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!

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