Should My Friend's Dental Implants Be Deemed Medically Necessary under Medicare

Hi guys, my friend messaged me today saying he has to get all of the top row of his teeth extracted along with some of the bottom row. He's in his mid-20s and finally brushing his teeth regularly while no longer drinking a bottle of coke a day.

As is common knowledge, Medicare doesn't really cover dental once you're over 18. Don't want to get in a debate over it but I think that's quite silly.

On some sites, it says "Medicare may cover part of the cost if the procedure is deemed medically necessary." I was struggling to find if his situation would be one of medical necessity, or if people are expected to walk around with no teeth and unable to effectively eat. The fact he's so young makes me feel like it should be, as a result of how the jaw can degrade/change over time when left without teeth.

A larger problem is finding out how much Medicare will co-pay if he does meet their threshold. I called up a couple of dentist offices but no receptionist was able to help me.

From what I've heard, none of his teeth are rotting/infected, just severely corroded and dental implants would cost $15,000. This seemed very cheap compared to the estimates I saw of $2,000 to $6,000 per tooth.

I'd love any help clearing this up as I'm quite sure he doesn't have $15,000 lying around

TL:DR - Brush your teeth and flossing can't hurt either

Comments

    • Are full removable denture the one that covers the whole arch of teeth that you can easily slide on and off?

  • -3

    Your friend was smoking coke, not drinking it

  • +11

    This is a really good example of why Medicare should cover dental.
    Nobody is choosing painful and involved dental surgery that isn’t necessary.
    And a really great example of why preventative care that is at no cost can avoid future costs.
    Costs that may have been avoided with free dental on Medicare.

    • -4

      I believe it's covered for under 18s

      Once you're an adult you're on your own. The government's pool of money is not unlimited.

      • +11

        Except dental issues can severely impact people’s health. Dental care can be prohibitively expensive. I can see the unlimited pool issue but if we support people with health issues then dental should be included. It should cover health issues not cosmetic ones. Maybe we get one less submarine so we can fund it.

        • I vote we pull all the teeth of any politician supporting AUKUS and then deny tax payer cover denatl when they join the implant queue.

          • +4

            @Protractor: Based on size of population It should be called USUKA. However, if you say it out loud you realise how duped we’ve been.

          • @Protractor: That's not really equivalent though is it. It'd be more like we make any politician supporting AUKUS have to pay for his or her own dental care. Which already happens (via private health insurance).

            No one earning as much as a politician is getting any taxpayer funded dental.

            • @justworld: No.
              I think ripping out their teeth is a worthy aspiration.Given what the cost,risk and liability AUKUS is, it's a small sacrifice. The Beetroot and the Spud will be long gone when the shit hits the fan.

        • +5

          I think it's silly to exclude it under Medicare, oral health issues can have far-reaching impacts on the rest of the body. If we put some money in to prevention/treatment of oral health then we may save some money later down the line not only with oral treatment, but also mental health (having bad teeth isn't going to make you feel better) and physical ailments (like pneumonia and cardiovascular health problems). All of this still discounts individual patient outcome being more positive on the whole

        • +2

          Health impacts are one thing, but the social effects are also significant. I wonder how many people have made a few years of f***ing terrible choices, nuke their body, manage get back on the rails, but can't get a job due to having Gollum teeth. Obviously not a guarantee, but a couple of grand worth of government-covered dental care might be all that's needed to get some people back out into the tax-paying workforce.

      • +2

        The government's pool of money is not unlimited.

        Probably should stop giving themselves raises then.

    • +2

      Not everything can be paid for by the government.
      Personal taxes are already excessive for many income brackets.

      What was the outcome of exploring early super release if the OP's friend has zero savings?

      • +1

        If Medicare covered dental, you would have coverage too, and cheaper private insurance/out if pocket expenses.
        Similarly as with prescription pricing and other public health services, government funding would put pressure on providers to keep prices low.

        • "If Medicare covered dental, you would have coverage too, and cheaper private insurance/out if pocket expenses."

          You'd also have higher taxes, unless you think that money comes from nowhere.

          • @justworld: Do you not spend any money on dental care?
            Or do you think dental costs aren't currently paid with money?

            • @mskeggs: I pay for private health insurance which covers my dental care. In that sense, I already pay for it.

