Healthy Teeth and Eyes Not Actually Wasteful Extravagances

In all the recent discussion about the Senate's proposed excise tax on health plans [1] started by Bob Herbert's New York Times column [2], a policy that seems set to make insurance coverage cover less health care [3] and ultimately cost patients more money, I feel an important point is once again being lost in the health care debate. As Herbert says:

Some of the benefits of higher-end policies can be expected in many cases to go by the boards: dental and vision care, for example ...

Dental and vision care are routinely presented as extra frills, but raise your hand if you know someone with glasses. Raise it again if you know someone who's had a tooth infection. Anyone keep their hands down for both questions?

Families that can't cover new eyeglasses may lose a child's ability to see the blackboard at school [4] or a breadwinner's ability to drive in an area where public transportation options are few to nonexistant. These are serious hindrances to economic prosperity for both present and future generations of working families.

Even when people are able to function well without healthy eyes, it does make life harder. Indeed it's hard to imagine someone willing to make the case in public that good vision is a needless excess.

Families that can't afford dental visits may have to watch a loved one die [5] of a tooth infection [6], which is a painful and debilitating way to go [7]. People may suffer pain that makes every meal a torment when they have to let cavities go untreated. They may lose their teeth and be unable to cosmetically repair the gap in their smile, negatively impacting their future ability to find work.

Let me emphasize that last point again, lest it fall by the wayside as trivial: missing teeth are a real drag on employability. There used to be a blog called Body and Soul written by a blogger called Jeanne D'Arc whose mother had lost several teeth [8] from being attacked by her father. In a post that's since been put behind a firewall after she stopped blogging, she described how her mother later took her and got out, then sought work to support them, only to be told by employers when she was in her early 30s that those missing teeth made her too unsightly to work in a front office. An employer might not say that up front these days, but as Jeanne asked readers to consider, when was the last time you remember seeing someone with missing teeth even bag your groceries?

But we all know that it goes far beyond employment concerns. When your mouth is in pain or you have a hard time chewing, it takes away one of life's simplest pleasures and can destroy the appetite. In the elderly and sick, further decreasing the appetite can cause dangerous wasting and immune suppression.

So I don't know about you, but I use my eyes and teeth every day. I don't consider them a luxury, either, though I'm exorbitantly grateful for my ability to eat solid food and see. If keeping those abilities requires a 'Cadillac' plan, then dammit, I think I deserve a Cadillac. And so do you. And so do all our fellow citizens.