance structure was that it facilitated freedom to consolidate business ventures at a critical time in the development of the modern healthcare market.

[Dave W.]

The Other Mark:

Not sure what your question is. The main reason that I can't as an individual go out and bargain with an individual doctor or dentist is that they have all been convinced to charge their non-insurance patients many times what they charge the insured. That is why there is a theoretical freedom to DIY, but not a practical freedom.

[The Real Bill]

Dave,

If the government would get out of the healthcare business, we might just see a functioning market.

Jersey,

Nothing is worth anything to you when you're dead. So what? Buy your own health insurance and stop trying to steal it from others, thief.

[Steven Crane]

One thing I wonder:

If people in the UK have fewer cases of heart disease/cancer (I'm assuming this is per capita) than people in the US... then what exactly do people in the UK die of?

[the other Mark]

Dave,

Proof by counterexample?

I wish more doctors did this. I only need to go to the doctor every few years, and I'd prefer to pay in cash and keep a smaller insurance policy just in case of lukemia/motorcycle accident/bear attack.

Plus, I wouldn't have to wait as long at the counter and deal with those fucking rude-ass receptionists and their eye-watering perfume.

[the other Mark]

Dave,

I forget what I was asking you "how do you figure?" about. I should have been more specific.

Stupid brain. *smacks head*

[Dave W.]

If the government would get out of the healthcare business, we might just see a functioning market.

Getting government money out of the market might (or might not) help. What the government does need to do is to deconsolidate the cartel so that there are a multitude of truly independent competitors *actually competing against each other* in the business sector. If that happened, I would call it a market instead of a business sector. i know that many independent competitors actually competing against each oter are required to have a market because Adam Smith told me so. What Adam didn't realize is that markets don't spring up naturally under all conditions. You either need physical / communications barriers to consolidation (Smith's time) or antitrust law (in the post rr / telegraph era).

[Jersey McJones]

I have excellent insurance - but then, of course, I don't work for Americans.

What I am still waiting for is proof of the value added to the industry by the private insurance industry.

Dave points out, quite correctly, as usual, that in the early days of the industry, insurance was a vital resource. Now, though, as exemplified by the rate hikes immediately following the last market crash and recession, the "insurance industry" has shown itself to have become nothing more than an investment banking industry, as exemplified by "Prudential Financial."

So, why couldn't the government contract out actuation to the lowest bidder/highest quality actuators through a single payor system?

JMJ

[the other Mark]

So, why couldn't the government contract out actuation to the lowest bidder/highest quality actuators through a single payor system?

Yeah! And we'll put Mike Brown in charge!

[Another Lurker]

"Look, can you show me a cost benefit analisys that shows the value added to the healthcare system by private insurance?"

Under private I don't die waiting for rationed care. Canada is full of horror stories such as this, but they are too proud to admit that they have created the largest HMO in the world. They acted so haughty about it they can't admit they screwed up and that it sucks. That is a shame. Go to Canada and break you leg or get pneumonia and see what happens to you if you don't have the money to pay up front as a foreigner.

I can also choose my doctor under private care. I can also opt out of insurance and deal directly with the doctor as pointed out above thus taking out some of the overhead.

I have no problems with looking for better solutions for the underinsured, but not if the solution comes at the expense of everyone else. I don't need a cost benefit analysis to tell me this.

[Dave W.]

So, why couldn't the government contract out actuation to the lowest bidder/highest quality actuators through a single payor system?

I think this is a 2d best alternative -- much, much preferable to the current system. If you get rid of the market, you want to at least have some kind of sanity check so that prices don't get too far out in front of costs. Normally the invisible hand of the market does this, but . . .

Not sure if you saw it McJersey, but in one of Bailey's posts a month or two ago, he was pitching some kind of hopeful, future (probably vaporware) medical treatment by saying "how much would you pay for this?" How much would you pay? What kind of unsophisticated customers does he think we are at HnR? The appropriate question is how little will your associates being willing to do this for? They have gotten so acclimated to profiteering in US healthcare that I don't even think they know what the word means anymore.