              You are proposing a system where my taxes would cover everyone who doesn't have private health insurance to have the equivalent coverage under the public system. Do you think that would be free?

              • @justworld: If the government was paying your dental, why would you continue to pay for dental insurance? Do you have a private firefighter on call, and pay for a private air traffic controller too?
                What I am proposing is a system of good quality dental care for all. If you wanted to fly to Thailand and pay for treatment, you still could, but if you got good quality treatment covered at one, why would you?
                This is a bargain site, not “How can I waste money site?”

                • @mskeggs: "If the government was paying your dental, why would you continue to pay for dental insurance?"

                  Probably because the medicare surcharge would add a $5,000 yearly tax impost if I didn't take out private health insurance which I otherwise don't want. You know that's how it works, right? About a quarter of Australians are forced by the surcharge to take out private insurance which then subsidises the public system. That money has to come from somewhere.

                  If I wasn't forced to, I'd just pay my own way for a yearly dental cleaning ($200) and save $1800 a year on junk insurance I don't want.

                  If dental was covered for all, it would increase the need for public funding, and I would have to pay more tax, either through a higher medicare surcharge, or through higher base taxes. Why do you keep avoiding the obvious point?

                  • @justworld: Your extras policy has nothing to do with the healthcare levy. There is no tax advantage for paying it. You know that's how it works right?

                    You seem really wedded to a system you admit doesn't work for you. How about instead of assuming everyone is coming for your precious tax dollars you spend a moment thinking about how things could be improved instead of accepting a poor system is unchangeable.

                    I am pleased you have had good dental health to date, I hope you continue to not need that insurance. But your choice to pay insurance to cover extras you don't get value from is a lot like paying taxes for services like firefighting and air ambulances. It makes sense to fund them as cost effectively as possible, eliminating middlemen taking profits along the way

                    • @mskeggs: Holy shit. How disingenuous can you be. If we include dental in medicare, it will cost billions. The Greens have a plan to do so, at the cost of $54 billion.

                      https://www.theguardian.com/australia-news/2024/oct/03/green…

                      This is more than the yearly cost of the NDIS, and as you know, when the NDIS was introduced, it was partly paid for by a 0.5% NDIS levy. For someone on, say, $400,000 a year, that means an extra $2,000 in income tax. More than what it would cost to pay for private dental insurance…which incidentally…I already have, and am forced to pay for anyway.

                      But keep skipping the point. Can you guarantee that spending billions on putting dental into medicare wouldn't raise my taxes?

                      You talk about savings - I don't need savings when I already have private health cover, do I? Are you going to make that free for me, too?

                      The reason the system doesn't work for me is that I pay hundreds of thousands a year in tax and am forced to buy up private health that I don't need, all to subsidise others, and you then pretend that somehow I'm going to be a beneficiary of even greater subsidies.

                      • +1

                        @justworld: I have no interest in seeing you pay less tax. I agree that under our progressive income tax system people earning more than $400k will indeed pay more in tax than they would pay in extras cover

                        I'm simply pointing out that you won't need to pay dental insurance as well as income tax if dental is covered by Medicare. So you would then have the freedom to arrange your affairs with work and tax as you wish, without the inefficiencies of paying for insurance operations and middle men. This would protect you as a rich person, and should you ever become one, a poor person.
                        You seem very certain you will never have need of public dentistry, so perhaps think of running dentistry under Medicare as an efficiency exercise - removing the costs of insurance and out of pocket expenses with a system paid by taxes.
                        While I don't know whether the greens policy is the best, or if $50billion is what dental would cost, it is remarkably disingenuous of you to suggest we would have to pay $50billion extra, without accounting for the many billions that wouldn't be paid for insurance and out of pocket. Perhaps those costs are $60billion, so we would be much better now off as a nation?
                        I don't know anybody going to the dentist for fun, so maybe it would be a huge savings over a few years.

                        Each time you reply you seem unable to get past the status quo. Perhaps have a little think about how to improve things instead of kneejerk reactions.

                        • @mskeggs:

                          I'm simply pointing out that you won't need to pay dental insurance as well as income tax if dental is covered by Medicare.

                          Yes, so I could possibly save paying for dental extras and save $200 a year on my private health insurance.

