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From the Patient's Mouth

My friend and colleague Dr. Joe Goldblatt sent me an essay he wrote recently about his experience with National Health Care in Scotland. Below is a condensed version of the essay that I think those of you following the health care reform "debate" in the US might find interesting:

My Dentist and Why I Believe National Health Care Works

by Joe Goldblatt, patient

When we arrived in Scotland nearly two years ago, we were told to sign up with a local dentist who accepts National Health Service patients. My dentist is a soft-spoken, kind gentleman of 50ish from Mauritius. He has been practicing dentistry for more than 25 years. His dental office is spotless and yet has none of the typical artificial hygienic smells that I normally associate with a busy dental practice.

After examining my teeth, he noticed a cavity and suggested that he fill it. When I asked him if he provided local anaesthesia, he smiled warmly and said, “Yes, of course.” Then I asked if it would be alright if I had a wee dram of scotch before I came for my next visit to calm my nerves and he responded with a wink, “Yes, and then have two after the visit.” At the conclusion of the visit, I paid £10 (about $18.00) for the service.

My filling was painless and completed quickly. I see our friend the dentist twice per year. During each visit he inspects my teeth and gums and then gives me a thorough cleaning. There is no dental hygienist. At the conclusion of the visit I pay £5.00 (about $9.00).

During my last visit, I told the dentist that food continues to stick between two of my teeth. He said that he could either order a new crown and that would cost £100. (about $180), or he could apply a wee bit of glue. I chose the glue. My newly glued teeth immediately solved the problem. I now enjoy meals without an annoying trip to the loo to extract foreign objects. Oh, the indignities of aging! And by the way, there was no charge for the glue.

Whilst living in the United States, I often spent $3000 or more per year on dental care to mend my aging gums and teeth. One time I needed an extraction and a post and crown replacement. I went to see the specialist referred to me by my general dentist and was surprised to see a waiting room that looked like the lobby of the Waldorf Astoria hotel, only his reception area was more posh. He briefly (five minutes) examined my teeth and then led me into a show room displaying photographs of his past work. He offered me a crown from Beverly Hills, California (I’m not joking) or a standard appliance. The total charges for his services would have cost, if I had lost my mind, more than $5,000.

I know there are thousands of excellent dentists in the US who don’t charge anywhere near this fee and do a fine job. However, before a national health programme is summarily dismissed due to anecdotes, innuendoes and even lies, I would ask that my own experience be considered as one example of millions of people who have benefited from one country’s National Health Service for the past sixty years.

Finally, take the case of my 70-year-old neighbour who had his knee replaced this week. The average out-of-pocket cost for this in the United States is about $35,000. (Tulane University Hospital and Clinic, 2009) Instead, as an individual guaranteed health care by his government, he was diagnosed one month ago, had the surgery this week, and paid nothing. He’ll be home in three days, following comprehensive physiotherapy.

There is no perfect health care plan because there are no perfect patients or perfect doctors and nurses. However, I will continue to visit my local dentist and doctor, and will have a wee dram of whisky daily to celebrate that health care is affordable, safe, and reliable and freely available to all where I live.


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