MotherJones Blog: My, What Rotten Teeth Poor People Have: The Hidden Health Care Crisis and The Dems

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My, What Rotten Teeth Poor People Have: The Hidden Health Care Crisis and The Dems

On my deathbed, I will contend that the Clintons got a bad rap on their failed 1994 attempt at health care reform. An excellent piece in The American Prospect (hat tip: Washington Monthly) agrees and argues that this time, the Dems can pull it off. Here's (partially) why:

First, the moment is more amenable to reform -- in part because the reality has worsened. Fears abound that we are set to enter a deep recession, but even back when the macroeconomic indicators were fairly good, the health care numbers looked pretty bad. In 1994, 37 million Americans were uninsured. By 2007, that number had ballooned to 47 million. Between 1996 and 2007, the average employee's spending on health premiums for his family shot up 85 percent -- and incomes, of course, have not followed.

"My personal index," says Len Nichols, director of the New America Foundation's health policy program, "is the ratio of family premiums to median family income. In 1987, it was 7 percent. Today it's 17 percent. That fundamental dynamic, that health care costs are growing so much faster than economic productivity, means that even though unemployment is so low and the macro-economic indicators are good, there's still intense, acute anxiety." In other words, the concerns that once appeared only during recessions are now an enduring fact of American life. The health care system is so expensive, so unwieldy, so unstable, that today's participants feel much like the victims of the early-'90s recession.

Business also seems exhausted by the ceaseless march of health care costs and ready for reform. In 1994, when managed care was just beginning to squeeze cost growth, health spending grew by a mere 4.1 percent. It looked like the private sector might prove able to control costs just fine. But the gains from managed care dissipated as the 1990s wore on, and in 2005, health spending grew by 7.2 percent. Much of that cost was borne by the business community.

"It's a global competitiveness issue," says Charles Kolb, president of the Committee for Economic Development, a business coalition. "And even if it weren't, it's a cost issue. Health care costs are growing at a rate that's simply not sustainable. [Our members] are in the business of business, not the business of health care."

Unfortunately, while both Obama and Clinton are likely to at least try do something about health care both remain mum on a crucial aspect: dental care.

Sound silly? Go into the hood and check the choppers around you. I poll-watched last election in a Skid Row neighborhood, lucky me. Guys drunk, in donation barrel clothes with ropes for belts, at 8 am having been paid to vote. I was floored by all the toothless middle-aged and younger people coming in to vote. How could that be? At another community forum where inner city folks were confronting the local newspaper for better coverage—ditto. One woman complained bitterly to me that her neighborhood was red-lined such that she couldn't get a job in reception at the paper. I didn't want to suggest that it might be her exposed gums (among other things) that were the problem. The few teeth she had, all on the bottom row, pointed in every direction but up. We have a dental crisis in America and guess who's getting bitten. From The Nation:

Last Spring, following the death of twelve-year old Deamonte Driver of Maryland whose untreated tooth infection spread to his brain, I wrote about the national epidemic of dental disease and the lack of access to dental care faced by the poor and working class. Last month, an article in the New York Times painted a horrifying picture of the state of dental care, where bootleggers sell dentures that would otherwise be unaffordable to many people missing teeth; where low Medicaid reimbursement rates perpetuate a dearth of participating dentists; where untreated cavities are a leading cause of kids missing school, people use Krazy Glue to reattach broken teeth, or swish rubbing alcohol to treat an infection, "burning the gums and creating ulcers."

Currently, Medicaid only covers pulling teeth to treat infections -- not root canals or dentures –- which can certainly dim the job prospects for someone trying to earn a living in our economy.

"Try finding work when you're in your 30s or 40s and you're missing front teeth," Jane Stephenson, founder of the New Opportunity School in Berea, Kentucky told the Times.

We couldn't find $80 to have a 12-year-old's tooth fixed but found $300,000 for the hospital to treat him while he died of infection.

Lacking health care, I hadn't seen a dentist in nearly four years. Halfway through, I broke a back tooth and couldn't chew on that side. Nice, huh? Even once I got a job with benefits I had to pay 60% of the cost -- approximately $600. Doc said I'd been heading for a root canal. What a system. Yet, neither candidate would speak to reporters about their plan for dental coverage. Maybe they don't have one?

Comments

I TOTALLY AGREE WITH YOU ON YOUR POSITION OF What Rotten Teeth Poor People Have:..

I LIVE IN SOUTH DAKOTA WHERE THERE ARE 7 INDIAN RESERVATIONS..AND YOU ONLY NEED TO DRIVE THROUGH ANY ONE OF THEM(DON'T EVEN HAVE TO GET OUT OF THE CAR!!) TO SEE OVERWHELMING EVIDENCE OF THE RELATIONSHIP OF THE POOR TO THEIR LACK OF DENTAL CARE...ON THE RESERVATION, PEOPLE ONLY GET GOVERNMENT DENTAL CARE(THATS THEIR OPTION-GOVT, OR NOTHING)...WHICH MEANS WE CAN PULL 'EM FOR FREE, BUT THATS ALL FOLKS!...THE DOCTORS AND DENTISTS ON THE RESERVATION ARE ALL STATIONED THERE, AS THEY ARE IN THE MILITARY...THIS IS A THROWBACK FROM OUR DAYS OF THE WILD WEST WHERE THE GOVERNMENT WOULD STATION THE MILITARY ON RESERVATIONS TO CONTROL THE INDIANS...IT ALL JUST CONTINUES...TO THIS DAY!!

