Pretending that we are all created equal leads the privileged to narcissism and the non-privileged to despair. It divides us into winners and losers, as if we all start off life at the exact same starting line, like runners in a race.
I love how you ended this one, bringing it back to the root (canal). On this subject, I take comfort in the idea of faith over works. When we use 'works' to self-justify, it's always a trap, win or lose. I'm so glad I was up before the kids to read this in a timely manner and I must say, I can't believe you produce pieces so thorough week after week.
I agree, and this ties nicely to David's excellent point about guilt not applying to advantages over which he had no control originally. This is also, at least in the Christian tradition, why faith is considered to be a mystery, and why Jesus relied so heavily on parables (there was no way to communicate his message directly, essentially). When I have thought about this, I have also considered that even Jesus did not do everything he possibly could have, and turned down some requests.
As someone with terrible facial pain for 3 weeks and who has suffered through because $$$ I appreciate this story so much. I only wish more who need the message would read it. I just finished Serviceberry and I dream of such an economy that she lays out in the book.
Well, honestly, you should do more reading and less writing. Gordon Wood can instruct you on the DecksI am not too impressed if that is your argument for universal healthcare, which
Walking our dog in the heart of a city, I’ve met many people whose mouths are caverns of neglect. I complain about the cost of dental care in later life, but not after one of these encounters. It’s a privilege to have teeth. Every writer needs an obsession. I’m glad to follow your quest to the heart of yours. “Pretending that we are all created equal leads the privileged to narcissism and the non-privileged to despair.” How neatly said.
Well, honestly, you should do more reading and less writing. Historian Gordon Wood can instruct you on the Declaration of Independence and its meaning of equality, Adam Smith and Friedrich Hayek on morality and society, Weber and Michaels on the Iron Law of Bureaucracy and Oligarchy.
I am not too impressed if that is your argument for universal healthcare, which you do not define.
This essay has a fine gloss of intellectualism with a promising introduction to Chinese thought, followed by disparate musings.
You could have followed the original thought with a fine essay on our spiritual obligation to help the deserving poor and the less fortunate. That might require consulting the Bible.
Sorry you did not like it. If I included the Bible, Weber, etc., it would have been too long and would have taken away from the “debate” between Confucius and Zhuangzhi, which was new to me and, I assume, new to most others.
As for Gordon Wood, he writes, “Equality was based on a new understanding of people’s capacity to transform themselves. Educated people in the late 18th century came to believe — it was the basic premise of all enlightened thinking — that people were not born to be what they might become.”
I disagree. All experience shows us that this was not true in 1776 and it is not true in 2026. From birth people are unequal in so many ways.
Gongfuzi was really just a well-spoken bourgeoisie, for the reasons Zhuangzhi elucidated. But he sucked up to royals and elites with his social Darwinism, and they loved him for it.
You might find the multi-dynasty, multi-century rivalry between court Taoism and Buddhism in China. Which often turned violent, in ways reminiscent of Rome's struggles with Christianity. In the "tripod" of early Chinese thought, while Gongfuzi was all about the stability of the state, the other two were staking out the mystical, beyond-the-beyond stuff, and competing with--even as they cross-pollinated--each other.
Thanks! Certainly worth my while to find out more about what was going on intellectually in ancient China and how that manifested in their politics and the wars.
I did like the writing, just thought it came up short of its potential.
On the special 4th, I have to respond that you have not fairly represented what our Enlightenment Founders meant by equality under the law and equality under God. They absolutely understood the inequality of individual capacities and circumstances.
Excellent essay. I agree that no one should have to suffer due to lack of funds to pay for dental or medical care. Offering to pay for that man’s dental work was very generous and glad it brought the endodontist around to finding a solution. Hopefully, not a high interest payment plan… The concept that we are “all created equal” is often taken too literally. Because, while we may be in the creator’s eye, we are not in our flawed world. I’ll focus on healthcare as you ended with it. At 62 and retired, I have to purchase individual health insurance - in my case I pay $1,500 a MONTH for BCBS. It’s not even that good. My deductible is still high. My copays are $75 and I am not covered in any state other than my state of residence (other than convenient care, the ER and hospitalizations). It makes me dream of turning 65 so I can go on Medicare… not that it will be anywhere near “free” - as high income individuals, we pay the IRMA penalty which amounts to around $800 a month for my husband at this time (he is 65) - all this to point out that even “well off” off people are feeling the pinch. I feel for the average family who cannot afford their policies. So, yes, this conservative is also all about making health care affordable for all. Call it whatever you want. It needs to get done! And include dental, vision and hearing!
