A really interesting paper by Katherine Ho and Matthew Neidell looks at how public goods (goods that people cannot be excluded from, and goods for which use by one person does not diminish use for another) impact businesses. Specifically, they look at fluoridation and the dentistry business. In their own words:
In this paper we consider how the dental industry responded to the addition of fluoride to public drinking water. We take advantage of the staggered introduction of fluoridation throughout the country to analyze the changes in numbers of within-county dentists relative to physicians in the years surrounding the change in fluoridation status. We find a significant decrease in the number of dental establishments and an even larger reduction in the number of employees per firm following fluoridation. We also find that fluoridation in neighboring markets was associated with an increase in own-market dental supply, suggesting that dentists responded to the demand shock by moving from fluoridated areas to close-by markets. Further analysis suggests that some dentists may have retrained as specialists rather than moving geographically. Our estimates imply that the 8 percentage point change in exposure to water fluoridation from 1974 to 1992 may have led to the loss of as many as 0.6 percent of dental establishments and 2.1 percent of dental employees, suggesting a substantial net impact of this public good on the dental profession since its inception.
Pretty good stuff. Neidell has used this identification strategy before, but to look at the effects of good teeth on wages.
3 comments:
"as many as 0.6 percent" -- that doesn't sound like a very large magnitude to me. although i like all of the theories tested in this paper -- very economic take on a health policy issue.
The loss of dentists does not reflect that less dental care is needed. On the contrary, while dentists focused legislators on fluoridation as a cure-all for tooth decay, cavity rates have gone up. Tooth decay is a silent epidemic, according to the US Surgeon General's 2000 report.
6.5 Million children on Medicaid have unfilled cavities. Two children died from the consequences of untreated cavities and thousands flood emergency room for dental care costing ten times the amount of a simple filling
Whenever a free day of dentistry is offered, lines appear with Americans whose dental health resembles that of third world countries.
80% of dentists refuse Mediciad patients and over 120 million Americans don't have dental insurance and that number is growin daily.
Modern dentistry has priced itself out of affordability for the average american. Furthermore, dentistry caters to wealthier Americans. Many have transformed their offices into spas.
Fluoridation has not reduced tooth decay. Fluoride overdose symptoms - dental fluorosis - white spotted, yellow, brown and/or pitted enamal, is a lucrative new market for cosmetic dentists who can charge upwards to $1,000 a tooth for veneers to cover up fluoride discolored teeth.
The lower number of dentists has nothing to do with fluoridation. The whole premise of this argument is wrong.
This is an interesting hypothesis, but its pure speculation.
Post a Comment