B.A.Ware

Are you like myself working on observations and experience or are you quoting facts. The difference here might be where you were bought up. My experience in a city, is that in low income families, going to the dentist was way down the priority list probably behind beer and cigarettes, which is were your point carry’s water. In this case we are all free to spend our money on what we choose and people would only use the dentist when they really need it. Therefore it would be cheaper for them in the long run because they wouldn’t be constantly paying for check ups.
Whether this is better for the health of the nation I don’t know. There is another point I will concede about dentists that would reduce the cost to the consumer, why do we need to constantly have check ups ,we don’t have 6 monthly heart and brain scans. Crickey you’ll make a raging capitalist out of me yet.

Bryan Parry

BAW: exactly. I don't think some people quite grasp how it works in inner-cities, or large cities, or in city-council estates. Quite different to rural or suburban upbringing. Different priorites, often, and different concerns.


Indeed. People who are clever can "shop around" and get cheap deals on most anything which are still of high quality. However, it doesn't generally work this way for poorer people; you are poorer, so you buy lesser quality food, have less hygienic surroundings, get poorer service, and to compund this you probably also smoke/drink/have to pay bills like everyone else, and thus find it quite tricky. I am sorry Paul, and especially sorry if this sounds emotional at all ( ), but single mothers (to quote a cliche) living on the paltry child support benefits, not really in a position to be in full-time work, can scarce afford to feed their kids, let alone well, and let alone go to the dentists themselves (except for when they DO have a gum or tooth problem and physically HAVE to go). Saying its all their own fault, or they aren't trying hard enough is all well and good (and often at least part-true), but it isn't exactly a solution to the problem.

Paul Birch

The period we're talking about here is eighty years ago, before either of us was born, and before the growth of today's welfare state (though not before the dental licensing monopoly - Dentists Acts 1878, 1921 - so there was no free market in dental care and prices were far higher than they should have been).

Coming back to the present, there is certainly a behavioural difference between the social classes; the lower classes do tend to look after their health less well than the middle and upper middle classes. But it's not really a matter of cost. Often the lower classes spend more than the middle classes, but do so wastefully. The people who tend to go for dental check-ups least frequently are actually those on benefits, who would get them free of charge.

The free market price of a checkup would be pretty low - I suspect that most dentists would offer them free or as loss-leaders in order to get customers. It's a five minute job and shouldn't cost more than a fiver at most.

It might be good if we did. In a free market I'll bet some canny manufacturer could soon make scanning kiosks (like photo booths) where anyone could get a scan with a quid in the slot.

Technology should make things cheaper; medical technology has been driven quite the wrong way by the absence of "customer power" or a quantitatively priced market.

Sarumano

I've been thinking on this private/nationalised industry business... someone shoot me down.

What we do is put a nationalised industry up for grabs. Everyone and anyone can set up a company to make a profit for themselves; and they take the risks that collapsing involves, and having their share of the market taken by leaner companies.

This could mean for instance that where a company has a more efficient ward structure, it could run wards in two or three hospitals. (Note that I would not intend 'efficient' to mean 'cheap'; the equation would be sick patients in divided by healthy patients out). That company would be liable, etc, and in competition with anyone who thinks they can do a healthier ward.

If the same principles were operating railways as roads?? Umpteen different bus companies all using the same roads, all in competition, all paying the Government for road repair via fuel tax. I know it's sort of happening now with railways. Very few of these companies clash over territory; when they do there's a price war, or there should be.

And you get employee loyalty by hiring people the waitrose way... you make them partners, then they all have an interest in training and seeing efficiencies and returning customers.


Odd thought number two... 'nationalise' doctors, dentists and opticians. Pay them from the government purse/ lottery money. Patients who need medical treatment come with a pay stoppage for as long as they are ill...

Number three: independent inspectors travel the country on basic salary with a pay bonus for every discrepancy they find.