Thanks for the comment. I do think affordable healthcare and greater coverage would be both popular and morally correct. But it will mean higher taxes. Again, well worth it.
I’m so glad you offered to pay for the man’s dental work. I’m not surprised! I tend to think that there is a lot of room for agency in the world. I have worked with kids who are told over and over again that they are oppressed, that every problem they face is due to systemic racism, and whose families are dependent on government assistance generation after generation. It does urban black kids no favors to tell them they are eternal victims. So many just check out of school and any hope of law abiding employment. They may not be likely to become emperor but they could get decent jobs if they did their schoolwork and didn’t join gangs or commit crimes. Liberals often like to complicate this but it’s really obvious when you see what the people are actually doing. I despise the culture of envy that is now gaining popularity as socialism. The people I know who espouse it are almost all on some kind of government assistance and none are working full time or near their capacity. If we choose not to work we can’t expect material wealth- except those who want to steal it from others either directly or through taxation. I’ve made some bad decisions in my life that have left me less financially secure than I want to be but I don’t blame anyone else for that. Sure I was dealt a bad hand in some ways but taking responsibility for my own actions is way more productive and inspiring. There’s a middle ground between all merit and all circumstance. Happy Fourth to you and Debbie! Where is the Debbie story ?
Thanks Michael. I thought about including that but then it would have been too long. But it's a great example of Zhuangzhu's point about the elite making self-serving justifications of why they are elite.
This is a good start and I'm glad you wrote about it from your perch. There are fewer and fewer intersections between those that have and those that have a precarious perch based on whether their car works, they are healthy, have food, etc. So perhaps you and your readers will continue to explore the vast space between 'the littles' which at this point in history include the merely very wealthy and a few creatures with so much wealth (more than many governments). The implications of this vast wealth should be examined fiercely because the rest of us live with under "them". With a small (maybe 1,000?) but growing billionaire class the ones with power can afford to make decisions in a closed system and there are few things that could knock them back into the space where the rest of us work, work, work for a little play and to pay for what we need or want. We were never created equal as you say but take a look at the priorities and aspirations of those back in the day when those words were written and the priorities and declarations of those at the very top today. "We" have the volume but they have their hands on the dial. Will we get louder and force their hand? What will it take?
Bonnie, it seems inevitable to me that the many will regain influence. The question is whether it will come incrementally or with great haste and revenge.
"All people are equal" does not mean or include that everyone is "the same".
The awareness or sense of being "equal" and possessing "worth" simultaneously empowers and encourages individuals to value and develop themselves.
For this reason, societies that combine constitutionally enshrined equality with a clear awareness of human diversity—which can also entail the possibility of failure—are the ones best positioned to develop.
That might also be the right way to look at "guaranteed" healthcare.
It is neither "the solution" nor destructive, rather it depends on the conscience of the people involved in it.
When "We The People" are understandably disgusted by the "Democrats"´way of conducting but want to find an "answer" in electing sth. like Trump, doubts regarding self-restraint conduct of "The People" appear understandable.
All societies that guarantee a fundamental right to health insurance and medical care all face and deplore similar problems: for instance, mostly constantly rising costs, a growing sense of entitlement, and the expectation that the health insurer will cover "everything" without the individual making any personal provision, taking personal responsibility, or striving for a healthy lifestyle.
On the contrary, the biggest profits are actually made from absolute rubbish and a.o. from harmful, unhealthy food and consumer products.
"The state" reaps the most revenue from such junk, only to a.o. then use the resulting "tax" income to support the "needy"—and so the spiral continues.
Doubts regarding self-restraint conduct of "We The People" are obviously justified.
However, this is not because "evil forces" and "conspirators" are supposedly "orchestrating" things that way, but because the overwhelming "majority" rejects personal responsibility and self-criticism, or viewing them as an imposition—"terribly exhausting"—or as a form of "patronizing" interference.
While "S*cialism" is clearly defined, there is no such thing as "The" "Capitalism"; rather, the participants themselves decide how "good," "humane," or progressive "capitalism" is—and what it entails or not.