[Jersey McJones]

Lurker,

Why are you so naive as to believe such tripe? Did you know that life expectencies in virtually every country with national healthcare is longer than ours? Disease rates? Infant mortality rates?

Why are you so ready to believe such a steaming pile of shit? Oh yeah - post rationalization...

JMJ

[Jersey McJones]

Good point, Dave. There's a cognative dissonance at play with this issue that seems almost insurmountable - and I still get get a good answer on the value-added question. I'bve been asking that for years...

Then there's the drag on our exports, then there's the drag on our providers, and on and on. Yet no one has any answer but "Adam Smith!"

Jeesh.

JMJ

[the other Mark]

Jersey,

I don't think anyone around here who believes that the current system isn't an unmitigated clusterfuck. But really now, what makes you believe that the US government, of all entities, would suddenly find enough competence to fix it?

[Another Lurker]

Jersey why are you so willing to believe the pie in the sky? There is not a socialized healthcare system that is not groaning to the point of near collapse. Especially with the generation that is about to hit retirement age.

Why also are you willing to sell all choice down the river just so you can have "guaranteed" care?

I certainly don't think the American system is a panacea. Most of the problems and expenses come from litigation and legislation. As your Doctor how much their office alone had to shell out for the worthless and redundant privacy legislation from a few years back. Who paid for that? All of us with increased costs.

Talk about believing in a steaming pile, have you checked out the one you are standing in?

[the other Mark]

...I don't think there's anyone...

[Dave W.]

There are other people out there besides me suggesting antitrust-type deconsolidation action againt US healthcare companies as a central mechanism of healthcare reform?!?! I want to study these people. I want to give them contributions and vote for them. Who are they?

I feel about the Adam Smith solution to healthcare the way Ghandi felt about Western Civilization.

[Jersey McJones]

I think you have an excellent point there, Dave. Insurabce premiums should be for insurance expenditures - not market speculations...

JMJ

[kulm]

The reason why life expectencies in virtually every country with national healthcare is trifle longer than ours has a lot to do with the not so trifle fact that the USA are still IMPORTING POVERTY to a much higher magnitude than these countries. Same with disease rates and infant mortality (not to mention illiteracy and uninsured drivers in junkers).

Abate illegal immigration, and life expectencies will grow (not a lot but still)!

[Jersey McJones]

Kulm, or perhaps we run ourselves ragged working for the corporatocracy that you libertarians workship like Baal....

JMJ

[Russ 2000]

Would you want your teeth worked on by a Dr. Anis??

[ChicagoTom]

I think you have an excellent point there, Dave. Insurabce premiums should be for insurance expenditures - not market speculations...

That's the biggest problem with the insurance industry / companies today. They speculate quite a bit in the financial markets, and then jack up premiums when they lose money (or the economy goes south).

Most people don't understand that the premiums they pay are taken and invested in the financial markets, and then have no idea why their premiums started to sky rocket when the "recession" started. It's not as if people started getting that much sicker than the 90's -- its that the economy went to shit and and the insurance companies had to recoop their market losses.

[Dave W.]

I think you have an excellent point there, Dave. Insurabce premiums should be for insurance expenditures - not market speculations...

That's the biggest problem with the insurance industry / companies today. They speculate quite a bit in the financial markets, and then jack up premiums when they lose money (or the economy goes south).

This gets us close to the nub of the problem, but not quite there.

Of course any business ("insurance" or not) that takes in a bunch of pre-paid money has to be concerned about getting a good return on the big cash pot sitting there. Of course the performance of the cashpot will have some affect on what they charge all those pre-pay customers on an ongoing basis. That part is not an indictment of the healthcare insurance sector, at least not as far as I am concerned.

