When I saw the headline, “Dental Care Just a Faint Dream for Virginia Homeless” in today’s WaPo, my reaction was, “No s “That’s news?”
After a few paragraphs of anecdotes about how horrible it is to live “a hard life,” have one’s teeth deteriorate, and live in excrutiating pain, we get to the point:
For most homeless adults in Northern Virginia, dental care is difficult to find. Medicaid in Virginia does not cover dental work for adults. Fairfax employs three 20-hour-a-week nurse practitioners who visit homeless shelters, but they are not set up to deal with serious dental issues. Shelter social workers try to get serious cases to dentists who will work for discounted rates, but there are few.
As the story notes, though, the people “contend with myriad medical issues, including drug and alcohol addiction and depression.” The issues that keep them from getting jobs, houses, baths, toothpaste, and so forth are the same ones that prevent them getting dental care. If our aim is to fix the problems of the homeless, I’m not sure I’d start with the teeth.
UPDATE: To clarify, I’m not being flip. Being in agonizing pain because of defective teeth is a horrible situation, obviously. So is sleeping outdoors in subzero temperatures, being at the mercy of criminals, and a complete lack of dignity.
My point is that the problem goes a hell of a lot deeper than inadequate access to dental care. The vast majority of these people are mentally ill and/or drug addicts without the ability to manage their lives. Unless we’re willing to institutionalize them or otherwise fix the “root causes” of their problem, expanding Medicaid benefits is unlikely to do much for them. Indeed, if medical care were entirely free, 99% of the homeless would not have any idea that the change had been made, let alone manage to get themselves to a dental appointment.