People like Mamdummy or Bernie Sanders - but not just them - want nothing to do with this, as their lies guarantee them "voters." Yet, virtually all other "politicians" differ from such a quagmire only in degree.
One can and should expect personal responsibility from everyone, but how is that possible when "the state" itself acts irresponsibly?
Handing out money to people who have never learned to manage it responsibly—and who fail to do so—is disastrous; yet this is by no means a trait unique to the "poor."
The situation becomes disastrous when this issue is exploited for political ends, "socialized," and used to single out and blame "culprits."
At that point, there is no longer any talk of genuine (personal) responsibility, and the act of taking personal responsibility—of looking in the mirror—is itself disparaged as "individualism" in a downward spiral.
Of course, when I give money to s.o. in need in a market, a bakery or wherever, I always ask myself if it´s "the right person". But there are so many needy, that the question appears superfluous.
I only know absolutely sure that a "solution" can never be to "take it all from the rich" because then soon no one will have anything and no one will see any sense in striving when they know it will be taken away from them.
Every so-called "socialism" has always and inevitably made this experience - the only question is how often that CRIME "Socialism" will be allowed to be offered as a "virtue" and not a devastating crime, and when people like Sanders or Mamdummy land in jail like the Venezuelan One.
I agree that socialism does not work, but capitalism can be reformed. I do think the United States ought to provide more in the way of healthcare but that will require greater taxes. And the only way to generate greater taxes is to ensure that capitalism is preserved as an engine of growth.
David, your experience makes me think about the roles we play, and the roles others want us to play in their lives, and what happens when those don’t line up. I think it's beautiful what you did in offering to pay for a neighbor's care. The need for this kind of compassion shows us a bigger problem. With all due respect to the barber-surgeons of history, modern Dentistry is serious healthcare. It is essential healthcare.
Why is Dentistry so separate from the medical realm of healthcare? This makes absolutely no sense to me. Teeth are part of the head: highly innervated, close to the sinuses and the brain, the esophagus and the trachea. An infected upper tooth can lead to encephalitis. An infected lower tooth can cause swelling of the neck that compromises the patient’s airway. (See: Ludwig’s angina--yikes!) The ability to chew is Step #1 for good nutrition and digestion. Not to mention talking, smiling, etc. My gosh.
As an ICU Nurse by training, who has now chosen to work in the field of Oral Health, I can, with some objectivity, say that the work of Dentistry is extremely difficult, precise, and stressful surgery—all day long. The standard of care here, in the U.S., is very high in terms of education required, skills tested, and standards of infection control maintained. It is a highly competitive field and the training is rigorous.
Yet, most Dentists tend to be modest, hard working souls. Many are apologetic and self-deprecating about the role they play in the healthcare system. They don’t work in hospitals with all the protections and conveniences available to other physicians. Instead, they’re trying to run very high-overhead, high-quality, small businesses. It is so difficult to do in a way that leaves room for free or reduced cost of care for patients who need it. That would not be sustainable in our current model.
Sorry to go on and on. I have such a heart for this. I have worked in some very fine clinics—both private and public charitable ones. I've worked on a mobile charity's bus (that was very cool!) These options work in very different ways, with different procedures and possibilities.
Bottom Line: Dentistry needs to be done as gently, as kindly, and as expertly, as humanly possible. For all of us. Until these realities are recognized, we will continue to scratch our heads and wonder what’s happening here.
Indeed. To add to your premise, I have seen what the constant pain of a bad tooth does to people's function. Low-level infections of the teeth pull the entire immune system down. Dental insurance never pays enough to really make a difference when you need major work. What current dental insurance does do is pay for routine cleanings where problems can be found and fixed early at lower cost.
There is no reason this country cannot fix this problem.
Ann, I agree that it makes no sense that dentistry is not as much as a priority in terms of coverage as any other preventative care. 'm sure there are studies that show taking care of a tooth problem at its early stages has a great impact on not only well-being but on lowering future health costs. I'm associated with an organization that recently arranged for a young person with very bad teeth to get her teeth fixed. She became confident because of that and is now in nursing school where before she was too shy.
I love hearing this David. I’m sure she will be a devoted and compassionate nurse. What a perfect example of the importance of Dentistry in terms of wellbeing and quality of life.
