A Modest Proposal:
A Dental Insurance Plan for All Students

Edward B. Seldin

In “An Open Letter to the MIT Faculty” in a previous issue of the Faculty Newsletter (January/February 2006), I expressed the personal belief that the Institute creates for itself an ethical responsibility to provide reasonable access to dental care when, because of the excellence of its graduate programs, it attracts foreign students to come study in Cambridge.

It may not be generally known to the faculty, but some of our students come from countries in which the average graduate school-aged individual may have received either no dental care up to that time, or care that is deficient by U.S. standards. The plight of some students is compounded by a knowledge deficit regarding what constitutes good dental health as well as by economic factors. Some students may not recognize that they have a significant problem until irreparable damage has been done by disease processes that only produce symptoms at an advanced stage.

Medical insurance is provided for students by the Institute as a matter of course, and there is now legislation that prevents foreign students from waving local medical insurance offerings.

But no dental insurance is currently provided by the Institute for its students, and the difference in the way medical and dental issues are dealt with seems almost to suggest that the teeth and oral cavity are not legitimate parts of the human body.

The extent to which members of the MIT faculty and administration agree with my statement regarding Institute responsibility probably varies widely. Proximity to the problem may be the principle determinant of how it is viewed.

I can tell you, as the principal on-campus provider of oral and maxillofacial surgical care for the MIT community during the past 30 years, that every time I have had to preside over the premature loss of teeth (ones that might have been saved had a given student been properly screened for critical needs upon arrival at MIT, given a baseline education regarding dental health and treatment options, and provided with the wherewithal to access care in a timely manner) I have, on every such occasion, felt like an accessory – not to a crime – but to a certain institutional indifference to the dental plight of such members of our community.

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Beyond its being an economic fact of life, it should be an embarrassment to all of us that some foreign graduate students find it less expensive to stop work and fly home to get dental care, rather than to seek help locally. The differential in the cost of care offsets the roundtrip airfare. A student I encountered in the last few weeks almost did not make it back to MIT after such a dental saga because of a visa issue. Another student I was told about suffered for a month with a toothache before he could make arrangements to fly to Eastern Europe and back.

For a provider of dental care, it is hard to reconcile the disparity between medical and dental insurance offerings for students. No doubt, there are more important aspects of life for MIT and for each individual member of this community than teeth or dental health. But it is remarkable how attention getting such concerns can become for anyone in the throes of a dental misfortune. Certainly time lost due to illness is the same whether the problem is medical or dental.

Presumably, a college or university is “about” its student body. How then does one explain the anomaly that at the Institute, students comprise the only sub-set of our population that goes without the benefit of a dental insurance offering?

Would the administrators at MIT who, as a temporary measure, brokered a discounted rate for dental care for our graduate students at a local dental school think it was optimal to send their own sons or daughters across the river to be treated by undergraduate dental students rather than to get care on campus, at MIT’s own Dental Service?

In this brief essay, I would like to make the “modest proposal” that MIT break new ground and do something novel and innovative: design a capitated insurance plan that provides a baseline level of care for all students, such that premature loss of teeth need not be part of the price of an MIT degree. Then, in the next capital campaign, seek one or more donors who would be willing to underwrite the cost of such a plan and make it self sustaining.

Endowed care may be not as visible as real estate, but some enlightened donors might feel that supporting such a plan would be a meaningful display of generosity. I am convinced that an individual who arrived at MIT as a student from overseas with significant unmet dental needs, who was able to retain his or her teeth because of such an endowed program of education and care might (upon striking it rich, as some do) be no less grateful to MIT than a student who lived in a dormitory endowed by a generous donor.

I don’t know what it takes to generate discussion regarding such a matter, but in submitting this essay to the Newsletter I am trying to attract some attention to this issue. I hope that members of the Community with feelings about this issue will speak up.

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