On the surface, you’d expect dentists to be fond of the Democratic proposal to expand Medicare to include dental (along with vision and hearing) coverage. It’s one of the things progressives are battling to include in the fiscal year 2022 budget reconciliation bill, a.k.a. the Build Back Better package, assuming Democratic centrists don’t shrink the price tag so much that big Medicare improvements become unaffordable. So the medical professionals who care about good teeth and gums and would get the actual Medicare dollars must be big fans, right? Wrong, as the Wall Street Journal reports:
The American Dental Association is mobilizing its 162,000 members to fight a proposal to include dental coverage for all Medicare recipients, opposition that could prove pivotal as Democrats look to make cuts in their $3.5 trillion domestic policy agenda.
Giving dental, vision and hearing benefits to the 60 million older and disabled Americans covered by Medicare will provide needed care to people who otherwise might not afford it, supporters say.
The ADA supposedly wouldn’t mind a low-income dental benefit, since that would subsidize care for those least likely to secure it on their own. But for better-off Americans, the guaranteed customer base it would assure is less significant than the lower prices Medicare would likely insist upon, compared to what dentists would otherwise charge. Before you say “cry me a river,” it is true that dentists are not typically as lavishly compensated as MDs. But they are not starving, either: As of 2019, the Bureau of Labor Statistic calculated the average salary of U.S. dentists as being $175,840.
The other factor is that dentists are famously a profession with a lot of people who are just conservative politically. Back in the day, it was common to find John Birch Society literature in dentists’ waiting offices. It wasn’t an accident that conservative extremists often violently opposed fluoridated water as a communist plot that would, incidentally, reduce the demand for dental services.
But dentists are hardly alone among health-care professionals who frown on government involvement in their lives and work, even if there’s some money in it for them. The American Medical Association strongly opposed enactment of the Medicare program from the get-go, hiring a well-known Hollywood celebrity to front its campaign against the evils of “socialized medicine”:
Doctors got used to it, of course, though no grievance in the whole wide world is more durable than physician complaints about Medicare and Medicaid reimbursement rates. You can expect a similar mix of views among dentists if Medicare does move in that direction. But if you happen to have a checkup, teeth cleaning, or a cavity treatment in the very immediate future, don’t be surprised if you are warned that Uncle Sam is trying to ruin your smile.