With the Obama administration preparing to address the problem of health care, they should remember that the most effective form of cost containment is to encourage patients to treat themselves. Britain’s National System has perfected this technique. As the Guardian reported last year:
Large numbers of people are going without dental treatment and some even report extracting their own teeth because they cannot find an NHS dentist in their area, a survey reveals today.
The Dentistry Watch survey of more than 5,000 people, from the Commission for Patient and Public Involvement in Health, found widespread unhappiness among both patients and dentists despite government reforms to increase the availability of NHS dentistry. More than three-quarters of those who have a private dentist consider they were forced into it because their own dentist went private or they could not find an NHS dentist.
Just over 10% were not registered with a dentist at all. A third of those (35%) said there were no NHS dentists nearby, 22% said they did not know how to find one, 13% said they were on a waiting list and 30% said there were other reasons.
But 6% of the respondents said they were self-treating, which often included pulling out their own troublesome teeth. “Fourteen teeth have had to be removed by myself using pliers,” said one Lancashire respondent. “Have pulled teeth out before, easier than finding a dentist,” said one in Hull. “Because I could not afford the treatment cost, I had to extract my own tooth on one occasion,” said one in Harrow. “I took most of my teeth out in the shed with pliers. I have one to go,” said another in Wiltshire.
Some of the respondents show considerable ingenuity. “Filled own teeth – clove oil and Polyfilla,” said one in Essex. Another fixed a crown with Superglue and a third used a screwdriver to scrape off plaque.
The survey was carried out by Patient and Public Involvement (PPI) Forums around England. It was triggered by complaints received by PPIs following a new contract for dentists in April 2006, which was supposed to increase access and simplify the charges levied on NHS patients.
What could be a better approach for the government? If only the NHS could convince patients to do their own amputations and heart surgeries, costs would really fall!