Thinking about this in the context of Taylor Swift's wedding last night - apparently she donated millions of dollars to small food banks across the city, which is probably their operating budget for a year or more, but also cost the city at least $1M for security, blocked off a busy part of Manhattan, etc. Who's to say cosmically how that shakes out?
At least she tried, I guess. She is not my cup of tea as I'm way too old to follow pop stars, but this does seem to show that she is self-aware or at least wary of destroying the goodwill of her fan base.
Well done. In the law, we talk about equality of opportunity rather than empirical equality between individuals. Studying law caused me to gain real clarity about how we create political systems and laws based on our subjective emotions, psychological tendencies and cultural biases. So, we apply a test called "rational basis" to any law. This means is this law objectively useful and/or beneficial to the entire society or is it merely indulging the subjective internal needs of the drafter of the law?
What is so incredibly radical about the American experiment is the framers' attempt to create a rational, objective and impersonal legal framework for Americans' "pursuit of happiness". That phrase recognizes that people won't be intrinsically equal, but that our creator endowed everyone with the right to try to get ahead. In the realm of government, laws should not be infringing on our liberties unless there is a rational basis for doing so.
Thus, in a perfect world, government would not infringe the personal liberty of a citizen because of the color of their skin, but it would infringe their liberty for anti-social actions like murder. It is way too easy for humans to concoct after the fact some kind of pseudo-rational basis for infringing a liberty when in fact that infringement is (maybe subconsciously) based on the irrationality of bias.
This is the constant push-pull of human life. What is so extraordinary is the framers attempted to create a government with a framework to mitigate human irrationality.
Thanks Cynthia. I think of the Declaration as almost like a book proposal for the Constitution that eventually followed. And the constitution aims for a more perfect nation so you're right that even with the best of people in power, there will always be a push pull.
I love how you ended this one, bringing it back to the root (canal). On this subject, I take comfort in the idea of faith over works. When we use 'works' to self-justify, it's always a trap, win or lose. I'm so glad I was up before the kids to read this in a timely manner and I must say, I can't believe you produce pieces so thorough week after week.
I agree, and this ties nicely to David's excellent point about guilt not applying to advantages over which he had no control originally. This is also, at least in the Christian tradition, why faith is considered to be a mystery, and why Jesus relied so heavily on parables (there was no way to communicate his message directly, essentially). When I have thought about this, I have also considered that even Jesus did not do everything he possibly could have, and turned down some requests.
It's wild to think that these two Chinese philosophers predate Jesus by 500 years or so. Although quite confident Jesus was not familiar with them.
Thanks Isabel. Both Faith and Works are necessary and symbiotic.
As someone with terrible facial pain for 3 weeks and who has suffered through because $$$ I appreciate this story so much. I only wish more who need the message would read it. I just finished Serviceberry and I dream of such an economy that she lays out in the book.
Shawn, so sorry to hear that.
Well, honestly, you should do more reading and less writing. Gordon Wood can instruct you on the DecksI am not too impressed if that is your argument for universal healthcare, which
Walking our dog in the heart of a city, I’ve met many people whose mouths are caverns of neglect. I complain about the cost of dental care in later life, but not after one of these encounters. It’s a privilege to have teeth. Every writer needs an obsession. I’m glad to follow your quest to the heart of yours. “Pretending that we are all created equal leads the privileged to narcissism and the non-privileged to despair.” How neatly said.
Thank you Rona. Yes, why teeth are not covered is wrong.
Well, honestly, you should do more reading and less writing. Historian Gordon Wood can instruct you on the Declaration of Independence and its meaning of equality, Adam Smith and Friedrich Hayek on morality and society, Weber and Michaels on the Iron Law of Bureaucracy and Oligarchy.
I am not too impressed if that is your argument for universal healthcare, which you do not define.
This essay has a fine gloss of intellectualism with a promising introduction to Chinese thought, followed by disparate musings.
You could have followed the original thought with a fine essay on our spiritual obligation to help the deserving poor and the less fortunate. That might require consulting the Bible.
Sorry you did not like it. If I included the Bible, Weber, etc., it would have been too long and would have taken away from the “debate” between Confucius and Zhuangzhi, which was new to me and, I assume, new to most others.
As for Gordon Wood, he writes, “Equality was based on a new understanding of people’s capacity to transform themselves. Educated people in the late 18th century came to believe — it was the basic premise of all enlightened thinking — that people were not born to be what they might become.”
