Coyote Blog

The NY Times outdid itself last week with a truly awful article on dentistry.  They started with just one fact:

Previously unreleased figures from the Centers for Disease Control and Prevention
show that in 2003 and 2004, the most recent years with data available,
27 percent of children and 29 percent of adults had cavities going
untreated. The level of untreated decay was the highest since the late
1980s and significantly higher than that found in a survey from 1999 to
2002.

They then apply the patented NY Times class-based story-generation model to assume a cause for this rise that is not supported by the study itself:

But many poor and lower-middle-class families do not receive adequate
care, in part because most dentists want customers who can pay cash or
have private insurance, and they do not accept Medicaid
patients. As a result, publicly supported dental clinics have
months-long waiting lists even for people who need major surgery for
decayed teeth. At the pediatric clinic managed by the state-supported University of Florida dental school, for example, low-income children must wait six months for surgery.

So is the rise in untreated dental problems concentrated in the poor?  Well, they don't say, and there is not data for that in the study, but that does not prevent the NY Times from just assuming it to be so.  In fact, the article itself contradicts this premise, by noting that the problem is not limited to the poor:

The lack of dental care is not restricted to the poor and their
children, the data shows. Experts on oral health say about 100 million
Americans "” including many adults who work and have incomes well above
the poverty line "” are without access to care.

By the way, how did they figure a 100 million don't have "access"?  I don't know, but the figure is suspiciously close to this one:

With dentists' fees rising far faster than inflation and more than 100 million people lacking dental insurance...

Anyone want to bet that the NY Times just made its usual logical fallacy of equating lack of insurance with lack of access?  And by the way, dental insurance is a HORRIBLE investment.  I have priced it many times myself and for a normal family, it is much cheaper to just pay the dental bills, particularly since there are not that many things in your mouth that can go wrong that will be bankrupting.  Trying to push everyone to dental insurance is a terrible idea.  Every time there is a dental procedure in our family, it turns out there are several options for fixing it at different prices.  We actually have the incentive to ask for these alternatives and make trade offs.  What do you think would happen if we had insurnace?

In fact, I can think of a LOT of reasons why people don't go to the dentist as often as they should.  One reason is that no one like the dentist.  Another is people's busy schedules.  And certainly rising costs are a factor -- As I mentioned before, our family makes very different decisions about treatment options than we used to with a fat corporate dental plan.  Which is as it should be. 

By the way, note the screaming socialism here:

The dental profession's critics "” who include public health experts,
some physicians and even some dental school professors "” say that too
many dentists are focused more on money than medicine.

"Most
dentists consider themselves to be in the business of dentistry rather
than the practice of dentistry," said Dr. David A. Nash, a professor of
pediatric dentistry at the University of Kentucky. "I'm a cynic about my profession, but the data are there. It's embarrassing."

I wonder.  Does Dr. Nash accept a salary for being a professor?  Then I guess he is focused more on the business of education than the practice of educating.

Oh, and by the way, how is socialism in dentistry working out?

In a survey of 5,000 people in the UK, six percent claimed that
they had done DIY dentistry, including yanking their own teeth and
fixing cracked crowns with glue. Apparently they resorted to such self
treatment because they couldn't get in to see a National Health Service
dentist "¦

One respondent in Lancashire, northern England, claimed to
have extracted 14 of their own teeth with a pair of pliers. In
Liverpool, one of those collecting data for the survey interviewed
three people who had pulled out their own teeth in one morning.

"I took most of my teeth out in the shed with pliers. I have one to go," another respondent wrote.

I am always floored by the number of progressives who embrace all kinds of wacky non-scientific health theories.  These are the same folks who criticize creationists as being anti-scientific.  I am not a creationist, but I might be able to embrace it faster than I could, say, the insanity that is homeopathic medicine**. 

