Comments on: Dentistry, Health Care, and Bildad the Shuhite

By: Stephen

Stephen — Thu, 17 May 2007 15:01:51 +0000

Government-controlled health care. Ideally, a tiered program like France's; Ezra Klein has a good summary of how France's system works.

By: Pol Health Guy

Pol Health Guy — Thu, 17 May 2007 06:21:10 +0000

“I expect going to a government-controlled health system would add annoyance to run-of-the-mill health care for those of us who already have insurance and are relatively well off.”
So what would be the solution for everyone then?

By: A Mind Occasionally Voyaging

A Mind Occasionally Voyaging — Thu, 08 Mar 2007 17:41:31 +0000

Economy of Scale…

As you may know by now, there was some news recently about A guy dying of a toothache because he didn’t have insurance. I hadn’t been planning to comment, because, hey, it happens. Even at my most financially destitute, I……

By: Missy Krebs

Missy Krebs — Fri, 02 Mar 2007 15:34:43 +0000

In the legal profession, we are required to either perform legal services for the poor without pay each year, or contribute several hundred dollars to a fund to provide services for those who can’t afford them. That’s considered your duty because you are able to make a good living in our profession. And I don’t have a problem with that.

Although I know a few doctors and other medical professionals who do this voluntarily, I’ve never understood why it isn’t (or couldn’t be) required. Medicaid pays for services for the very poor already. It’s the people stuck in the middle that could use some help.

By: Geof F. Morris

Geof F. Morris — Thu, 01 Mar 2007 23:44:55 +0000

I would argue that the U.S. stands as good of a shot at making nationalized health care a go as any other Western nation given our expertise at management. The reason that developing countries have issues with command economies is the lack of skilled managers in filling key positions. The U.S. has as much of a surplus of competent managerial talent as anyone.

Government-run healthcare does indeed exist in this country—military members and their dependents. I spent the first 12 years of my life in military health care, during which I was diagnosed with [and saw resolve] a potentially lethal heart defect. I received excellent care and am quite obviously alive today.

[As a weird sidenote, I'll note that millitary medicine did dentistry horribly, and that military insurance paid for private dental care.]

As I’ve thought about this issue more and more lately, I’ve come to the conclusion that, as in education, this country’s best approach is probably a parallel system: public, taxpayer-funded healthcare with a private, for-profit system available. Is the quality of the care in the private system going to be superior, in some cases? Yes. But private healthcare could certainly stand to be the risk-accepting component of the healthcare system, pushing out against new thearpies and pushing the envelope.

By: siliconchef

siliconchef — Thu, 01 Mar 2007 19:10:15 +0000

“Do you have any stats on the number of people coming here for medical care? That’s an open question to everyone, by the way — I’m interested in seeing how large or small that number is.”

Numbers … not handy. But Singapore has made it a small industry. Hospitals there have the equivalent of a “travel agent” to book packages for out-of-country patients.

By: Stephen

Stephen — Thu, 01 Mar 2007 18:52:00 +0000

If our government really can spend the current health care money better on national care, then it’s a possibility. I just have this fear, often justified by the reality of government control, that such a health care system won’t be any better.

There’s no guarantee, of course, but I’m willing to try given how broken the current system is. The problems you mention are not government problems, they’re big organization problems. Large organizations like big pharmaceutical companies or insurance companies have similar inefficiencies, only we don’t get to see those as easily.

I expect going to a government-controlled health system would add annoyance to run-of-the-mill health care for those of us who already have insurance and are relatively well off. For the working poor, it would make things easier. Being poor adds to the hoops you go through to get routine care. The linked article gives a good view of how much you have to do to get care if you’re poor, whereas I can bop on down to my local doctor or dentist and pay my co-pay.

More importantly, government-controlled health care would drastically reduce the rate of financial ruin due to illnesses. Given all of that, I’ll take some waiting in line.

For every person who dies because they have no insurance, there’s plenty who leave countries with government run health care to the US or Singapore to get a procedure the government won’t cover or can’t do in a timely fashion.

Do you have any stats on the number of people coming here for medical care? That’s an open question to everyone, by the way — I’m interested in seeing how large or small that number is.

By: Ross

Ross — Thu, 01 Mar 2007 16:51:57 +0000

Just as another data point, while it’s true that your doctor charges an uninsured person more than he charges the insurance company (Though it’s more complex than that: if your doctor charges $100, and the insurance company agrees that you will pay $20 and they will pay $40, and the doctor only gets $60 — But in addition to that, he generally also gets some sort of yearly “stipend” from the insurance company based on the number of insured patients he has. There’s also some kind of bulk discount going on. So, while I’m sure you do get the shaft a bit, the disparity isn’t really as big as the bill implies), dental insurance tends to work a little differently. The insurance company has a schedule of how much a procedure “ought” to cost, and they pay some percentage of that, and you pay the rest, and the dentist agrees to accept that total amount. My family dentist billed different rates for insured and uninsured patients. If you had insurance, he charged what the insurance allowed. If you didn’t, he charged his own rate, which was generall quite a bit *less* than the insurance rate.

By: Joyous

Joyous — Thu, 01 Mar 2007 15:47:02 +0000

I’ve lived without insurance, and you’re right, it sucks. The Russian roulette, thing, yeah…by the time I finally got my first job w/ insurance and could afford a dentist, I had eight cavities.

I’ve also lived w/ socialied health care…I can’t speak for how other countries do it, but in France they go to the doctor for the slightest little thing. This means loooong wait times when you do go. I remember sitting there all day in a big crowd. (My host family was surprised, and a little suspicious, at my attempt to treat my own cold with Sudafed–I’m not sure they knew what the little red pills were.)

By: siliconchef

siliconchef — Thu, 01 Mar 2007 15:07:26 +0000

If our government really can spend the current health care money better on national care, then it’s a possibility. I just have this fear, often justified by the reality of government control, that such a health care system won’t be any better.

For every person who dies because they have no insurance, there’s plenty who leave countries with government run health care to the US or Singapore to get a procedure the government won’t cover or can’t do in a timely fashion.

Heck, even Jim Henson has health insurance … that didn’t save him from deciding not to go to the doctor.

Insurance has totally screwed up health care in this country. Every private practice doctor I know hates it. I just don’t know if senators can fix it. Every time I stand in a voting line or at the DMV I think “is this what government health care would look like”.

The charitable part of me would have given him the $80 out of my pocket, but I am not sure if I want the money taken at gunpoint through taxes.