I disagree. All experience shows us that this was not true in 1776 and it is not true in 2026. From birth people are unequal in so many ways.
Gongfuzi was really just a well-spoken bourgeoisie, for the reasons Zhuangzhi elucidated. But he sucked up to royals and elites with his social Darwinism, and they loved him for it.
You might find the multi-dynasty, multi-century rivalry between court Taoism and Buddhism in China. Which often turned violent, in ways reminiscent of Rome's struggles with Christianity. In the "tripod" of early Chinese thought, while Gongfuzi was all about the stability of the state, the other two were staking out the mystical, beyond-the-beyond stuff, and competing with--even as they cross-pollinated--each other.
Thanks! Certainly worth my while to find out more about what was going on intellectually in ancient China and how that manifested in their politics and the wars.
Well done. I speak Chinese. The pinyin commonly used is Kong.
I did like the writing, just thought it came up short of its potential.
On the special 4th, I have to respond that you have not fairly represented what our Enlightenment Founders meant by equality under the law and equality under God. They absolutely understood the inequality of individual capacities and circumstances.
Excellent essay. I agree that no one should have to suffer due to lack of funds to pay for dental or medical care. Offering to pay for that man’s dental work was very generous and glad it brought the endodontist around to finding a solution. Hopefully, not a high interest payment plan… The concept that we are “all created equal” is often taken too literally. Because, while we may be in the creator’s eye, we are not in our flawed world. I’ll focus on healthcare as you ended with it. At 62 and retired, I have to purchase individual health insurance - in my case I pay $1,500 a MONTH for BCBS. It’s not even that good. My deductible is still high. My copays are $75 and I am not covered in any state other than my state of residence (other than convenient care, the ER and hospitalizations). It makes me dream of turning 65 so I can go on Medicare… not that it will be anywhere near “free” - as high income individuals, we pay the IRMA penalty which amounts to around $800 a month for my husband at this time (he is 65) - all this to point out that even “well off” off people are feeling the pinch. I feel for the average family who cannot afford their policies. So, yes, this conservative is also all about making health care affordable for all. Call it whatever you want. It needs to get done! And include dental, vision and hearing!
Thanks for the comment. I do think affordable healthcare and greater coverage would be both popular and morally correct. But it will mean higher taxes. Again, well worth it.
I’m so glad you offered to pay for the man’s dental work. I’m not surprised! I tend to think that there is a lot of room for agency in the world. I have worked with kids who are told over and over again that they are oppressed, that every problem they face is due to systemic racism, and whose families are dependent on government assistance generation after generation. It does urban black kids no favors to tell them they are eternal victims. So many just check out of school and any hope of law abiding employment. They may not be likely to become emperor but they could get decent jobs if they did their schoolwork and didn’t join gangs or commit crimes. Liberals often like to complicate this but it’s really obvious when you see what the people are actually doing. I despise the culture of envy that is now gaining popularity as socialism. The people I know who espouse it are almost all on some kind of government assistance and none are working full time or near their capacity. If we choose not to work we can’t expect material wealth- except those who want to steal it from others either directly or through taxation. I’ve made some bad decisions in my life that have left me less financially secure than I want to be but I don’t blame anyone else for that. Sure I was dealt a bad hand in some ways but taking responsibility for my own actions is way more productive and inspiring. There’s a middle ground between all merit and all circumstance. Happy Fourth to you and Debbie! Where is the Debbie story ?
Thanks April. Definitely room for agency in the mix! Apologies for no Debbie story! Will try to rectify asap!
I taught "rectify" in SAT camp this week! Good use of a vocab word! Please give my Fourth of July greetings to Debbie!
I enjoyed this post! As I read through, I was reminded of Calvinism and predetermination
Thanks Michael. I thought about including that but then it would have been too long. But it's a great example of Zhuangzhu's point about the elite making self-serving justifications of why they are elite.
This is a good start and I'm glad you wrote about it from your perch. There are fewer and fewer intersections between those that have and those that have a precarious perch based on whether their car works, they are healthy, have food, etc. So perhaps you and your readers will continue to explore the vast space between 'the littles' which at this point in history include the merely very wealthy and a few creatures with so much wealth (more than many governments). The implications of this vast wealth should be examined fiercely because the rest of us live with under "them". With a small (maybe 1,000?) but growing billionaire class the ones with power can afford to make decisions in a closed system and there are few things that could knock them back into the space where the rest of us work, work, work for a little play and to pay for what we need or want. We were never created equal as you say but take a look at the priorities and aspirations of those back in the day when those words were written and the priorities and declarations of those at the very top today. "We" have the volume but they have their hands on the dial. Will we get louder and force their hand? What will it take?