The problem is lack of competition. If there was true competition among these companies, then they would speculate in different ways. Some would speculate very conservatively to avoid any price spikes. Others would speculate more wildly, perhaps achieving lower premiums over the long run, but with lots more year to year fluctuation (which might drive away customers despite the long run cost savings). [i]Speculative companies would have to lower their premiums when the investments paid off[/i] -- customers will not appreciate the speculation if they don't take a pretty good share in it. Specifically, the customers would go with companies that speculated less and took more of the McJersey approach (insurance premiums are for medical care, not investment).

So, to my mind, the problem isn't the speculation, but the lack of competition in speculation. The attitude seems to be "we, the health insurance co's, are all speculating, so we can feel free to milk the smart investments and let the premiumpayers eat our loser investment. This strategy only works if your customers are captive because of lack of consumer choice. THAT is the real problem here.

A great problem for antitrust law, but so many people have bought into the current-US system (cartel) versus socialized medicine debate that third choices are hard to get across, even here at HnR.

[Jersey McJones]

Well Dave, there are investment rating systems that could be regulatorily attached to the different plans for the sake of disclosure. That sounds fair. You could score an insurance company by it's investment ratings, for example, or you could restrict different types of plans to types of ratings... hmmm...

JMJ

[Serafina]

Under private I don't die waiting for rationed care.

People in the U.S. die waiting for rationed care all the time. We simply ration by ability to pay rather than by another mechanism.

[Dave W.]

Yeah, McJersey -- I mean I think even the US is headed to socialized medicine (HnR notwithstanding) and I already moved to Canada, so obviously I am not too put out by the prospect.

It is frustrating for me because the two options everybody has in mind are centralized private control (the current system in the US) and centralized public control (socialized med).

My option is decentralized control, and I think this missing option has great advantages over each of the two options that everybody considers. For example, decentralization can make the degree and types of healthcare provider investment speculation more intelligent because of its multitudinous, dynamic, trial and error approach. I would much rather have Hillary ensuring multitudinousness than monitoring the quality of speculation of others. Even if she did make a bundle speculating at one time -- scratch that -- precisely because she made a bundle speculating at one time.

[Col Dubois]

Are Dave W and JMJ finished sucking each other off yet?

[Dave W.]

While McJersey and I seem to have some mutual respect going, our posts on this thread are in pretty profound disagreement. Bring me the dick of Adam Smith!

[Rex Rhino]

People in the U.S. die waiting for rationed care all the time. We simply ration by ability to pay rather than by another mechanism.

No they don't. Hospitals and doctors in the U.S. pretty much treat everyone who comes in. My Canadian cousin, with no job, no insurance, single mother, etc., chose health care in the U.S. to her birthright in Canada, because even poor people with not a single penny recieve better healthcare.

I know first hand, that hospitals in the "ghettos" of Detroit are still a lot nicer that the hospitals I have visited in Canada.

Any difference in life expectancy is because:

1. Americans eat shit and don't exercise.

2. The victims of 18th and 19th century racism of America, live in America (African Americans and Native Americans), where as the victims of 18th and 19th century racism of Europe live in Haiti, the Congo, India, South Aftrica, India, etc., etc. Lets see how efficient Europe's health care system is if they had to deal with the racist past they pretend never happened.

3. America imports poverty, through immigration. The most "liberal" immigration policies in Europe would give Pat Bucannan a hard on!

[Dave W.]

Any difference in life expectancy is because:

What do you reckon the US life expectancy would be if they didn't have such great healthcare, Rex Rhino?

60?

55?

It almost seems like the US should re-channel some of its healthcare spending into a more direct assault on the problems that allow people in the more successful nations to live so much longer.

Now, I wasn't considering Mexico as one of these more successful nations, but, still, check the Wiki:

"Life expectancy in Mexico increased from 34.7 for men and 33 years for women in 1930 to 72.1 for men and 77.1 years for women in 2002."

In light of this stat, I don't think I can buy into the "let's blame immigrants for short life expectancy thing" that would be so convenient to your viewpoint were it only true.