                          Will the addition of dental to medicare cost me more than the $200 savings? Well, the additional NDIS levy costs me $2,000 a year, so I'm betting the answer is likely: yes.

                          "So you would then have the freedom to arrange your affairs with work and tax as you wish, without the inefficiencies of paying for insurance operations and middle men"

                          Only if you get rid of the private health surcharge entirely. The fact that I need to buy junk hospital cover is the main inefficiency.

                          If you really care about efficiency, you would agree to have medical insurance be wholly user-pays, like car insurance - you get to select your level of cover, based on your level of risk. Of course, you don't believe in that. You believe that health insurance should be community rated, and that people who can't afford health insurance (i.e. those who don't pay any Medicare levy at all, let alone those who don't pay private insurance) should still have healthcare. That is the very opposite of efficiency, as I'm sure even you understand.

                          "You seem very certain you will never have need of public dentistry"

                          Wrong. It's that I'm certain the cost of paying for others to have public dentistry will outweigh the cost of having for myself to have dental extras cover. If I was only paying for myself, the cost would likely be equivalent. But not everyone contributes to medicare because not everyone pays any significant tax.

                          You are trying to frame it as if I am covering a transition from private dental to public dental. In reality, I am covering a transition from 3 people having private dental and 7 people having nothing, to 10 people having public dental.

                          • @justworld: I certainly don’t have the figures to show you that public dental would save you personally money, but in the same way a public firefighting service doesn’t save you money until it needed, I am pretty confident that public dental cover would add up to less than private dental out of pocket with for profit dentists, plus dental insurance with for profit insurance companies plus the cost of untreated dental concerns that fester and eventually get paid for as emergency healthcare would be lower than the cost of all those things.
                            It is cheaper if nobody has smoke alarms, but the long term costs are higher.
                            Your idea that 7 people currently pay nothing for dental health just shows you are only interested in this year’s bill.

                            I take a longer view, thinking about is it cheaper to give someone a checkup and possibly a filling now, or nothing now and a many thousand dollar bill for serious emergency work later.

                            I can’t help that short sightedness, except to say if you adopt it in other areas of your life you will find yourself very happy now, but up for bigger bills later.

                            I guess if you have a terminal illness, you might not think beyond next year, but we can’t all make our financial decisions based on someone who can’t think longer term.

                            • @mskeggs: "It is cheaper if nobody has smoke alarms, but the long term costs are higher."

                              You're still not seeing the point. Adding dental to medicare requires higher earners to pay not only for the cost of their own dental insurance, but also for the costs of all those people who do not pay any medicare levy to begin with. So yes, it might work out for me to buy home insurance in case my home burns down. It doesn't make sense for me to buy home insurance for three other families as well. All of a sudden it makes no economic sense.

                              "I take a longer view, thinking about is it cheaper to give someone a checkup and possibly a filling now, or nothing now and a many thousand dollar bill for serious emergency work later."

                              Except the situation right now is that the person, if it comes to it later, has a relatively cheap denture made. So the cost to the system is much less than if the person had full coverage for implants, veneers, etc.

                              "I am pretty confident that public dental cover would add up to less than private dental out of pocket with for profit dentists"

                              Dentists are still going to be out there making a profit, as they should be. The only difference is now they're being subsidised by the public.

                              • @justworld: I think you are missing the point.
                                You keep making arguments against progressive income tax. That is one of the ways we get the money to pay for things.

                                This post is about the possibility of covering dental under Medicare. A question about how how and which things we pay for.

                                So you do seem a bit muddled. You also feel wedded to the idea that dentists and insurance company shareholders have some right to profit. I don't understand that. There are plenty of dentists who work in public health or are employees of a company who seem to work for salary rather than a profit. And there are non-profit insurers.

                                I am guessing your personal priorities of gaining wealth make it hard for you to consider there are options that are better for many others if they aren't better for you.
                                I do hope one day you have the opportunity to be a high income earner, so you might understand one of the benefits of having some wealth is you don't have to be constantly on guard that someone less fortunate might get a sore tooth treated as a result of your taxes.

                                • @mskeggs: "I am guessing your personal priorities of gaining wealth make it hard for you to consider there are options that are better for many others if they aren't better for you."

