Seriously Though Why Are Vision and Dental Coverage Extra?

I took a look at my body in the mirror this morning, just to make sure everything was where I’d left it, and indeed, everything appeared to be. Every now and then I like to do that, you know. One thing I noticed about my body, and something I think about rather a lot, actually, is that my eyes and teeth appear to be rather firmly and permanently part of it. I mean, I guess I couldn’t have been looking at my body at all if I had no eyes, so obviously those came factory installed in my case, but when I opened my mouth, lo and behold, a set of choppers loomed at me and I was reminded that I needed to brush my teeth.

Yet, health insurance companies as well as government health care programmes seem to believe this is not actually the case, that eyes and teeth are either not part of your body, or are optional upgrades. Extras that you can pay more for if you want them, but aren’t supported under warranty, so to speak. Like, okay, we’ll insure your smartphone, but if something happens to the special bluetooth headset you bought to go with it, don’t come whining to us, because that’s not our responsibility.

Except that, oh wait, a human body is not actually analogous to an electronic device. It’s a complex living organism with numerous interconnected systems, and those systems need to be kept as healthy as possible for the whole of the organism. Eyes and teeth cannot be considered separate and independent from the body not just because their functioning is key to quality of life, but also because they can be directly connected with some pretty important medical conditions. When things happen to your eyes and teeth, in other words, they can affect the rest of you. I know, heady stuff.

Take the teeth, for example. As anyone who’s ever had a toothache knows, having toothaches royally sucks. It makes it difficult to eat, think, or really do anything at all other than wanting to curl up, cry, and yank your tooth out by the roots just to get the pain to stop. Pain is actually not good for you physiologically or psychologically, which is one reason to get toothaches treated. And there’s a risk that infection in the teeth and jaw could spread to other regions of the body; the big concern here is endocarditis, which you really do not want to get.

Treating endocarditis is expensive, uncomfortable, and time-consuming. While proper dental care doesn’t mean there’s no chance you will get it ever, it can reduce the risks, which is a good thing; managed care should include appropriate interventions to prevent conditions that could be costly to treat. Regular dental cleanings and checkups can both prevent dental problems and in the long term prevent a cascade of health issues, as well as catching them early. Regular dental visits can also allow patients with unusual symptoms to have their problems identified and addressed.

My father, for example, had a heart attack after experiencing transient jaw pain for over a year, which is one way angina can present in some patients. A sharp dentist could have caught that and suggested a cardiac evaluation (p.s. readers over 65, please go get your hearts looked at if you haven’t already), and my father’s declining heart function and severely stenotic arteries could have been caught before he needed a costly and invasive emergency medical procedure. A procedure which, I’d note, the government had to pay for (thanks, Medicare!), though it wouldn’t have covered expenses for dental care which might have caught the problem early. Which strikes me as a somewhat disappointing lack of forethought, let alone priorities.

Consider the eyes, as well. Vision problems are generally unfun just on their own; floaters, cataracts, progressive blindness, and all the other amazing things eyes can do to make it hard to see are not enjoyable, and they require careful management, sometimes for life. Some are also symptoms of more serious issues, like, uh, brain tumors, which are bad, and high blood pressure, which is also not such a great thing to be having. In other words, in addition to being the windows to the soul, the eyes can also be the window to the body’s general overall state of wellbeing, which is one reason why it’s a good idea to visit an optometrist regularly.

You might not mind that you’re seeing double, because, hey, double the fun, but it could be a sign that something is seriously wrong, not just with your eyes but with your brain, and that’s something that you want to get treated. Only you’ll have to pay extra for it, because it’s likely your insurance or government coverage doesn’t consider your eyes part of your whole body, and refuses to bundle them into holistic treatment to ensure that you get prompt evaluation and treatment for vision problems.

What gives? Why is dental and vision coverage often an addendum to a policy, and a costly one, at that, forcing many people to just pay out of pocket for these services when they should be considered part of full medical coverage? It’s true that dentistry and optometry have kind of diverged from other medical specialties pretty radically, to the point that the educational paths followed are very different, but these are still skilled and specialised medical providers, offering a particular service that benefits patients, and they should be considered part of a larger provider network.

The fact that insurance companies are reluctant to pay for basic routine preventative care that can not only prevent pain and suffering but also prevent serious medical complications is illustrative of the overall greed of the industry. As for the government cutting dental and vision benefits (in cases where it even offered them at all), it’s clear that in austerity, nations take lessons from the most greedy among us.