Universal Neglect: A Failure to Protect Americans’ Health

by Walter Brasch

I received a letter from a friend this past week.

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.]


Award-winning journalist and author, specializing in social issues, media, and pop culture. http://www.linkedin.com/pub/walter-brasch/9/846/616

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  1. So what is the answer — one that won’t raise the ire of conservatives who think too many expect government to care for their basic needs for dental and health care?

  2. Thanks, Walter. As usual you hit the big problems while most of us dwell on the minutia. You are correct, of course, lack of dental care not only is painful, it also leads to a lower life expectancy. Dental health is no different from other types of physical health. The fact that it got left out of the original Medicaid and Medicare programs is unfortunate. I know it would cost a lot to provide dental coverage in those programs now, but as you pointed out, poor dental health does lead to other problems and is also associated with heart problems. The ACA also missed this gap in health coverage, probably because of the cost/political factor.
    As a kid I was fortunate to get free dental care at my local Boys Club, otherwise I don’t know how things would have worked out up to this point.

    Anyway, again thanks. It is unfortunate that like fracking there will be few commenters torn away from the other important issues.

  3. I’ve always had good health insurance but no dental so for many years I put off even going to the dentist. In 2008, after way too many years of neglect, I HAD to see a dentist… The bid for work needed was over $20,000.

    Fortunately a friend that ‘snow-birded’ in Yuma, AZ told me about ‘The Dentist Capitol of Mexico’… Los Algodones. There are over 600 dentists there providing QUALITY dental work a fraction of what it costs in the U.S.

    Long story short… I got two root canals, two post build-ups, and an 8 tooth fixed bridge for about $1,500. With the other work needed my total cost was less than 10% of the price quoted in the US.

    It may not be for everybody but it’s so convenient, 12 miles from Yuma, AZ, park on the US side and walk to your dentist. And it’s popular… This time of year the border crossing looks like people going to an AARP Convention.

  4. Wow, Steve. I have a friend who did that, I think. I know she was in Mexico having her teeth fixed. It makes me wonder WHY dental work has to be so awfully expensive here! I don’t have dental insurance either mostly because for what you pay, you get very little coverage for the big jobs that need doing as people get older. I guess there really isn’t an answer — unless you can go to Mexico! (Which I can’t do.)

  5. I so agree Walter, know many people that suffer with these kind of mouth issues with no dental and limited resources ….

    I do know of one thing that really does work and have shared it with numerous people with great results for over all health of the mouth.

    It is a age old Ayurveda process called Oil Pulling. I began this a couple years ago and it brought back the health of the gums. It is suppose to be good for the rest of the body. I know for sure it works great for any kind of mouth issue. When there is any kind of infection in the gums or tooth pain add a couple of drops of tea tree oil to the oil for pulling…

    I do it once a day and with great results…Preventive is the only solution i know for not having dental coverage…


  6. OS, thanks for the link. I might try it.

  7. OS,
    That is an interesting preventive measure. I wonder if the mechanism at work is the displacement of water with the oil in the crevices between teeth and between teeth and gums, resulting in a protective film of oil. It would be similar to the way oil/WD40 is used to prevent corrosion of metal.

    Part of the problem with oral health may be the fear/apprehension of going to the dentist resulting in delayed visits and larger bills. I highly recommend NOX.

  8. But will OP work on a Rep’s teeth, what with all the eating of our own?
    Perhaps mixed with the WD40.

  9. :)

  10. Zusai maybe this link would point to the science of it… i believe it pulls infection and inflammation from the mouth and from the body overall… just know it really works.. the tea tree oil is a well known antibacterial…


    Walter was also thinking more about your post…Another group similar to the journalist with these issues are musicians/artists. In KC we have a foundation that is now spreading across the nation to assist artist that have medical emergencies without coverage.. Maybe it is time to start one for journalist?

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