Bonnie, it seems inevitable to me that the many will regain influence. The question is whether it will come incrementally or with great haste and revenge.
"All people are equal" does not mean or include that everyone is "the same".
The awareness or sense of being "equal" and possessing "worth" simultaneously empowers and encourages individuals to value and develop themselves.
For this reason, societies that combine constitutionally enshrined equality with a clear awareness of human diversity—which can also entail the possibility of failure—are the ones best positioned to develop.
That might also be the right way to look at "guaranteed" healthcare.
It is neither "the solution" nor destructive, rather it depends on the conscience of the people involved in it.
When "We The People" are understandably disgusted by the "Democrats"´way of conducting but want to find an "answer" in electing sth. like Trump, doubts regarding self-restraint conduct of "The People" appear understandable.
All societies that guarantee a fundamental right to health insurance and medical care all face and deplore similar problems: for instance, mostly constantly rising costs, a growing sense of entitlement, and the expectation that the health insurer will cover "everything" without the individual making any personal provision, taking personal responsibility, or striving for a healthy lifestyle.
On the contrary, the biggest profits are actually made from absolute rubbish and a.o. from harmful, unhealthy food and consumer products.
"The state" reaps the most revenue from such junk, only to a.o. then use the resulting "tax" income to support the "needy"—and so the spiral continues.
Doubts regarding self-restraint conduct of "We The People" are obviously justified.
However, this is not because "evil forces" and "conspirators" are supposedly "orchestrating" things that way, but because the overwhelming "majority" rejects personal responsibility and self-criticism, or viewing them as an imposition—"terribly exhausting"—or as a form of "patronizing" interference.
While "S*cialism" is clearly defined, there is no such thing as "The" "Capitalism"; rather, the participants themselves decide how "good," "humane," or progressive "capitalism" is—and what it entails or not.
People like Mamdummy or Bernie Sanders - but not just them - want nothing to do with this, as their lies guarantee them "voters." Yet, virtually all other "politicians" differ from such a quagmire only in degree.
One can and should expect personal responsibility from everyone, but how is that possible when "the state" itself acts irresponsibly?
Handing out money to people who have never learned to manage it responsibly—and who fail to do so—is disastrous; yet this is by no means a trait unique to the "poor."
The situation becomes disastrous when this issue is exploited for political ends, "socialized," and used to single out and blame "culprits."
At that point, there is no longer any talk of genuine (personal) responsibility, and the act of taking personal responsibility—of looking in the mirror—is itself disparaged as "individualism" in a downward spiral.
Of course, when I give money to s.o. in need in a market, a bakery or wherever, I always ask myself if it´s "the right person". But there are so many needy, that the question appears superfluous.
I only know absolutely sure that a "solution" can never be to "take it all from the rich" because then soon no one will have anything and no one will see any sense in striving when they know it will be taken away from them.
Every so-called "socialism" has always and inevitably made this experience - the only question is how often that CRIME "Socialism" will be allowed to be offered as a "virtue" and not a devastating crime, and when people like Sanders or Mamdummy land in jail like the Venezuelan One.
I agree that socialism does not work, but capitalism can be reformed. I do think the United States ought to provide more in the way of healthcare but that will require greater taxes. And the only way to generate greater taxes is to ensure that capitalism is preserved as an engine of growth.
David, your experience makes me think about the roles we play, and the roles others want us to play in their lives, and what happens when those don’t line up. I think it's beautiful what you did in offering to pay for a neighbor's care. The need for this kind of compassion shows us a bigger problem. With all due respect to the barber-surgeons of history, modern Dentistry is serious healthcare. It is essential healthcare.
Why is Dentistry so separate from the medical realm of healthcare? This makes absolutely no sense to me. Teeth are part of the head: highly innervated, close to the sinuses and the brain, the esophagus and the trachea. An infected upper tooth can lead to encephalitis. An infected lower tooth can cause swelling of the neck that compromises the patient’s airway. (See: Ludwig’s angina--yikes!) The ability to chew is Step #1 for good nutrition and digestion. Not to mention talking, smiling, etc. My gosh.
