Poverty Bites
By Justin Gardner | Related entries in Health Care, Social ProgramsMalcolm Gladwell, author of the best selling books The Tipping Point and Blink, points out an interesting correlation between poor dental health and poor people:
People without health insurance have bad teeth because, if you’re paying for everything out of your own pocket, going to the dentist for a checkup seems like a luxury. It isn’t, of course. The loss of teeth makes eating fresh fruits and vegetables difficult, and a diet heavy in soft, processed foods exacerbates more serious health problems, like diabetes. The pain of tooth decay leads many people to use alcohol as a salve. And those struggling to get ahead in the job market quickly find that the unsightliness of bad teeth, and the self-consciousness that results, can become a major barrier. If your teeth are bad, you’re not going to get a job as a receptionist, say, or a cashier. You’re going to be put in the back somewhere, far from the public eye. What Loretta, Gina, and Daniel understand, the two authors tell us, is that bad teeth have come to be seen as a marker of “poor parenting, low educational achievement and slow or faulty intellectual development.� They are an outward marker of caste. “Almost every time we asked interviewees what their first priority would be if the president established universal health coverage tomorrow,� Sered and Fernandopulle write, “the immediate answer was ‘my teeth.’ �
I’m not saying that this observation is revelatory, but the logic is significant. What if we could provide dental care to those around the poverty line? What if we simply start with the children? I know many cringe when I speak about universal health care, but what about just simply universal dental care?
The article goes onto make some other very important points about those who “have not”.
The U. S. health-care system, according to “Uninsured in America,� has created a group of people who increasingly look different from others and suffer in ways that others do not. The leading cause of personal bankruptcy in the United States is unpaid medical bills. Half of the uninsured owe money to hospitals, and a third are being pursued by collection agencies. Children without health insurance are less likely to receive medical attention for serious injuries, for recurrent ear infections, or for asthma. Lung-cancer patients without insurance are less likely to receive surgery, chemotherapy, or radiation treatment. Heart-attack victims without health insurance are less likely to receive angioplasty. People with pneumonia who don’t have health insurance are less likely to receive X rays or consultations. The death rate in any given year for someone without health insurance is twenty-five per cent higher than for someone with insur-ance. Because the uninsured are sicker than the rest of us, they can’t get better jobs, and because they can’t get better jobs they can’t afford health insurance, and because they can’t afford health insurance they get even sicker.
It’s a Catch 22, and it’s only going to get worse if we keep ignoring it. Read the entire article from Gladwell and tell me what you think.
This entry was posted on Wednesday, August 24th, 2005 and is filed under Health Care, Social Programs. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
August 24th, 2005 at 9:33 am
I have quite a few dentists as clients. In the U. S. dental health is better than ever and dental care is significantly more affordable than medical care. Dentists’ incomes are rising faster than physicians’ and dentists appear to be happier about their work than doctors. I think there are a number of reasons for this:
Dentists view their work differently than doctors do, take a more businesslike approach, and don’t guard their prerogatives as jealously as docs do.
Dental insurance is not nearly as widespread as medical insurance.
The government is not nearly as involved in dental health care as it is in medical health care.
My advice: don’t get government or the insurance industry more involved in the dental health business more than they already are.
August 24th, 2005 at 9:53 am
So you’re saying that quality of care is more important than more people getting it. My question to you is does it have to be one or the other? People are hurting as a result of not having this insurance. In fact, it’s leading to more serious health problems. Investing in dental insurance now could help lessen the need for health insurance later on down the road when people usually need it, saving us trillions.
We’re also talking about preventative medicine too, something that isn’t mentioned very often in the US health care industry. If people have healthy teeth they’re happier, and they’re less likely to abuse their children, those children are less likely to act out in school and more likely to learn, and then everybody is less likely to committ crimes and we may be able to stop that vicious cycle. If extending something as simple as dental care to everybody in the nation could help start that trend, why would you be against it? Is it still for the reasons you’ve given above?
August 24th, 2005 at 2:09 pm
“The leading cause of personal bankruptcy in the United States is unpaid medical bills.”
Medical bills are one of the easiest debts to get rid of in a bankruptcy. Other debts you’ll still be stuck with, so there’s no point in declaring, but if your problem is a hospital bill you can completely solve it.
