December 4, 2014
Public Policy Lesson from the Simpsons #2
Managing a health issue or medical emergency can be stressful. Having health insurance can mean the difference between coping with a medical need or managing an escalating health and financial crisis. A classic 1993 episode of The Simpsons provides a powerful (and very funny) illustration of what it means when lower-or middle-income households can’t afford to pay for necessary health expenses.
21st Century Fox, via www.springfieldspringfield.co.uk
However, the Simpsons soon face a major crisis: the International Brotherhood of Jazz Dancers, Pastry Chefs and Nuclear Technicians – the union representing Homer and his colleagues at the nuclear plant – is considering a contract offer from their employer that would take away dental benefits in exchange for free beer. Though it takes him a while, Homer eventually realizes the high cost of giving up dental insurance benefits, and he convinces his fellow workers to push back in negotiations.
21st Century Fox, via www.springfieldspringfield.co.uk
Unfortunately, the labour tensions quickly escalate, leading to a walkout and power outages throughout Springfield. The striking power plant workers stand their ground and succeed in fending off the proposed cut to their dental benefits.
21st Century Fox, via www.springfieldspringfield.co.uk
While it all worked out for the Simpsons and other employees of Mr. Burns’ power plant, there are some important public policy lessons we can draw from this episode.
There are some important gaps in our public health care system
Before you dismiss Homer’s experience as unique to the American context, keep in mind that dental care is not covered in the Canadian public health care system. In fact, most health care services delivered outside of hospitals or doctors’ offices, including prescription drugs and physical therapy, are not covered under Canada’s public health insurance system. Indeed, the Canada Health Act doesn’t even mention them. When it comes to dental services, 94 per cent of the cost is left either to private insurance or out-of-pocket payments by individuals. In fact, when it comes to dental care expenses, less is covered now by public health care insurance than 30 years ago (when “only” 80 per cent was not covered).
Access to dental care has become part of the broader trend in workplace inequality
The result is that ability-to-pay is now a major factor in Canadians’ access to care.
The inequality between people with employer-based benefits and those in more precarious work without those benefits extends beyond dental care to prescription drugs and other extended health care services.
Short-term gain can produce long-term pain
Neglecting dental health can be very costly for individuals, but also for governments. Oral health problems have significant health consequences and create major downstream costs for the health care system when doctors and hospitals get involved. Poor oral health can also have a (harder to measure) impact on employment, which can drag on the economy.
Many provincial and territorial governments have programs to help those who can’t afford dental care, such as the Healthy Smiles program in Ontario and the Yukon Children’s Dental Program. However, people who don’t qualify are still left facing tough financial compromises or forced to choose financial over oral health. As many have asked before: where is Homer Simpson when we need him?
21st Century Fox, via www.springfieldspringfield.co.uk
— Noah Zon