                                  This is the first time you have acknowledged that putting dental into medicare might actually leave me worse off financially. Till now you have been disingenuously arguing that we can somehow do it yet still save me money. If that is the case we might as well cover everything with medicare since the money will magically appear from other savings.

                                  "I do hope one day you have the opportunity to be a high income earner, so you might understand one of the benefits of having some wealth is you don't have to be constantly on guard that someone less fortunate might get a sore tooth treated as a result of your taxes."

                                  It's pretty hard to build wealth in this country when most of your income is taxed at 47%.

                                  That said, I'm doing my best. Once I hit financial independence in my 40s I won't have to work any more. After that I will only have to pay about $40k of tax a year and the government can finally stop leeching off me.

                                  • @justworld: I don’t know if Medicare covered dental will benefit you more than the extra tax or not.
                                    If you had a major dental issue you might be surprised how little the insurance you pay for covers. It isn’t very unusual for somebody paying a lot of tax to also to also receive much more financial benefit under Medicare, just an accident or diagnosis can easily require tens of thousands of dollars of treatment. I guess it is similar with dental.

                                    Best of luck climbing the ladder. Hopefully when you are a bit older and a bit wealthier monetarily you will have equally seen good growth in your generosity of spirit.

                                    All the wealthy people I know are very interested in their communities and sharing the good fortune they benefitted from.

                                    • @mskeggs: "All the wealthy people I know are very interested in their communities and sharing the good fortune they benefitted from."

                                      I will be FIREd long before I become wealthy. It is not my goal to attain large amounts of wealth. Just enough to live comfortably.

                                  • @justworld: Curious what would you be doing everyday when you retired early?

                                    • @ATTS: house husband duties, video games, road trips, chess, reading

  • +2

    I had to have an implant in 2018.
    It was from an unfortunate accident in primary school where I and another guy ran into each other on the field and a front tooth was half knocked out, held on by my braces. I had a root canal that lasted 20 years before it failed and I got an abscess and they pulled the whole tooth.
    Medicare covers like $150 out of the $6k or whatever it was.
    Unfortunate events happen, I think Medicare should cover more than just the extraction ($150).
    The rest of my teeth are great, I don't even have a single filing so it's not like I did anything wrong.

    • +3

      The health care system is structured to remove teeth. Cheap,nasty,lazy conveyor belt option. Then we have the downstream Medicare costs of the hundreds of associated side effects of that stupidity.Once again the industry is self regulated and makes it's rules up re charging rates and what's covered. Medicare can't compete when the goal posts are so mobile. It all gets back to the basic driver.

      None of this shit gets any better as populations bulge even more.

  • Medicare won't cover it. Get $5k and have in done in Bangkok is best solution to this problem.

    • What is included for 5k? Also are there any horror stories doing in Thailand?

      • +1

        Plenty of horror stories, and if there is a issue (high chance of it if you are starting with a non-ideal mouth) you are on the hook for every $$ spent rectifying it.

        • Thanks

      • Also travel insurance doesn't cover you if you travel for medical purposes (the fine print is intense). So not only can things go bad but you have to pay a huge amount to get back and you could be worse.
        This is part of the poverty loop - we'll often look for opportunities to get us out of situations that we can't afford, but those opportunities might be even more costly in the long run.
        Ironically public health is making the same mistake by not funding dental - there are very clear links between dental issues and heart, cardiovascular, organ health later in life. There's a huge impact on our self image which has costs as well.
        I don't get the logic that dental care stops at 18.

        • +1

          Thanks

  • +2

    I personally think dentures are underrated. Maybe I am biased as I got my first plate when I was 10 years old and am heading into my late 60's now. I had a VERY dysfunctional childhood and never really brushed my teeth until it was way too late. I have had dentures all my life and haven't found them much of a problem however I have a sister with an implant who always seemed to be battling some sort of issue with it. Most of my peers have dentures as back in our day the emphasis was more on pull them out and get false teeth. Once you have dentures (unless they break which is unlikely as these days they are pretty strong) you never have to see a dentist again and even if they do break you can go straight to a denture maker and cut the middle man. Maybe that is why the big deal about implants is so rife now so you have to keep going back.

    • Problem with dentures is the gums and bones start erode because of lack of structure the teeth provide? I mean if you have 20 years left sure maybe not an issue but if you have 50+ years…..
      So my question to you is, how are your bones and gum lines?

