Tuesday, March 3, 2009

Don't Get a Toothache in Fort Kent, Maine

The New York Times has an article about a shortage of dentists in Maine. It's weird because it reminds me very much of this hysterical little number they had last week about how instead of using Charmin we should all employ cardboard or reusable sponges in our restrooms. It made me want to check the quality of the TP in the Times public restrooms.

Like the toilet paper piece, it's not new. FoxNews covered the dentist shortage late last year for example. Also like the toilet paper piece it coincided with the announcement of an Obama initiative - health care reform.

Anyway the gist of the Maine dentist shortage piece appears to be that there aren't enough dentists, especially in rural areas. The author attributes this to the vague notion that "many young graduates do not want to work in rural areas." Now setting aside for a moment the fact that the author of this piece lives in Manhattan, which might bias her against the joys of rural life, that explanation seemed to me to be a bit vague.

So I actually did some RESEARCH (which I guess was left out of the history degree that Katie Zezima got at BU) because according to this little piece from an actual Maine newspaper the problem is very different. The reason dentists don't want to get a hobby farm and practice out in the middle of nowhere is that most folks in those areas get their dental work reimbursed by MaineCare which is state provided health insurance for poor people.

Now according to the advocates universal health care, programs like MaineCare are supposed to overcome the "market-based" problems that limit access to decent medical care for folks who don't have insurance in the middle of nowhere - and Maine has a lot of "nowhere" where kids are so bored they are popping Oxycotin and shooting up because there's nothing to do.

Anyway, why is there this shortage of dentists when MaineCare should be providing dentists to rural Maine? It terms out, market incentives are the problem, because despite the attraction of the annual moose hunts in rural Maine, dentists don't like getting paid 13 bucks to examine a kids mouth, which is all that MaineCare will pay.

So will Obama's universal healthcare create doctor and dentist shortages by "cutting costs?" Something to chew on for advocates of universal healthcare - or maybe gum on if things go like they do in rural Maine.

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