As an ICU Nurse by training, who has now chosen to work in the field of Oral Health, I can, with some objectivity, say that the work of Dentistry is extremely difficult, precise, and stressful surgery—all day long. The standard of care here, in the U.S., is very high in terms of education required, skills tested, and standards of infection control maintained. It is a highly competitive field and the training is rigorous.
Yet, most Dentists tend to be modest, hard working souls. Many are apologetic and self-deprecating about the role they play in the healthcare system. They don’t work in hospitals with all the protections and conveniences available to other physicians. Instead, they’re trying to run very high-overhead, high-quality, small businesses. It is so difficult to do in a way that leaves room for free or reduced cost of care for patients who need it. That would not be sustainable in our current model.
Sorry to go on and on. I have such a heart for this. I have worked in some very fine clinics—both private and public charitable ones. I've worked on a mobile charity's bus (that was very cool!) These options work in very different ways, with different procedures and possibilities.
Bottom Line: Dentistry needs to be done as gently, as kindly, and as expertly, as humanly possible. For all of us. Until these realities are recognized, we will continue to scratch our heads and wonder what’s happening here.
Indeed. To add to your premise, I have seen what the constant pain of a bad tooth does to people's function. Low-level infections of the teeth pull the entire immune system down. Dental insurance never pays enough to really make a difference when you need major work. What current dental insurance does do is pay for routine cleanings where problems can be found and fixed early at lower cost.
There is no reason this country cannot fix this problem.
Cynthia, agreed!
Ann, I agree that it makes no sense that dentistry is not as much as a priority in terms of coverage as any other preventative care. 'm sure there are studies that show taking care of a tooth problem at its early stages has a great impact on not only well-being but on lowering future health costs. I'm associated with an organization that recently arranged for a young person with very bad teeth to get her teeth fixed. She became confident because of that and is now in nursing school where before she was too shy.
I love hearing this David. I’m sure she will be a devoted and compassionate nurse. What a perfect example of the importance of Dentistry in terms of wellbeing and quality of life.
Thinking about this in the context of Taylor Swift's wedding last night - apparently she donated millions of dollars to small food banks across the city, which is probably their operating budget for a year or more, but also cost the city at least $1M for security, blocked off a busy part of Manhattan, etc. Who's to say cosmically how that shakes out?
At least she tried, I guess. She is not my cup of tea as I'm way too old to follow pop stars, but this does seem to show that she is self-aware or at least wary of destroying the goodwill of her fan base.
That's good to hear. She seems to be attuned to giving back, which is so important as he is a role model for so many.
She apparently gave about 10x what Bezos gave last year to Venice. So that’s a point in her favor!
David ❤️ You do so much good, on and off the page.
Thanks Christine.
Nice piece, David. I have a dental appointment next week if you care to join me. Tooth or consequence! Love, C
The root canal was more painful than your pun but it was a close call! Thanks Carll.
Well done. In the law, we talk about equality of opportunity rather than empirical equality between individuals. Studying law caused me to gain real clarity about how we create political systems and laws based on our subjective emotions, psychological tendencies and cultural biases. So, we apply a test called "rational basis" to any law. This means is this law objectively useful and/or beneficial to the entire society or is it merely indulging the subjective internal needs of the drafter of the law?
What is so incredibly radical about the American experiment is the framers' attempt to create a rational, objective and impersonal legal framework for Americans' "pursuit of happiness". That phrase recognizes that people won't be intrinsically equal, but that our creator endowed everyone with the right to try to get ahead. In the realm of government, laws should not be infringing on our liberties unless there is a rational basis for doing so.
Thus, in a perfect world, government would not infringe the personal liberty of a citizen because of the color of their skin, but it would infringe their liberty for anti-social actions like murder. It is way too easy for humans to concoct after the fact some kind of pseudo-rational basis for infringing a liberty when in fact that infringement is (maybe subconsciously) based on the irrationality of bias.
This is the constant push-pull of human life. What is so extraordinary is the framers attempted to create a government with a framework to mitigate human irrationality.
Thanks Cynthia. I think of the Declaration as almost like a book proposal for the Constitution that eventually followed. And the constitution aims for a more perfect nation so you're right that even with the best of people in power, there will always be a push pull.