Unfortunately, these are the same folks who will likely make up the backbone of the socialized medicine bureaucracy when and if the US finally decides to hand health care over to a consortium of the Post Office and Walther Reed.  So here is a preview of what we will get:

Tom and Donna (not their real names) are professional
shamen. They teach classes in shamanism at a "foundation", where you
can learn "soul retrieval healing", help the dead "continue their
journey into the Hereafter", and investigate "the Fairy Kingdom". These
soul retrievers and Fairy Kingdom investigators also work for the NHS "”
where, according to Tom's foundation profile, they "use complementary
therapies to help those with mental health difficulties". Shaman
therapies are not the only unorthodox treatments for which the NHS will
gladly pay.

Taxpayers are also subsidising Emotional
Freedom Technique (EFT) "therapy", in which, according to one NHS
trust, "subtle energies" are reordered via "tapping with the fingertips
to stimulate certain meridian energy points while the client is "˜tuned
in' to the problem". "¦If EFT doesn't do the job, an NHS foot massage
might help. Reflexologists believe that each part of the foot maps to a
different organ, and that massaging a particular point can treat that
organ. Medical doctors think it's absurd. "¦Most depressing of all for
the rational taxpayer is the NHS Directory for Alternative and
Complementary Medicine, which aims to promote "dowsers", "flower
therapists" and "crystal healers". We've just learnt that some
hospitals are removing every third light bulb to save money, and that
nurses are being paid half the minimum wage "” or being asked to work
for nothing "” at others. That's how bad the financial crisis has
become. Meanwhile, the National Health Service is employing shaman
fairy enthusiasts as psychological counsellors, enthusiastically
providing treatments invented by "an ordained minister and a personal
performance coach" who thinks tapping your body can cure diabetes,
promoting dowsers and crystal healers and spending vast amounts on
therapies that can't be scientifically supported.

Just as with the Walther Reed mess, the left wants to write off this stuff as just bad management, as an exception.  But unfortunately, this is the rule for government management.  It always goes bad.  Mismatched incentives + lack of individual choice + strong unionized bureaucracy most concerned with its own job security + impossibly complex information flows = mess.  Always.  I get very tired of the excuse, as I wrote here, that "if only we were in charge, everything would work great." 

Throughout these years, libertarians like myself argued that there
were at least three problems with all of this technocratic statism:

• You don't have the right to make decisions for other people.
  Period.  No matter how high-minded and idealistic you want to portray
  it, at the end of the day you are proposing to use force to coerce
  another man into doing your will.  You may stop them from using force
  or fraud against others, but an adult may make decisions for
  themselves, even if they are bad.  I am reminded of a great line from
  the HBO show Deadwood, "Can you let me go to hell the way I want to?"

• You can't make better decisions for other people, even if you
  are smarter, because every person has different wants, needs, values,
  etc., and thus make trade-offs differently.  Tedy Bruschi of the
  Patriots is willing to take post-stroke risks by playing pro football again I would never take, but that doesn't mean its a incorrect decision for him.

• Technocratic idealists ALWAYS lose control of the game.  It may
  feel good at first when the trains start running on time, but the
  technocrats are soon swept away by the thugs, and the patina of
  idealism is swept away, and only fascism is left.  Interestingly, the
  technocrats always cry "our only mistake was letting those other guys
  take control".  No, the mistake was accepting the right to use force on
  another man.  Everything after that was inevitable.

Everyone has had a turn running the place (except libertarians, I might observe) and everyone has screwed things up.

** I am amazed I have not posted a rant on homeopathic medicine, but searching through my archives, I don't find anything.  If you don't know, here is the fast answer why homeopathy is silly.  Advocates of homeopathy argue that they can make certain substances more effective by diluting them, and the more they dilute them, the more effective they are.  Go to one of their web sites, and you will see dilution rations that translate into having less than one molecule of the active ingredient in a mass of water the volume of all the world's oceans.  Advocates argue that even though the molecules are gone, some sort of resonance remains.  Uhh, right.