Torturing poor kids for profits

Nathan Archuleta, not quite three, suffered the symptoms of Post-Traumatic Stress Disorder after going to a dentist. Why? Because in under 25 minutes, the dentist gave the boy three crowns, two baby root canals and six silver fillings. His mother heard him screaming and crying and burst into the room to see three clinic employees holding up down and strapping him onto a board. Nathan had nightmares and just “wasn’t my little boy” for some time after.

This begs a few questions:

Question #1: Huh? Could that amount of work ever be necessary for someone that young, even if he’s never seen a toothbrush? And isn’t he going to lose those baby teeth in a few years anyway? Answer:

A dentist who later reviewed Nathan’s records said the work was shoddy and many procedures unnecessary. A dentist who saw Nathan the following year wrote that he had “severe situational trauma.”

Question #2: So why on earth did they put him through that? Answer:

Because it was Medicaid and Medicaid would pay them.

Question #3: How can anyone be that money-grubbing? Are people really just that greedy?

Sure, a small minority of individuals are just this greedy and remorseless enough not to feel bad about it later. But the problem at the Small Smiles chain of clinics is systemic, not individual, and that makes it worse:

Such practices violate a settlement the company reached with the Justice Department in January 2010, following allegations that it was bilking taxpayers by doing unnecessary and substandard procedures on low-income children.

When you get group psychology going, whether it’s an angry mob or just a company or business, the worst facets in the group become magnified. Not everyone involved needs to be completely selfish and capable of objectifying children in this way; just a few who have that mindset can spread the poison throughout. The rest simply follow the group’s lead.

These are the kinds of problems poor mothers and children face. Businesses see the poor the way serial killers see prostitutes: as easy targets no one cares about.

We need to do something about Small Smiles, don’t we? Oh, wait – we did. Three years ago, without admitting wrongdoing, they paid $24 million, promised to change their ways and agreed to be monitored by an independent organization. This is the result – and Nathan is not alone. There have been complaints from other parents, government investigators and former employees.

There are a lot of details about other allegations and findings against Small Smiles in the above-linked article, and I encourage you to read it. But I’ve picked just this one to highlight:

In a sample of 34 records, 20 patients were restrained and given baby root canals with insufficient anesthesia.

Because restraining costs nothing, but anesthesia ain’t cheap. Why give a kid the full amount you’re going to bilk Medicaid for?

There’s talk of denying this clinic chain access to Medicaid funding, but there are entire cities where no dentist is willing to take Medicaid’s relatively low payouts, leaving poor families with no other option at all. Perhaps the most heart-breaking aspect of it is the guilt the parents feel, which should be on the clinic. Another mother whose little boy received shoddy work from one of these clinics said:

“It’s kinda my fault,” she said as tears rolled down her face, “Because if I would have had the money, he probably wouldn’t have felt any of that pain that he had to go through.”

It is not her fault. This society likes to believe that money is all the time rainin’ down on the poor, only they’re too stupid or lazy or something to grab onto it. Often times, poor people buy into this idea too. But it is not true. In a society where 1% makes all the wealth and one family (the Wal-marts, or whatever their name is) makes the same as 40% of all Americans, somebody has to be down and out and the children pay the price. That this woman feels irrational guilt about this shows she is someone who takes her parenting duties seriously and reviews her past decisions to learn to make better ones. That’s more effort than a lot of wealthier parents put into their duties.

How to fix this specific problem is a topic for others. My point in sharing this here is to illuminate what poor mothers and their children go through, and why – especially if you’re against abortion and/or contraception – you need to advocate public support for the poor. You need to be concerned that poor mothers are able to get their children educated and medically cared for, because that’s the only way they will break out of poverty. But remember: for every child that breaks out, someone else’s child has to fall in. This is unregulated capitalism. This is the system most Americans think is just dandy. This is what happens when you decide to set the floor for American living standards at rock bottom instead of something a little more decent yet modest.


  1. Gabriella says

    I just… who inflicts that kind of needless pain on someone, especially one so young? Without, you know, already beingn a sadist.

  2. says

    Gabriella, well, that’s the thing. For the most part, it doesn’t require sadism (enjoying causing others pain), it just takes objectification, which so many people think doesn’t really cause a lot of problems*. For the policy makers at this chain, they’re not hands-on doing the dentistry, so they can easily talk themselves into the idea that performing extra dental work on these abstract kids will make them more money without really harming anyone. The kids are objectified partly because the people writing policies will never meet them, but also because they are part of the impoverished class, which so many people see as… well, livestock. They don’t attribute dreams, needs and capability to this class. They see these people more like they see cattle, who feed at the farmer’s expense and need to earn their keep by providing milk and meat.

    *PETA’s ads objectifying women are a particularly hideous example of this phenomenon. They get that objectifying animals is wrong, but one of the reasons it’s wrong is that it leads to objectification of people… which they happily engage in, in hopes of winning over misogynistic men to their cause… of not objectifying animals, but happily objectifying women. And what’s worse? It’s not even a smart strategy. Misogynists typically see animals as even lesser beings than they see women.

  3. Angry Millenial says

    I am on medicare, and you would not believe the leeches I’ve had to deal with. Had to fire my chiropractor through my cell phone’s blocklist, as he’s quite persistent about getting those appointments! I get that people want money, but find someone not living at half the poverty line. The de facto therapy sessions were annoying too: come on dude, I don’t want to listen to your marital problems and golf habit; fuck you.

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