Dental health is important in overall health, and fewer Americans opt for dental coverage as opposed to health insurance coverage, despite its importance.

While there is much to be excited about in the new health reform law, one critical piece of care is still going to be missing for millions of Americans: Dental care.   An estimated 132 million Americans are without dental insurance (compared to the 47 million without health insurance).

While many Americans perceive dental insurance as a luxury they cannot afford or oral health problems as a minor inconvenience, anyone who has ever had a toothache knows better.   Oral health problems can be painful, but they also have some big implications for the rest of our body.  For example. poor oral health can lead to heart disease.  In 2007, a young boy from Washington DC died after an infection from a molar spread to his brain, prompting outrage.

The Importance of Dental Coverage

Oral health problems are also a significant issue for employers and educators.  Studies tell us that over seven million days of work are missed every year in this country because of oral health problems.  Oral health problems are the leading cause of missed school days for children.  And oral health problems are a significant problem for older adults.  Many seniors are surprised to learn that Medicare does not pay for routine dental care.

States Cutting Dental Benefits

The truly bad news is that all these problems may become worse before they get better.  In response to budgetary woes, a number of states have cut dental benefits for their Medicaid populations in recent years.  For example, California no longer covers optional adult dental care under its Medicaid program (recipients can get badly needed care such as extractions).  While federal health reform expands eligibility for Medicaid, this may be challenging because so few dentists will see patients covered under the program.

The new law does provide subsidies to help adults obtain overall health care coverage.  Such subsidies indirectly could help Californians pay for dental treatment by lessening the financial burden of medical care, but with 132 million Americans without coverage for their teeth, there is still a long road ahead.

photo credit: Joaquin Villaverde

Under the current health insurance system and until the new law takes effect in 2014, it is the most difficult to get insurance when you try to purchase it as an individual or family (as opposed to getting the coverage through your employer).   In the “individual market” people are routinely denied coverage for certain conditions or denied coverage altogether for a long list of preexisting conditions.

Why Do Companies Deny Health Insurance Coverage?

While this practice makes insurance companies appear heartless, the practice has historically existed to help keep insurance rates lower for other customers and to keep the insurance company solvent.  If a person with any physical aliment could buy insurance at any time, many might wait until they are very sick to buy insurance, generating large medical bills.  The way insurance works today, the customers’ premiums are pooled together to collectively cover everyone’s health care expenses.  This helps the insurance company spread the risk and ensure the solvency of the pool.

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An illustration of how Health Care Reform will manage high-risk individuals who were denied coverage. The federal government has stepped in to increase the amount of funding for high-risk pools, but the type of coverage will vary by state.

The great news is that, come 2014, no one will be denied health insurance because of a preexisting condition.   The less-than-good-news, for people shopping for their own insurance who have diabetes, asthma, or even a pregnancy, is that 2014 is still more than three years away.

Under existing law in many states, insurance companies can turn down individuals for a wide variety of preexisting medical conditions.   Some will offer coverage with a preexisting condition exclusion or a waiting period; they won’t cover a medical expense associated with that condition for an extended period of time.

Why Insurance Companies Deny Coverage for Preexisting Conditions

Insurance companies have a very smart reason to take a hard look at preexisting conditions.   In a totally free market, people would have an incentive to buy insurance when they get sick to cover their bills, but not purchase it when they are healthy.  This works fine for the individual, but not for others covered by the same insurance, because the very concept of insurance relies on the company being able to spread risk among healthy (ier) and unhealthy patients.

Health Reform Offers Insurance for All – Regardless of Condition

In 2014, when the new health reform law goes into effect, denial of coverage will no longer be an issue, because the law requires everyone to have insurance.  “Everyone into the pool!”, including the young and healthy helps spread the risk, so that insurers can cover the 67-year-old diabetic without him bankrupting the system.

So what can individuals do from now until 2014 if they have a pre-existing condition and cannot get individual coverage?   Under health reform, many states have already begun to create or expand their ”high risk” pools – an option for people denied coverage.   In other parts of the country, individuals can enroll directly into the government’s new Preexisting Condition Insurance Plan, or they can request a quote for coverage here.

In many cases, coverage for those who are usually denied coverage is not cheap — not even close.  But it is coverage and a bridge to get us to 2014 when there will no longer be “pre-existing” conditions and insurance rates won’t vary based upon one’s health status.

Living and maintaining a healthy lifestyle is always something that should be a top priority. Your body is the only one you are going to get in this lifetime, and you should always be thinking about how to take the best care of it. Ladies, when you’re having to think about being healthy for two (and no we aren’t talking about fretting over your partner’s alarming disdain for vegetables), your health is more important than ever.

Your body is home to a tiny, dependent little being, and making sure you have the best of resources available to you should be your top priority. Your baby needs frequent and adequate checkups from the moment of conception, and this can quickly get expensive if you don’t have health insurance during pregnancy. But sometimes figuring out the best health insurance for you and your soon-to-be new addition isn’t simple and straightforward.

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Breast cancer, contrary to popular belief, can occur in men. Although male breast cancer is a hundred times less common than with women, it is a dangerous disease. According to the American Cancer Society, 1,910 new cases of breast cancer in men were recorded in 2009. It is estimated that 440 men in the United States will die from the disease this year.

Really? Men Have Breast Cancer?

Although men are not thought of as having breasts, they do have breast tissue that exists in small amounts behind the nipples. As such, men are not immune from the occurrence of breast cancer. It is easier to detect cancer in men because an asymmetrical lump tends to appear. However, the problem is that men tend to ignore symptoms. The signs of male breast cancer are similar to those found in women: enlarged breasts, lumps, discharge, and pain. Men who experience or observe these symptoms are encouraged to avail of health insurance options for breast cancer and have themselves checked out.

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One of the key components to making sure that there’s enough money and health care available for all of us living in the United States is plan, plan, plan. If experts were just to estimate what the population will be in a particular year (and much of it has to be some speculation) or if age and gender breakdown weren’t taken into consideration, health care providers would find themselves with a huge demographic portion needing care and with no money available to serve them with. Luckily for all of us, the National Health Care Expenditure Accounts Projections Team (NHCEAPT) is all over this type of things, and they have identified a trend that all of us, from young to old, should be aware of. Here is what we can expect to see through the year 2017 (doesn’t that year just sound so scifi?) and some suggestions on how we can be prepared for it.

Get Ready Medicare: Here Come the Baby Boomers

Baby boomers are little kids rocking out and bopping around to some music on the stereo. A “baby boomer,” a term created by the U.S. Census Bureau, is used to describe anyone born right after World War II, when everyone was so happy to see one another return home safely that all they did was sit around and make babies. The decade is usually considered between the years of 1945-1955. My parents? Proud baby boomers. And soon enough, people like my folks are going to be needing to access public programs like Medicare. According to the folks with the NHCEAPT, the outlook for national spending in the next eight years calls for steady growth. Spending growth is projected to be 6.7 percent in 2007, similar to its rate in 2006. Average annual growth over the projection period is expected to be 6.7 percent.

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