PEOPLE WAKE UP!...THESE ARE ABSOLUTELY 'THE POOREST' PEOPLE IN OUR COUNTRY!!....STILL BEING CONTROLLED BY OUR MILITARY!!...(THE FIRST TIME I EVER SAW AN ARMY MAN HE WAS THE DENTIST-TALK ABOUT BEING CONFUSED!?!)

YOU CAN'T EVEN BRING UP DENTAL HEALTH CARE THERE WITHOUT RAISING SOME IRE...EVERYBODY...I REPEAT EVERYBODY THERE HAS DENTAL PROBLEMS!

NATIVE AMERICANS(FROM WHOM WE HAVE STOLEN THIS GREAT COUNTRY BY LIES, BOOZE AND FORCE) CONTINUE TO BE DENEGRATED AND DEMEANED BECAUSE OF WHAT THEY LOOK LIKE...FOR THEIR POOR DENTAL HEALTH....IN INDIAN COUNTRY, PEOPLE HAVE EVEN LEARNED TO IGNORE GLARING AND OBVIOUS DENTAL PROBLEMS/DISASTERS WHEN SPEAKING WITH SOMEBODY, BECAUSE THERE IS NOTHING THAT CAN BE DONE...THESE ARE OUR ELDERS AND OUR CHILDREN!...NO AGE BOUNDARY...AND THERE IS NO MONEY...UNEMPLOYMENT IS THE NORM...THERE IS NO TRIBAL INVESTMENT...SOME TRIBES ARE ACTUALLY BROKE!...AFTER HAVING SOLD THE ENTIRE STATE OF MINNESOTA FOR FOR 8 CENTS/ACRE!!(SANTEE)(THE MOST VALUABLE FARMLAND AND WATER RESOURCES IN THE WORLD)...AND SOLD SOUTH DAKOTA FOR $25/YEAR FOR 5 YEARS!(CROW CREEK)

CONTINUING THESE PRACTICES ARE PART OF A HUNDRED YEAR OLD PLAN TO BRING THESE ONCE PROUD PLAINS WARRIORS TO THE LEVEL THEY ARE AT NOW AND WHERE THEY WILL CONTINUE TO REMAIN FOR YEARS TO COME...DUE TO THE IRRESPONSIBLE/PURPOSEFUL WAY THAT OUR GOVERNMENT HAVE 'TAKEN CARE OF THEM.'

Posted by: BIG JON on 01/23/08 at 12:15 PM Respond

OOPS, THERE ARE 9 RESERVATIONS IN SOUTH DAKOTA...JON

Posted by: BIG JON on 01/23/08 at 12:26 PM Respond

Thanks, I wanted to say the same thing but i did not know how!!

Posted by: Ken Four Cloud on 01/23/08 at 1:55 PM Respond

It's not just the lack of dental care that is a problem. Poor people also don't get the vitamins that they need. They have to eat food they can afford so that means a lot of spaghetti or macaroni and cheese. I searched out recipes that didn't need milk or eggs so I could always make biscuits or bread without having to buy those things and a cake that was made from scratch with no eggs or milk. And I could always make gravy with a little flour and margarine using powdered milk we got for free each month. Needless to say, these are not nutritious, but they were filling so my kids weren't hungry. Many times I went without to feed them.
It wasn't until April 2005 that I finally got sick enough to take myself to the emergency room. Of course my kids are grown and parents themselves now and we survived. But by the time I went to the emergency room that day, I'd been having chest pain for years. That particular night they didn't stop and I spent the whole night in too much pain to sleep and finally making up my mind at 7am that I would HAVE to go to the hospital instead of going to work. I hadn't seen a doctor for 16 or 17 years. The doctor told me I was severely anemic. My blood pressure was through the roof. I have since gotten a stent and have 11 medications I have to take, 3 of them twice a day. They told me if I had gone to work that morning instead of going to the hospital I wouldn't have lived another day.
People make fun of people who are overweight because the stereotype is they are lazy and eat too much. In most cases it's just that they can't afford to eat the healthy food. Do you know that Ensure is close to $10 for a package of 6 cans? I don't drink it myself, but doctors recommend it for people who need more vitamins. I opted for instant breakfast instead and that is expensive too, but at the time I was in a very LONG recovery from surgery and had to have the extra protein. That at a time when I'd been sent home from work because I couldn't wear my proper shoes and had no income and was not getting food stamps either.
And yet I hear all the republicans whining about cutting medicaid and medicare AGAIN. Cutting pay to doctors who treat those patients AGAIN. Mitt Romney thinks that everyone who goes to the emergency room gets FREE health care, therefore we don't need to change anything.
Dennis Kucinich is the only one who KNOWS how stupid it is to pay insurance companies instead of doctors for health care and you see what they are doing to him. They ignore him and deny him the right to be heard. I know ONE thing. Four more years of Republican Rule will be long enough for them to decimate Medicaid and Medicare to the point there will be no doctors left willing to treat those patients. We have already lost 4 primary care physicians in my small town alone. Without Medicaid, I and many others WILL DIE. As far as I am concerned, that is what ALL republicans want and Democrats don't care enough to fight for us either. Except one. The one who cannot be HEARD.

