I was laughing when I read this:Gladwell indicates his confusion on the issue of moral hazard by offering as another

My impression is not that we don’t read articles, but that we start with different assumptions. Gladwell probably weights “Several years ago, two Harvard researchers, Susan Starr Sered and Rushika Fernandopulle, set out to interview people without health-care coverage for a book they were writing, “Uninsured in America.” They talked to as many kinds of people as they could find, collecting stories of untreated depression and struggling single mothers and chronically injured laborers—and the most common complaint they heard was about teeth.” more heavier than we would.

He dismisses “moral hazard”, but we are more likely to want to consider the long-term effects.

Of course, the current system does seem full of “moral hazards.” For instance, emergency rooms have become points of socialization (this year I’ve ended up in them twice and was struck by the level of familiar chatter among the other patients). And one of my ems students claimed that there were two prices on some equipment – an exorbitant one for medicare and medicaid, with a lower one for others.

Most of our local doctors (this isn’t considered, I suspect, the most desirable of locations) are from third world countries – many displaced Indians that came here directly from places like Uganda. Are we outsourcing medical education because our schools teach so little science or because the med schools have developed monopolies and intend to keep them? (I don’t know – am just asking.)
Problems can arise because of a language barrier.

Before you get billed for unnecessary work, you have to agree to have the work done. Is it too much to ask patients to think critically about such things, as they do for other purchases? My dentist once recommended expensive work that I thought was unnecessary, so I changed dentists. Who are these Americans who submit to whatever course of treatment the dentist suggests?

>The reason there are so few dentists in the UK is that they do not do a lot of unnecessary work, as their main income comes from insurance.
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>There is a shortage, which will probably go in time.
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>But British people do not generally have to worry about thousands of dollars of bills arriving for unnecessary work, as do Americans and people in other countries.

This is all wrong. Ignore it.

If he was getting his work done on the NHS then his comparison was ridiculous anyway, because the cheapness of his treatment was a result of the fact that it’s been paid for through higher taxes.

What puzzled me was that I presumed every British person knew this — even the most dim-witted and resolutely left-wing of my friends/acquaintances is aware that the government/taxpayer is paying the NHS bills — so I though that maybe he was making some more subtle point. But I can’t see what.

The fact is, Americans win just about every time and Europe’s a poor third much of the time.

But Brits like to complain and they’d do it no matter which country they were in.

Its not actually negative often, its just their way of talking. They like discussion, argument, and intellectual challenges. They’re waiting for you to come back with an interesting response.

What drove me crazy in America was it was so hard to get a good argument going, I really missed that. People either agreed or disagreed, but generally wouldn’t discuss much.

Brits often converse through polite disagreement, whereas Americans tend to shy away from legnthy, detailed argumentative discussion. That’s my experience anyway.

Dentistry

The reason there are so few dentists in the UK is that they do not do a lot of unnecessary work, as their main income comes from insurance.

There is a shortage, which will probably go in time.

But British people do not generally have to worry about thousands of dollars of bills arriving for unnecessary work, as do Americans and people in other countries.

I would also say this, sadly, that the UK immigrants to the US that I have known, are just really full up on critiques of US medical practices. They continue to complain about this many years after coming here. I include WWII ‘war brides’. This might not be noticable, the USA not being perfect and all, but that’s not the end of the whining.

Complaints about the political system here dominate their ‘conversations’. Ditto complaints about the progression of the immigration system as it applies to them (British citizens having the very LEAST problem of all nationalities, save maybe Canucks). The whining spreads out from there in many directions.

There is something about all this ‘critique’ of former Brit Americans that does not compute. I have lived in Suffolk, known many ‘blokes’ in many parts of the world, but this is just a matter of NO understanding to me. Can anyone account for this, or am I just unlucky in my Brit aquaintances??? G

Even today, a quick internet search suggests that normal filling prices are in the $250-$350 range. Unless the price of silver was particularly high 10 years ago, one would imagine the price of fillings back then would’ve been less than this.

For reference: when I had my wisdom teeth out (around 1991), I went to see a senior oral-surgeon (if I remember right, a professor at New York University’s school of dentistry) with an office overlooking Central Park and $750 was the charge for removing 2 wisdom teeth.

(Though, as an aside, while visiting Canada I had a cavity in one of my remaining wisdom teeth and I was told that I could have the remaining pair of wisdom teeth removed, instead of getting a filling, for nothing or next to it…but I opted to get the filling and later have them out in NYC).

Of course, if Dave got a gold filling, all bets are off, since those can cost $1200, but I don’t think gold is used for “temporary fillings” since they are known to last several decades, so I’m assuming that this is not what Dave got.

Last time I looked, Manchester United was an American owned team. :)

That is, however, no longer the case; a self-employed taxpayer may deduct medical insurance premiums on line 31 of Form 1040 (2004 version of the form). That has been the case since 2003, I think. I do it myself.

Private dental work in the UK is not subsidized. You only get the tax-payer support if you have an NHS dentist. On the NHS the basic stuff is free, and you pay a nominal amount for things like white (as opposed to mercury) fillings, like £30-40.

I presume Dave was talking about going to an NHS dentist — private dentists here are not cheap. Maybe American dentists are really, really expensive, but $750 (ten years ago) for a filling sounds like it wasn’t a standard job, and if he’s having non-standard filling jobs done in the UK privately, we aren’t talking £40. I’ve had private work for difficult filling jobs and caps, and we’re talking £400-800 a job.

How does that work? Are all fees supported publicly? Or just those that participate in the NHS?

If/when we get associational health care accounts, I expect that we’ll be moving to that and getting insurance via our church or other stable affiliation to take advantage of group rates.