It's 3:30 am on the morning of April 24th in the year 2012 in Houston, Texas and I'm sitting up holding the left side of my face hoping the agony in which I find myself will simply subside and I'll be able to get back to sleep. Unfortunately I'll have no such luck.
My teeth have been bothering me off and on for the past several months but for the past several weeks they've been waking me up at night and the pain has been excruciating. This would be when any "normal" person would pick up the phone and call Dr. Kennedy DDS and schedule an appointment to receive care for this pressing problem. Unfortunately for me as I'm one of 25% of households without health insurance the odds of my being seen by Dr. Kennedy or any OTHER dentist in the sate of Texas are remote. The lone star state holds the distinction of having MORE uninsured adults than any state in the United States and Texas' political and business climate doesn't see that changing any time soon.
As the healthcare debate waged in Washington between men and women in congress with 100% healthcare coverage over the merits of providing either health care or access to medical insurance to the vast majority of Americans I heard many ideas flying back and forth and they ranged from free healthcare for all to survival of the fittest. Many of those opposed to healthcare reform painted unflattering portraits of persons like myself who are without insurance. We were said to be either illegal aliens who don't wish to work for anything, welfare recipients who want yet another handout or simply irresponsible men and women who simply don't fathom a time when they will ever need medical or dental care. I won't pretend that people who embody those three popular stereotypes don't exist but the vast majority of us who don't have health insurance simply can NOT afford it.
I've worked for the past eight years for a school district in the role of "support staff." Several years ago the district classified people who do what I do as "contract labor" and to that end the vast majority of us don't get any type of benefits. While a great deal has been made over billions being poured into education it would sadden many to know that the bulk of that has been allocated to bonuses for principals, huge contracts for firms who provide either standardized tests or study guides for the tests in question or "miscellaneous" which could entail anything. My point I and millions of other Texans hold jobs and simply can NOT afford to pay insurance premiums and our employers don't offer us reasonable options.
Back to the pain in my teeth, I've tried an over the counter numbing agent to dull the sensation of pain but it no longer helps. Gargled with an anti-septic but to no avail and have taken some aspirin. None of these quick fixes is helping. I toss and turn in bed for another hour or so then come to terms with the fact that I have to see someone, anyone who can give me some relief. There are options one of which is the University of Texas Dental clinic's emergency care. It opens at 7:30 in the morning four days a week but is first come first serve. In other words the earlier you arrive the better your chance of being seen. At 5:00am I hop into my car and head for Houston's medical center.
At 5:30 am I find myself sitting on a hard rubber bench with a bright white light at my back. Across the street there is a red light atop the parking garage from which steam is rising in the cool morning air. The dental clinic doesn't open for another two hours but I'm the first to arrive so I know I'll be seen. Fifteen minutes after I arrive I'm joined on a the bench by a short, jovial man who has a broad smile despite the fact that he has an inflamed wisdom tooth. He asked me if he was in the right place and I assured him he was. His name is Luis. He owns his own construction company and had to take a day off work to tend to his tooth. As we sit and talk about life the universe and everything a line forms behind us including a Vietnamese kid in his mid twenties who is accompanied by his mother and sister. He is in such pain that he's nearly in a fetal position. Luis and I forget our pain for a moment as we see someone whose suffering is MUCH worse than our own.
The line grows bigger behind us and eventually we're allowed in. Men and women from every race are in line behind us. They don't appear to be the unwashed, unemployed masses that the talking heads on Fox News so often describe. They look like the same people you'd see sitting on a bus or in any shopping mall in America but today they're under dental distress. As I and the others sit and wait, the young dental students who will perform our procedures shuffle past in immaculate green scrubs. The majority of them appear to be young and female and all seem to be carrying the same metal tumbler of coffee.
At 8:15 I'm sitting in a dentist chair when a young woman introduces herself and lets me know I'll be her patient. After an x-ray she informs me that the bad news is that I have two options either a root canal or an extraction, but the root canal is less of an option because the canals have calcified (been enveloped by hardened tissue) and is beyond her expertise, also the tooth had been chipped and a crown would be too close to the bone which would cause further problems. An extraction was the simplest course of action, but we need our teeth. Any tooth you remove will have to be replaced with an implant or a bridge eventually. While they are beautiful teeth serve a purpose. They are how you chew your food and in the end serious dental problems can lead to other issues. The dental school can't help me if I want the root canal so I'm told that I have to go to the other annex of the dental school staffed by their residents. At 9:00 am I'm told that the only openings they are for 1:00pm and 3:00pm but I figured I had no choice. I sit in comfortable chair in the plush offices napping occasionally until I'm finally seen by a diminutive Vietnamese doctor who looks as if she's all of 17 years old. She studies my charts and tells me about the importance of the tooth, how risky a root canal would be and how much it would cost and needless to say...I knew I couldn't afford it. She advised me to give the issue some thought because extractions are permanent and once a tooth is gone it's gone forever. I didn't want the tooth removed but I knew I couldn't afford to be treated either.
She seemed genuinely saddened by the fact that there was nothing she could do for me either that or was one of the most talented actors I've ever met. She tells me to take ibuprophen until I can make up my mind about which procedure I'll ultimately choose. At the end of the day one of the clinic's dental assistants asks me why I didn't go to the Veterans Administration dental clinic.
Funny thing about veterans health care. A veteran of the U.S. Armed forces at any time after his/her discharge from active duty may apply for and receive medical care; however, they have only a matter of MONTHS in which to apply for dental benefits or they are INELIGIBLE for the remainder of their lives for anything save an extraction for which there is a fee. In other words, if a veteran doesn't run to the VA hospital and IMMEDIATELY apply for his dental benefits seconds after his discharge the only thing they'll do for him is to remove his teeth.
The kind hearted dental assistant gives me a list of dental clinics that provide low cost and sliding scale benefits to persons like me who can't afford a doctor or dentist or the insurance to pay them. I pay $12.00 for a token to leave the parking lot and try not to think about the fact that the excursion cost me a day's pay and $40.00 form simply having seen a dentist. I drive home along McGregor Blvd past the Mansions where Houston's wealthy Jews were relegated until they were finally allowed to move to places like River Oaks.
At the end of the day I'm still a guy with a job, but no insurance. I'm wrestling with the paradox being crammed down my throat about how it's essential to live a healthy lifestyle but marvel how there is a gym on every corner but an all you can eat buffet across the street. Big companies tell us how bad the economy is doing but continue to post record profits and give astonishing bonuses to those at the very top. The prevailing logic about the average employee at any organization isn't very dissimilar from what west indian sugar plantations must have been like. Work them into a grave as you'll have no problem replacing them.
I don't want to live in some great socialist eutopia where health care is "free" (as nothing is ever "free") but I WOULD like to live in a country where I and people FAR worse off than I am can at least afford to see doctors and dentist when we need them. I'm some middle aged, college educated veteran. In the grand scheme of life I don't have it that bad. What about single working mothers out there who can't afford to get sick? Tomorrow I'll be back at work, I'll probably be taking ibuprophen until it ceases to help me and then maybe I'll come up with some way of dealing with my teeth, but for now like many other Americans without insurance I have to go back to work.
Tuesday, April 24, 2012
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