Posted by: Laura Nason on 01/23/08 at 2:08 PM Respond

ON ANOTHER MOJO BLOG RUBEN POSTED:

Jon, I think the "Elders" are the Elders of Zion.

THE REFERENCE TO THE ELDERS OF ZION ARE ABOUT A BOOK THAT WAS WRITTEN(ATTRIBUTED TO JEWS)FROM WIKIPEDIA: and takes the form of a speech describing how to dominate the world, the need to control the media, finance, replace traditional social order, etc. It is one of the best known and discussed examples of literary forgery, and a hoax...

SO WHAT DOES THAT HAVE TO DO WITH THIS TOPIC?...

IT IS WELL KNOWN THAT THE TRADERS, AND INDIAN AGENTS WERE ACTUALLY COLLUDING IN THESE EFFORTS TO DEFRAUD THE INDIANS OF THEIR LAND...

THE ELDERS I AM TALKING ABOUT ARE OUR HIGHLY ESTEEMED TRIBAL LEADERS...JON

Posted by: BIG JON on 01/23/08 at 2:08 PM Respond

I agree that this desperately needs to be addressed.

I'm not eligible for benefits at my job (32 hours per week) and my husband is self-employed. We can afford dental insurance, but STILL can not get it. I have never researched something that has been more frustrating.

No one needs to feel sorry for me, as if I have to, I can, in theory, fork out the $1200 to get us all a checkup and a cleaning, but what if somebody needs something else?

And moreover, what are people who couldn't come up with $1200 if their lives depended on it expected to do?

But I also agree with the commentor who sees the real issue as low-income and impoverished children receiving adequate nutrition so they develop strong, healthy teeth. If you have strong, healthy teeth, floss and a toothbrush you don't need a dentist all that often anyway.

Posted by: Staci Schoff on 01/23/08 at 7:54 PM Respond

The uniformed vs the uninsured? My mother lost her teeth at 27yrs. and my father at the age of 50. They stressed the importance of an education and I attended dental school in the late 1970's. My childhood could have been like Deamonte Driver's mainly from my parents lack of understanding or prioritizing dental health. Since dental school I have not had a cavity(knowledge heals). I have have a sixteen and a thirteen year old who have not had a cavity. I took responsibilty for their dental hygiene and diets with excellent results dispite their gene-pool. The author of the article and the working couple need to seek knowledge for a healthy mouth and cease to continue a mis-informed dependencing on the "smoke-and mirrors" dental benefit companies(they are making money also). (Note there is no such thing as dental insurance. They do not protect you from poor or catastrophic dental health, but only help slightly with a relative minor things)I suggest find a caring Dentist and work out a long and short term plan for a lifetime of good dental health for a lifetime. I was blessed to have been fortunate to have parents who culturally were not able to appreciate dental health when I was a child, but wise enough to understand that a education will help with many ills in the world. Knowledge and responsibilty by can end our mis-guided dependancy on someone else's benefit set. Knowledge is power and with the internet and guidance of caring dental health providers you can find the road to dental health that will fit your needs. Our priorities or values should be directed to improving our quality of life, unfortunately we as adults only get one set of permanet teeth. I hope your brush and floss your way to health and eat a healthy diet and live a long and productive life. Patrick J Foy DDS

Posted by: Patrick J FoyDDS on 01/24/08 at 4:49 AM Respond

Ms. Dickerson,

I used to work for a Federally Qualified Health Center (FQHC). That's about the only kind of health center President Bush approves. FQHC status gives the health center "enhanced" medicare and medicaid reimbursements. In other words the center can make a lot more per poor patient than a private doctor. These centers must provide care to those who do not qualify for medicaid through a sliding fee scale based on income. One practice that I was aware of in the dental department was to bring the medicaid patient back 3 times for routine things. For example; a patient would have his teeth cleaned and be given another appointment for x-rays, and then be given a third appointment for consultation with a dentist. Triple dipping. Just shows that you can make a lot of money on the poor. By-the-way, the FQHC also got a federal grant for providing care to those "sliding fee" patients. Thai would make a good story.

Posted by: Dale Godfrey on 01/24/08 at 10:03 AM Respond