A DENTAL DISASTER IN U.S. SOCIALIZED MEDICINE

The kid in the story below WAS covered by a socialized medicine system -- Medicaid -- but a disorganized mother failed him. There are also many stories of dental mayhem from Britain's NHS. See e.g. here

The Washington Post reported today that a twelve year old Prince George's County, Maryland boy died Sunday after the infection from an abscessed tooth spread to his brain. The boy had not been receiving routine dental care. According to the Washington Post, twelve year old Diamonte Driver first complained of a headache six weeks ago. He was treated at a hospital for a tooth abscess, sinusitis and the headache. Shortly after beginning treatment, he was hospitalized at Children's Hospital in the District of Columbia and underwent two brain surgeries, the Post said.

Diamonte's mother did not have dental insurance or Medicaid coverage; a timely $80 tooth extraction could have saved his life, according to the Washington, Post.The Post reported that when Diamonte first began experiencing a toothache, his mother was having trouble finding a dental provider who would accept Medicaid to extract six abscessed teeth from Diamonte's younger brother DeShawn.. After finally finding an oral surgeon who would accept Medicaid and making an appointment for DeShawn, she learned that her Medicaid coverage had lapsed and cancled the appointment. The coverage lapse apparently occurred when her family moved had moved from the homeless shelter address listed on the Medicaid application.

A 1996 study by the American Dental Association supports the conclusion that health insurance coverage relates positively to children's receipt of dental care. The study showed the 56% percent of children with private dental insurance made at least one dental visit during the year 1996 while only 28% of those eligible but without such coverage made at least one dental visit. For those with Medicaid insurance, 28 % made at least one dental visit during the year 1996 as compared with 19% of noncovered children in the Medicaid program (coverage varies from state to state). The study concluded that private insurance increased the likelihood of a child receiving dental coverage more than having Medicaid insurance did.....

States are required to provide Early and Periodic Screening, Diagnostic and Treatment (EPSDT) to children enrolled in Medicaid. It is up to each state to determine in conjunction with dental experts what coverage intervals meet reasonable standards of dental practice. At a minimum, Medicaid must cover pain relief, treatment of infections, tooth restorations and maintenance. Had Diamonte's Medicaid coverage not lapsed, treatment for an abscess would have been covered assuming his mother could have found a dentist willing to treat him. [Which she did]

Source

Update:

A reader writes:

"I took a look at your comments because the headline looked like you might be a little critical of the mother in Maryland. I wondered why none of the mainstream news articles had mentioned how earlier treatment could have prevented this or possibly how long since this child had seen a dentist, ever?

Thought I might tell you that in another case in the U.S., a mother was jailed for allowing her five year old to suffer with numerous rotted/abscessed teeth. By the time this woman too her child to the dentist, he could hardly eat. Her excuse was, "I knew they were baby teeth, I thought they'd just fall out." That child was treated and placed in foster care, hopefully to a more empathetic set of parents.

When I read that the boy in Maryland had a brother, even younger, with 5 or 6 abcessed teeth, I wondered what had that mom been doing the last two or three years in caring for these children. I have all the sympathy in the world for her losing a child, but dadgum it, sometimes as a parent you need to be taking care of things. Being poor doesn't limit a persons ability to brush. Having her kids brush and floss their teeth, not drink pop/kool aid, and making sure she got them to one of the 600 dentists in Maryland that did take Medicaid cards, preferably before their teeth were abscessed, for check-ups.

I know a lot of mothers that are the working poor, no dental insurance and no Medicaid, that would not let an expired card keep them from getting their kids some kind of treatment. I live in the Midwest U.S. Two years ago, through some kind of dental school experience/government grant program, they offered free dental care for the uninsured for maybe two days at a local university. No crowns or fancy stuff, just cleaning, filling cavities, and extractions. In my little state, they had over 4000 people sign up. Parents with no insurance took their children out of school for the day, waited in line for a long time, but really took advantage of the opportunity.

I guess I wonder how people turn all their responsibility over to the schools and to the government. Blaming Medicaid because she didn't give them a current address is ridiculous. If she had a card earlier, she should have gotten them in to a dentist two or three years ago. I'm sorry for any kids that suffer and there sure seem to be a lot of them. Too many children are still waiting for their parents to actually do what parents should do, be parents. I guess I'm wondering how in the world she could know her children were suffering and not figure out something. I'd have begged, pleaded, kept the appointment and explained that it was emergency, immediately contacted the Medicaid office and explained...something. What a needless death.

Sad thing is, communities in the U.S. offer parenting classes for free. Guess who shows up? Usually just the parents that are already doing a good job. I've been to seminars that explain the difference in thinking between those that live in poverty and those that don't. I know there's a difference, but somewhere along the way, we've lost something. People don't know how to have any initiative, any survival type skills as to what needs to be done. I have a theory that the more educated we become, the fewer things we actually know how to do."

***************************

For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Pages are here or here or here.

***************************