      • +3

        I am heading towards 70 and this last set I have had for over 30 years and I am assuming my mouth is the same size because they still fit the same. They have a metal sort of back where my first sets way back when used to be all plastic and they used to break and have to be fixed but these ones haven't been repaired since I first got them. So to answer your question I have had top dentures for close to 60 years. When I used to work (retired now) every so often I would get compliments on my nice teeth and smile. My answer with a grin was "thanks but they aren't mine" and if a kid was with them I would say to them that this is what happens if you don't brush your teeth. I have not a clue as to bones and gum lines just know I have a denture

        • I agree it can look good, I remember when my father got dentures it was very weird at first because most people don't have perfect teeth and with dentures it can look perfect to the degree that it seems a bit odd. I never noticed with my grandparents because I probably always knew them with dentures.
          I still worry about the slow erosion of the bone and gums without teeth but I'd have to do more research, hopefully my teeth will outlast me though haha.

        • Just curious was there a reason why you didnt opt for those ( not sure what its called) single dental implant that stays there the whole time rather than wearing and removing denture?

          I think it was like 2k per tooth.

          https://www.google.com/search?client=ms-android-samsung-ss&s…

      • How do u stop the gums and bones from eroding btw? Is there any other options?

    • Does it feel uncomfortable wearing dentures?

      Also does food taste different with dentures?

      • +2

        I have had these for close to 60 years and was a kid when I first got them so I pretty much don't remember any difference and back in my day you didn't have options especially if you were a kid from a dysfunctional family. The only thing I notice is sometimes I have burnt my palate from eating really hot food because you don't realise how hot it is until it is too late. They are part of me now. I was 10 when I first got them and come to think of it I don't remember any other kids with false teeth but it was so long ago and a very insignificant part of my childhood and just something I have never really thought about. Back in those days kids were never consulted or their opinions sort. You just did what you were told and got what you were given and were thankful. You didn't question because you were a kid and kids didn't question authority or adults. I don't think food tastes any different because you taste with your tongue and I don't even feel them as they are just there.

        • +1

          Thanks for this insight!

          It's good your outlook.

  • +1

    You can under certain circumstances access super for your teeth.

  • Ensure he gets professional advice on the longevity of each solution. Implants may be a good solution for an older person replacing one or two teeth, but for a young person getting so many, he could end up with lots of teeth issues later in life

    • Could you please elaborate on issues later in life from implants?

  • Op along with corroded teeth did he also have tooth decay or receding gums or gum disease to be advised to remove them

  • I know someone that spent 40k+ on new teeth in aus, so thats cheap

    • Curious how did they end up finding that dentist.

      I hear some are not technically qualified to do that all on 4 procedure? But they do it anyway

    • I have one implant replacing a central incisor and all up with bone grafting and titanium post, it cost $11,000 about 15 years ago. I think OPs estimates for costs might be a little off!

  • No

  • Medically necessary basically is heart condition other than that it's next to zero I don't care about the function of his teeth I've done this for another participant before the enjoys so you buy the option of going overseas or climbing on his super option first he has an some money. Overseas isn't as bad as people put it out to be.

    • Would they do something on medicare if you suffered a traumatic accident, like a car accident, and needed emergency facial surgery?

    • Curious Where did the accusation oversease dental work is bad come from

      • The British

  • +1

    Public healthcare shouldn’t cover diseases substantially caused by lifestyle factors.

    • +1

      Haha, but that covers most of the top diseases … (Cancer - much higher risk in the obese, Heart Disease - much higher risk in the sedintary, Diabetes - much higher risk from seed oil / sugar consumption)

    • +3

      Sounds like a slippery slope, soon you'll find that they can blame almost every disease on some sort of lifestyle choice.

      • +2

        This is why insurance vultures want medical record access by law

      • +2

        high cholesterol, cancer, uric acid, Heart Disease, Diabetes etc etc can be genetics, born abnormalities or be influenced by lifestyle/diet. Image if Public healthcare or insurance could select what to cover.. we would be (profanity) as they would just say lifestyle for everything.

  • +2

    Actions —-> Consequences

    Didn't brush teeth, drank lots of sugary drinks, got in fights and had a few teeth knocked out = go get a personal loan and pay for own teeth!