August 24th, 2005 at 2:29 pm
Respectfully, that doesn’t mean that this still isn’t the leading cause of personal bankruptcy.
But please, detail the process of getting rid of that debt so I can share it with our readers. I’m sure we’d all like to have this information and our fingertips if disaster strikes.
However, I’m sure you can also imagine that the working poor have less knowledge at their fingertips, and therefore, less opportunity to work the system so they can get these bills relieved. Most of them only have computer access at libraries, so the internet is not the pervasive knowledge stream it is in our life.
And let’s just say for argument’s sake, that they did have that information AND the means to follow through. Now imagine if there was even a 10% swing is debt relief for these people towards the positive. What would that do the health care industry? I haven’t look at the numbers, but it seems that the economic results would be crippling to an industry that is already crying foul over insurance premiums.
My point is, prevention seems to be the only method by which we can fix this problem, and if that means we at least just consider the option of providing dental care for the working poor and their children, I think it’s worth exploring.
August 24th, 2005 at 3:28 pm
“But please, detail the process of getting rid of that debt so I can share it with our readers.”
Google is your friend. One of the things you want to put in the search is the name of your state since laws vary so widely.
The point I was trying to make “cause of bankruptcy” is not the same as “cause of financial distress”, since the law regards some causes much more favorably than others.
I think prevention is a very good thing. I’m trying to steer you away from the weak arguments for it so you can concentrate on the strong ones.
August 24th, 2005 at 4:02 pm
I appreciate that, but then I Googled my own state’s laws and found no mention of forgiving this debt. In fact, you have to file Chapter 13 bankruptcy in order to lessen it. But this is only for sole propeitors who own their own business (usually farmers) True, you can get it down to 10 cents on the dollar, but what about people who have $100,000 in medical debt because they don’t have insurance. Sure, $10,000 is a better number, but I think you can see what Gladwell is pointing to here, since that $10,000 is a still a substantial mountain to climb for most who can’t even afford health insurance.
Here’s a bit more about it:
I also found this page with some useful links, but they still provide pretty vague advice like “haggling with your doctor.”
How about this…just point me to your state’s laws so I can see a sample of what you’re talking about. If I don’t have any documentation on this specific thing, it’s hard to understand exactly what you’re talking about.
Again, remember my point. I can Google this and find some slightly useful information, but I’m stumped as to find the specifics. Now imagine somebody who is at the bottom of the ladder and may not have the access or the skills to find even the information I found. That’s a BIG problem and it shouldn’t be discounted as a weak argument. I agree that personal responsibility is important, but we can’t turn a blind eye to the reality of the situation.
August 25th, 2005 at 6:00 pm
Okay, I retract my Google comment above–in this case it’s the friend of lawyers advertising for clients.
As of a few years ago when I did more detailed research, chapter 7 in California would allow you to retain enough of your possessions (ie, if you were broke you’d keep what little you had) to maintain a middle-class lifestyle. Credit card debts were hard to discharge because it was assumed that you could see this coming and had therefore bought things in bad faith. Medical debts were immune to that and were easier to completely discharge. Chapter 13 would be much tougher on them as you discussed above.
August 26th, 2005 at 11:12 am
Thanks for the followup on this one Karl.
Frankly, it comes as no surprise that California takes care of its working poor better than most states, especially when it comes to health care debt.
If only this were more widespread, I think we would see crime go down, our economy improve and a happier population all around.
August 27th, 2005 at 11:26 am
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February 15th, 2006 at 3:11 pm
Hell! why is it so that if I don’t own a health insurance that means I don’t have good teeth? I assure you, I’ve got solid ones. ;)
July 29th, 2006 at 2:04 am
I assured too that Jeniffer must have good teeths. Anyways i don’t find any corelation with health insurance and dental problem. Ya! some how because of negligence of dental care we have to face those problems anyway i got good ones so i’m not afraid of anything.
November 30th, 2006 at 4:26 am
Now imagine if there was even a 10% swing is debt relief for these people towards the positive. What would that do the health care industry? I haven’t look at the numbers, but it seems that the economic results would be crippling to an industry that is already crying foul over insurance premiums.