Wednesday, March 07, 2007

DENTAL CARE FOR POOR NEEDS ATTENTION

On February 5th, in a radio broadcast on KKOB, Albuquerque, Rush Limbaugh commented on the size of the proposed federal budget. He pointed out that the budget was for 2.9 trillion dollars. Then he said to this effect, “Don’t tell me there is anything [underfunded]!”

In our view his conclusion does not follow merely from the size of the proposed outlays. What are the outlays for? If the budget includes billions for corporation stockholder welfare (corporations do not pocket the money; CEO’s and stockholders do), and too little for Medicaid dental care, then indeed there is something underfunded. Or perhaps Mr. Limbaugh meant to say there is nothing that is unjustifiably underfunded.

We submit that Medicaid dental care is unjustifiably underfunded, or poorly administered. If the program is designed to provide dental care for people who cannot afford to buy dental insurance, and cannot afford to pay for the care, then it falls short. See an excellent article, with pictures, at page E2 in the Albuquerque Journal of December 12, 2006, written by Lean Holt. She says it is difficult in New Mexico to get dentists to take Medicaid patients. Her report centered on one not for profit clinic which opens at 7:00 a.m. but can handle only about 15 to 20 emergency patients a day. As early as 4:30 a.m., people are standing or squatting or sitting on the floor in the hall outside the clinic, suffering from swollen jaws and aching teeth, hoping to be among those who are given care that morning

The neglect of dental care for poor children because of poor pay by Medicaid is discussed in the post dated May 17, 2006.

Perhaps the Medicaid dental program is poorly administered. One solution is to require dentists to take Medicaid patients whether they want to or not. The lawyers have a tradition of serving indigent defendants in criminal cases for inadequate pay or for no pay. That was particularly true before the government started hiring public defenders. The government could hire dentists to serve, or could lower the standards for admission to practice as a dentist, on condition that these new dentists agree to take Medicaid patients for a few years at least.

Why require an undergraduate degree, with years of college, with many hours of electives, for a license to practice dentistry? Do you really care whether your dentist knows English literature, or grammar? A foreign language, say French or German? Really, what knowledge and skill does it take to administer an anesthetic to a suffering patient, and allow the dentist to diagnose and direct the treatment, to be administered by qualified persons other than those who have spent seven years in college?

We admire and respect the licensed dentist. But the system (the trade union aspect of the licensing laws) requires a brain surgeon to lance a boil. The system also requires one to take years of college courses which could be done after the dental school and while the graduate of dental school treats the needy.

The government could also raise the pay to the level at least of Medicare. That would be giving in to the present system, but would a least get the care to where it is needed.