Morning Ed: Health {2017.05.15.M}


Will Truman

Will Truman is the Editor-in-Chief of Ordinary Times. He is also on Twitter.

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24 Responses

  1. Avatar Brandon Berg says:

    I feel like I should have known there existed such a thing as natural c-sections.

    Phrasing it that way makes it sound much worse than it actually is. I was thinking more along the lines of Alien.Report

  2. Avatar Saul Degraw says:

    The Washington Post had a long article on the Two Americas of Dentistry. You have people who can afford to spend lots of cash to make their teeth a few shades whiter and people (including people with good jobs) who have to line up for hours to get teeth pulled.

    I do find it odd that Dental Insurance often seems more to work as a pre-paid plan instead of true risk-pooling and often doesn’t cover everything.Report

    • fillyjonk fillyjonk says:

      One of the things I am most grateful for in my benefits package is good and cheap dental insurance. I have bad teeth (apparently it’s a genetic thing) and I have four crowns – would have cost me something like $12,000 if I paid out of pocket – but I wound up paying maybe $900 for all of them. (Did NOT have them done all at once! They have slowly built up over the years).

      If I didn’t have insurance and was told “We can crown the tooth for $3000 or pull it for $200,” I admit I’d have to think really hard about “How much would I miss the functionality of having a tooth there”

      Also, my insurance covers all my prophylactic care. The premiums I pay run about what two cleanings/checkups and a set of x-rays per year would cost me, but still….it’s good to have that insurance in case of an emergency, like the time I broke a tooth really spectacularly badly.

      AFAIK, ours is more of a risk-pool type of system rather than prepaid.Report

    • Avatar Oscar Gordon says:

      Dental coverage is remarkably useless.Report

      • Avatar Saul Degraw says:

        I’ve only had it for a few times in my life and it seems to drive down costs and cover cleanings but I’ve also been lucky never to really need serious work beyond wisdom teeth removal.Report

    • Avatar LeeEsq says:

      Dental care is treated oddly like cosmetic surgery rather than something actually important in the American healthcare system. This is even though you can go for years without needing to see a medical doctor but keeping your teeth healthy requires two trips a year to a dentist to keep your teeth healthy.Report

      • Avatar Saul Degraw says:

        I think the article explains this well as a long accident of history when barbers had a monopoly on tooth pulling for centuries.

        The other aspect that goes into this geography. According to the article, dentists tend to have more student debt than others but need to go solo because that economic model is tough to break. So dentists will just flock to areas where people can and will pay a premium for nice looking teeth and have fancy looking offices.Report

        • Avatar LeeEsq says:

          From the LGM thread on the article, even countries with universal healthcare seems to treat dentistry as something of an afterthought.Report

          • Avatar North says:

            In Canada they provide a lot of standard care for kids-through teenagers (and a lot of fluoridation treatments to harden kids teeth). Then once you’re a teen it’s basically figure it out yourself.Report

      • Avatar Brandon Berg says:

        My understanding is that, as a rule of thumb, the aspects of dentistry that are necessary for maintaining health are routine expenses (regular checkups) and/or relatively cheap (filling or pulling infected teeth). The more expensive options are mostly elective and cosmetic (e.g. crown instead of removal). There’s no dental equivalent of cancer, which is expensive, unpredictable, and life-threatening. So there’s not much there to insure, precisely because it’s so routine.

        I mean, I get that what people really want is not so much insurance but free dental care, but that’s probably why insurance isn’t really viable.Report

        • Avatar J__A says:

          This is at least the case in the UK. Routine and preventive care is covered, but complicated things end in extractions, not crowns

          For very weird personal reasons, I do my all dental care in Panama as out of pocket, at very low prices, even though I carry (and pay for) dental care in the USA as part of my job insurance.

          The total costs in Panama are lower than my USA deductiblesReport

        • Avatar Saul Degraw says:

          I also believe that other countries never quite fetishized white and straight teeth with no overbite like the United States has. Orthodontry exists everywhere but braces don’t seem to be such the right of adolescent passage in other countries and this includes middle class and above people who could easily afford it.Report

          • Avatar LeeEsq says:

            Shiny straight and white teeth with no overbite does seem to exist as something as an American obsession. From what I’ve understood, dentistry was always more common in the United States than it was in other wealthy developed nations even during the 19th century.Report

          • Avatar DensityDuck says:

            “I also believe that other countries never quite fetishized white and straight teeth with no overbite like the United States has. ”

            I get that you have this class-warfare thing going, and that’s cool for you, I’m glad it’s working out, but I have scars on my tongue from where I used to chew the shit out of it before I had my teeth fixed so don’t be rolling around thinking that tooth-straightening is a rich-soft-white-American cosmetic fetish.

            Also I have never seen a single Asian ad with someone who didn’t have perfect straight white teeth, and I guess you’ll say that’s just because of American cultural influence, but it is a data point.Report

            • Avatar Troublesome Frog says:

              You’re right about that. There are a lot of potential problems that come from teeth not being in the right place. People underestimate the potential badness of it because of how often crooked teeth don’t cause any problems at all.Report

            • Avatar Saul Degraw says:


              Do you mean Asian or Asian-American? Asia is big and I can guarantee lots of people with substandard dental care and/or crooked teeth.

              Are you meeting these people in professional contexts filled with middle class and above types?Report

              • Avatar DensityDuck says:

                “Are you meeting these people in professional contexts”

                I’m talking about ads. Advertisements. The things that tell us what we want. And I for-sure don’t see many non-perfect teeth in ads in Asia.Report

          • Avatar aaron david says:

            Remember when Martin Amis got his teeth fixed? What a complete sh** storm that turned out to be.

            Part of what took everyone aback, said Peter Straus, the editor of Picador, a division of Macmillan, is that Mr. Amis is a literary novelist, not a commercial writer like the high-earning authors Jeffrey Archer, John Grisham and Barbara Taylor Bradford. “Commerce and literature are still meant to be separate in England,” Mr. Straus said. “If you’re writing mass-market fiction, it doesn’t matter your price: you can be as vulgar as you want in terms of money. But somehow that isn’t the same for literary fiction.”

            Famous English writer, son of famous English writer, fixes teeth when he has money, literati go nuts.Report

        • Avatar Oscar Gordon says:

          Where this sucks is when your teeth are damaged, but not missing. I’ve had multiple dentists write up lengthy explanations as to why I need to have crowns to fix my teeth because over the long term, I will have jaw alignment problems. But since my teeth are still in my mouth and technically functional today, dental insurance won’t cover crowns since they consider them cosmetic. They won’t even cover a portion of the cost.Report

          • Avatar DensityDuck says:

            I’m sure you’ve had this conversation before, but I’m curious. It seems like you might be able to approach that as orthodontia rather than dentistry; does your insurance coverage treat those two things differently?Report

            • Avatar Oscar Gordon says:

              Orthodontia was partially covered, so the teeth are in the right spot.

              Growing up my folks did not have dental coverage or enough money for anything by basic checkups. I’m a grinder, so all my adult teeth were ground down quite badly before I was told to wear night guards. This is why my jaw doesn’t align properly (teeth are too short).

              The Navy was going to fix my teeth (orthodontia & crowns) right after I got back from WestPac, except right after I got back from WestPac, I got hit by a car on the highway. Suddenly my teeth become a minor concern as the Navy figured out if I was going back on full duty or getting retired.

              A few years back, I got the uppers crowned for about $15K. I was going to get the lowers done last year for $10K, but the stem cell procedure for the knee took priority. Hopefully we can get the lowers done this year, if nothing else pops up to suck up the savings.Report