Archive for March, 2010

Endless blather about health care coverage. But why aren’t we talking about dental care reform?

The Obama administration’s agonizingly eked out health care reform will affect the dentistry industry in the United States in some minor ways, for example, requiring insurance plans to include pediatric oral health services for children up to 21 years of age, establishing public education campaigns, and ensuring that essential health benefits packages include oral care. But without insurance, Yankee teeth are in constant danger of eventually being, well, yanked.

We Canadians like to boast about our single-payer system and universal coverage for all. But when it comes to Canadian teeth, we play the same kind of insurance game with our health as our neighbours to the south. The Canada Health Act, as explained in a typically ponderous government document, provides for coverage of “medically required surgical dental procedures which can be properly carried out only in a hospital.” But if you need a filling or root canal work, you’ll need a cool thousand or a good insurance plan.

The dental profession means well. You frequently find token gestures such as one recently announced by the Manitoba Dental Association, which will re-introduce its “Free First Visit” oral health program, beginning in April 2010. This loss leader is designed to encourage dental visits for infants and toddlers by offering a free first check-up for all children age 3 years and younger. But what about the ongoing oral health care needs of children? Where is the much-needed integration of dental care into medicare? We pay taxes to educate our children and keep most of their bodies healthy, except, strangely, their teeth. What is so special about our oral cavities – as opposed to, say, our anal cavities – that leaves their care to the tender mercies of insurance companies. Why shouldn’t complete oral health coverage be extended to all Canadians? Let’s include eye care while we’re at it.

But enter our inner Calvinist. The Atlas-Shrugged types will argue vociferously that it is wrong to use taxpayers’ money to provide a safety net for the offspring of losers and gingivitic ne’er-do-wells who think floss is pink and consumed in great quantities at county fairs. Pundits from corporate-funded think tanks like the Fraser Institute and Manitoba’s Frontier Centre for Public Policy will gnash their bicuspids in horror at such a flagrant concession to human weakness. Obviously they’ve never had to endure a twanging molar or a suppurating abscess they couldn’t spend their way out of.

The arguments haven’t changed much since the overwhelming suffering of the poverty-stricken went unheeded by those opposed to the Health Care Act in the 1960s. And their arguments are still just as specious. Let’s keep moralizing out of health policy. We need only consider the annual expenditure by the public purse on spavined hearts and riddled livers to see that this kind of supercilious cost-accounting is all that’s left of decency after the nerve has been extracted.

CC licensed flickr photo by erix!

Library renovations: tool-carrying banshees get the hurly-burly done

The true triumph of reason is that it enables us to get along with those who do not possess it. So said Voltaire, and so I have liked to think for many a year. But to a desolate soul who has been subjected for hours to the continuous whining drills and the stupendous crashings that are the leitmotif of construction work, reason quickly gives way to a kind of death-drive retreat from cacophonous reality. We all become deranged, dispossessed, and a little desperate.

When you approach the foyer of my library (the Neil John Maclean Health Sciences Library) you immediately see the “walled garden” effect that the newly erected hoardings make. Thanks to the recent largesse of the federal government, we are one of many quickly-launched funded projects that are raising dust and breeding migraines all over Canada.  During Phase I of our renovation, which will last two months, the library’s main floor will be a frantic scenario that makes the mad scene in Lucia di Lammermoor look tame. Phase II and III will continue during the later spring and summer, leaving no corner of the library untouched and no mind unravelled.

“When the hurly-burly’s done, when the battle’s lost and won”
Workers have spent most of the past week putting up hoardings to contain the dust and commotion of construction (but not the noise, unfortunately). The north, east and west areas of the main floor have disappeared. Gone are the former Circulation Desk, staff offices, our boardroom, and most regrettably, the lunch room and toilets. Both circulation staff and librarians compete for breathing space at the reorganized Information Desk.

The rest of the staff are a crowded, oxygen-starved Ellenbogengesellschaft in the adjoining computer labs, which have been repurposed for the duration of construction. Some liaison librarians like myself have been able to find temporary shelter with their respective faculties.

Having escaped the great flood of 1997, when my staff and I had to move an entire library in plastic tubs from the basement to the (thankfully) still empty fourth floor of the St. Boniface Research Centre in Winnipeg, I can be philosophical about the current disruptions. And as I work yet another dreary shift at an Information Desk surrounded by tool-carrying banshees, I will try to live up to Voltaire’s maxim, even as I shout out complex directions to the toilets over a tumultuous roar that would never respond to a shush or a shaken finger.


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