Universal neglect: A failure to protect Americans’ health

I received a letter from a friend last month.

It was a letter he should never have had to write, yet did so out of desperation.

He is 80 years old, living off occasional writings and Social Security.

He has Medicare, but no dental insurance, and that’s the problem. He needs dental work. A lot of dental work, $10,000 worth of dental work.

Many dental insurance plans for individuals are so expensive, and give relatively few benefits, that many dentists suggest the premiums just aren’t worth it.

Without the dental work, my friend, like many people in the country, will suffer significant additional problems. Infection is one. Poor nutrition is another. There are even links to diabetes and thickening arteries.

So, my friend sent a letter to his friends asking for help. Not a lot of help. Maybe $100 from each of us.

Paul Krassner, my friend and colleague, is a giant in the world of social activism and journalism, praised by Groucho Marx and George Carlin, despised by the Nixonian establishment. He was a proud member of Ken Kesey’s Merry Pranksters; with Abbie and Anita Hoffman, Jerry Rubin, and Nancy Kurshan, he was a co-founder of the Youth International Party, better known as the Yippies. For almost five decades, he has been one of the nation’s most influential editors, satirists, and columnists, his writings appearing in major newspapers and magazines.

Recently, two of those magazines that ran his column decided they could no longer run it. One editor said the column was spiked because the magazine was “shifting to a more business/retail-oriented editorial content.” The editor of the other magazine, which had published his column for decades, said he had “great admiration for you and your writing,” but decided another writer would now take over that column. That’s just the way it is in journalism.

And so my friend has found his income not just slipping but in free-fall.

If he—the great writer, reporter, and editor—was the only one with this kind of problem, it still might be a story. But he isn’t the only one. And that’s why this story is so important.

Millions of Americans—most who have worked hard their entire lives, and now live on not a lot of money—can’t afford dental bills. So, they don’t see the dentist.

More than 45 million American adults don’t have dental insurance, according to a report by the Centers for Disease Control. Medicare doesn’t cover dental procedures; Medicaid, primarily for low-income individuals, only covers dental care for those under the age of 21. However, about one-fourth of all children have untreated tooth decay, according to a report by the Kaiser Family Foundation. “Our system of providing oral health care, particularly for children in this country, is ineffective, inefficient and it’s extremely expensive and it really deprives children of decent care,” says Dr. David Nash, professor of pediatric dentistry at the University of Kentucky.

Among adults, according to the Foundation, lack of access to adequate dental care impacts low-income families, the elderly, and minorities more than the general population. Want to know why so many people in those categories don’t have teeth? It’s because the cost to extract a tooth is significantly less expensive than the cost to do a root canal to save it.

Many dentists allow payment plans, or will lower their fees for certain patients; many will not, and demand payment up front. Many dentists participate in an American Dental Association (ADA) program to provide low-cost or free dental care to children; but, dental and medical societies, unlike the American Bar Association, don’t require pro bono community service work to maintain membership.

A number of community non-profit health programs exist, but there are far too few, with far too few financial resources. Patients can go to dental schools and have students, supervised by licensed dentists, work on their teeth. But, there are only 64 dental schools in 36 states, and many patients with dental problems can’t afford the time or gas money to drive more than three or four hours to an appointment.

The new Patient Protection and Affordable Care Act, which goes into effect next year, moved the United States closer to universal health care, already enjoyed by the citizens of 28 industrialized countries. But, it doesn’t cover dental care.

In a nation that doesn’t object to star athletes and Wall Street maggots making a few million dollars a year, or a strange pre-teen named Honey Boo Boo becoming a TV star, we neglect one of the most basic of all human needs. It is the need to assure that every American, no matter who, no matter what social class, has proper health and dental care.

Dr. Brasch’s latest book is Fracking Pennsylvania, an overview of the health and environmental problems from horizontal hydraulic fracturing by the natural gas industry, and the relationship between Big Energy and politicians that allowed the practice.