With the ever growing debate about health care, everyone keeps asking me what I think about it. I work in a community health center which, in theory, caters to the needs to the underserved and non-insured. In the past, it has generally been the case that people without dental insurance are relegated to low quality or no care. I'm proud to say that my office has state of the art equipment (including digital x-ray) and does not look like your typical community health center. I am 100% committed to providing the same care for the patients I encounter here as I will my patients in private practice. It is sad, though, that many patients have already told me that I'm "too good" to be working in this office. That tells me that years of experience have shown them that the care they receive cannot be as good as what their insured counterparts experience. I think there is a terrible misconception floating around in the general public about the type of people I see in my clinic. First of all, I would guess that less than half of my patients are on Medicaid, as Medicaid only covers dental treatment for people less than 18 (or less than 21 depending on which state you live in) or pregnant women. I only work on pregnant women in emergency situations (with the exception of a cleaning) so I rarely see that portion of the population. Instead, with the shift in our economy, I am seeing a different segment of society. Well dressed, highly educated formerly employed people who have beautiful veneers and crowns from the days when they were employed (or better employed) with dental insurance are flooding my appointment book. Our offices takes several dental insurance policies but if you don't have insurance, they bill you based on your income. I have one patient who is an engineer and designed the first electric car in the state of Texas. He was working overseas with a global intiative for solar energy when he was downsized. Recently, his home was sold in Houston and moved to Floresville where he lives in a modest home with his wife. What does he do now? He works for the state work force coalition helping other unemployed people find jobs for dollars on the hour. I asked if he planned on getting back in the engineering field and he laughed and said, "Dr. Williams, at my age I was about to be out of working. Period. Now I have no retirement and no insurance. I'm too old to compete with current workforce so I'm stuck." A patient from last week is three years older than I am and came in with a cavity. A dentist from another community center told him to just get the tooth taken out even though it's well within the realm of being saved. He recently moved to Texas to escape the cost of living in Southern California which he could no longer afford. Previously, he worked as part of the ever growing biotech industry until he was injured on the job. Without disability insurance he was forced to sell his large beachfront home and move here. He cannot work and is trying to get his prior employer to pay for the back surgery he desperately needs. I hope I can make his life a little easier by fixing one tooth but the sad reality is, a cavity is the least of his problems.
Healthcare reform is a complicated issue. So many people are screaming and fighting in the streets about while they have little insight into what life without viable insurance is like. Our current system isn't working for the majority and it's time for a change. Is the proposed plan perfect? No, but there has to be SOMETHING that's better than our current system. I just hope people can stop fighting long enough to find it.
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