On Poverty, Healthcare, and Choices

questioning my conservative view of the healthcare system

As of yesterday, I no longer have any missing teeth.

I used to be very poor—on various forms of welfare, and frequently one piece of bad luck from homelessness. I’ve written about this experience, and how my life changed when I finished school and got a good job.

While I was poor, I lost several teeth because I couldn’t afford a root canal. I don’t remember the exact numbers, but the situation I kept running into was this: an extraction was X dollars. A root canal was something like 5X dollars. In addition to 5X dollars, I’d need several hours in a dentist’s chair—hours during which I couldn’t work, go to school, or study. In each case, it would realistically mean a full day of not being able to work, go to school, or study, because PTSD issues would be a problem.

Without money or insurance, I could only go to the state-subsidized dental clinic, which was lower cost than private dentists but still expensive for any poor person. It also meant having male providers. Further, I’d probably need a doctor’s appointment to get a dose of Klonopin prescribed in the event that a panic attack ensued. Even if I had unlimited funds, it would have been a major ordeal to try to save the teeth. As it was, I had no choice. X dollars was hard to come up with; 5X might as well have been 500X.

(My PTSD is much better now than it was then, but back then, it would’ve taken a significant amount of time, emotional, and physical energy to gear up to handle these situations.)

When I got a good job, suddenly I had both dental insurance and discretionary income.

Suddenly, replacing the lost teeth was an option.

Surgery, Surgery, and More Surgery

Dental implants are extremely expensive, and the process is painful. An implant post is surgically installed in the mouth, which has to fully heal and be verified as such by the surgeon. Then the process of getting the implant is two more appointments. This means five appointments, minimum—the pre-op consultation, the surgery itself, and the post-op verification that the implant site is healed enough for the next step; then, the appointment to get impressions made to order the fake tooth and the final appointment, to install it. Depending on where the missing tooth is and how long it’s been missing, the surgery may also require bone grafts (determined by an expensive scan at the start of the process) or a sinus lift, and sometimes more follow-up appointments.

The surgery is also painful and, depending on where it is, can cause problems in eating for awhile. Types of food can get caught on the post, making brushing a complicated endeavor.

That’s a minimum of five appointments and, if you are able to get appointments without much waiting, about six months. Realistically, the start to finish process is about nine months.

Really good dental insurance, such as what I have through my employer, pays for a huge chunk of the total, albeit with a low annual limit, so sometimes appointments are delayed until the calendar rolls over and the insurance will start paying again.

My implants cost me about $1,300 each.

I have friends who’ve gone through this process without insurance; theirs cost north of $7,000 each.

I am extremely grateful to have had the chance to get my mouth fixed, and at a much more reasonable cost than some people I know had to invest in their own processes.

Still, it’s quite bizarre.

I can feel my other teeth shifting back into place. (Missing teeth cause the teeth around them to move out of place.) And I keep finding myself moving my tongue around to feel where the holes used to be, and memories of the people I grew up around, nearly all of whom were missing teeth, keep coming to my mind.

I don’t look like them anymore.

Will I always feel like I’m still one of them?

Will the trailer park ever be fully purged from my mind?

More Healthcare System Stupidity: Questioning Myself

I used to be a strong supporter of universal healthcare in the United States—specifically, single payer. I wrote about my change of mind here.

(Short version: vaccine mandates convinced me that if I want autonomy over my own body, I have to assume responsibility for always having my own, private coverage. The left gave up on “my body, my choice” and I blame them for the consequences.)

I try to regularly question my views, and be willing to change my mind.

I’m having a weird healthcare situation now that made me really question myself again.

Partly as a consequence of my childhood—human nervous systems are not meant to spend their developmental years marinating in cortisol, and the consequences are both long-term and unpredictable—and partly as a consequence of being poor for a long time, I have a lot of weird health issues.

Now that I can afford to do so, I pay for a teenager to help me do things that would tax my bad shoulder. When I couldn’t afford help, I sucked it up and was in a lot of pain, which meant taking the daily limits of OTC painkillers every day for years at a time. Which, yes, has its own consequences.

Lately I’ve been having a lot of vertigo, and it oddly correlates to both body aches and flare-ups of carpal tunnel syndrome in my wrists—which is itself a function of poverty, the years of spending 15 hours a day working and studying at ergonomically incorrect desks, and hunched over ergonomically incorrect keyboards.

Having done a tremendous amount of research and kept meticulous records, I suspect that I have a wheat allergy. The flare-ups consistently correlate to gluten-heavy meals.

So I went to my doctor, who said that they have a nutritionist on staff who specializes in helping people do an elimination diet and, if it improves their situation, find ways to maintain compliance with a gluten-free regime.

The nutritionist is expensive, but the insurance will pay if you get certain bloodwork done. If it shows the genetic markers for celiac disease and positive presence of certain antibodies, you’re home free.

If you “fail” the bloodwork, you’re on your own to pay for the nutritionist.

In classic “this is why doctors call me a zebra” fashion, I had a negative for the genetic marker and a strong positive (very high numbers) for the antibodies.

So, insurance bullshit means I’ll be paying for the nutritionist’s help out of pocket.

I Got It Right the Second Time

And I took some time to reflect on both of these—how the lack of universal healthcare resulted in my losing the teeth to begin with, and the insurance bureaucracy means I’m about to have a new, large expense as I try to spend two months without gluten and see if that’s the problem.

I thought about people with much more difficult choices to make than I do—people who have to support children, including children with their own expensive healthcare needs.

I thought about how many things may yet go wrong in my life, health issues that may prevent me from working and thus threaten my coverage.

I am not naive about the potential for disaster here. It’s entirely possible, despite my current, good situation, that the lack of universal healthcare in the US may one day result in my death.

But I haven’t changed my mind. The left, including the current President of the United States, proved that “my body my choice” is empty rhetoric. They were perfectly willing to demand that I be required, in order to keep my job/get a vaccine passport/maintain my civil rights, to comply with their insistence that I enter a room, remove part of my clothing, and have my body penetrated with a substance of their choosing—against my will and without my consent.

If a system where they could require that is the price of staying alive, it’s too high a price. Bodily autonomy is everything.

I do not want politicians deciding who’s allowed to have therapy or hearing aids or cancer treatment or anything else, and if they’re paying for it, they can and will decide these things. As Justice Kagan said during the Supreme Court hearings on Biden’s vaccine mandates: “the government is paying for the medical services so they have the right to dictate details of those services.”

No.

I’ve found my hill worth dying on. The grass is nice and green, and I’m not budging.

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