  • +1

    Why would tax payers fund a personal poor choice?

    • +1

      Ask farmers. On paper,broke.In life, easy street.

      • +1

        Farmers in a good year - I need a new cruiser Ute in and new John deer tractor

        Farmers in a bad year - government gime money I'm poor

  • If he has funds to get it done overseas, I can suggest a place in Delhi, India. Reputed clinic and get one implant with crown for $750-$1000 AUS. I had some work done there for my wife as well.

  • +1

    Come on OP, there is no friend. The last time I rang around a few dentists for my mate was never

    • -1

      I can assure you there is. I would assume most people haven't rang multiple dentists because most people don't have friends who need their entire top row of teeth removed. If you did, maybe you would care enough to try and help your friend, maybe you wouldn't. We're all different and we all make different decisions

  • +3

    I’m in the process of having ONE implant. $7000. So $15000 for 16+ teeth is already discounted,

  • +3

    I would recommend that he see a specialist periodontist +/- prosthodontist for his teeth.

    Overseas dentistry is fraught with danger, they often use weird / unknown components, and if you have a issue are you going to fly back there????
    If you had a issue here you would be sent to the specialist to deal with, so I would probably just rather see them from the start.

    You could also go to your local university hospital if they specialist registrars in the field. They are already qualified dentists specialising, so the level of treatment is comparable to that of a fully qualified specialist.

  • Fly to Thailand and have a 5* holiday at the same time as doing dental

  • +4

    hi! dentist here!

    it's a common misunderstanding that medicare doesn't cover adult dental care.

    medicare pays for all medically necessary dental care if you hold a health care card. to get a health care card your income has to be below a certain threshold. according to the mygov website, you need to earn below $40,000 to get a health care card.

    once you have a health care card, you can go to a community dental clinic and be put on a waitlist for general dental care or a denture voucher. implants aren't considered medically necessary but medicare will pay for dentures. there is a copayment of $150 for upper and lower full dentures. if the community dental clinic is too busy, they often hand out vouchers for people to get dental treatment done at private dental clinics, however, not all private clinics accept government vouchers.

    hope that helps!

    • Curious any link detailing government vouchers etc

      And whats medically necessary in general and in relation to dental

      How much denture privately btw?

      • hi!

        this is the website if you’re living in Victoria.

        https://www.dhsv.org.au/our-services/information/vouchers

        treatments that are medically necessary are fillings, cleans, deep gum cleaning, root canal treatments, managing trauma, taking teeth out and making dentures. draining abscesses, oral cancer care, cleft lip care are also medically necessary.

        full upper and lower dentures on average is $3000

  • +2

    Pretty dumb that the public would have to pay because someone decided to act like a child and refuse to look after themselves now needing surgery.

    But that probably applies to thousands of other situations where the public pays for people's stupidity.

    I need to take more advantage of this and use what I'm entitled to.

    • Smoking and drinking enters the chat

  • +1

    Hello,

    Firstly, hope your friend has taken on this as a lesson and looks after them more when he solves it.

    Secondly, as many have said I don't believe Medicare covers much unless not doing it will cause the person to die.

    Even if it means not having any teeth will cause him to have mis-aligned bite over time.

    As many have said, it's probably a better option to save up and do it overseas in an asian country, I have had friends who said Vietnam was extremely cheap and good for dental work.

    Also I feel everyone on here is as usual judgemental, either your friend wasn't educated or repeatedly told about dental hygiene as they grew up, or he had out right ignored it, either way a lot of people in this world do dumb things and are given another chance, I can only hope he can save enough money and fix his teeth up.

  • you can get plate made under it

  • +1

    this sounds like a job for captain hindsight

  • Implants are crazy costly like 7-9k for 1 implant. Go overseas if you have connects and you can fly biz class and still will be under that 7-9k!

  • If dental is covered by medicare (which it already is to some degree for eligible individuals), the overall quality of work will decrease. See the UK's NHS dentistry for example

    • Free market absolutist nonsense.

      • -1

        The LNP mission statement

  • You can still live without teeth. Sucking your way around….

  • Go to Thailand or Turkey. Cheaper.

  • No, implants are not a medical necessity.

  • So you want the tax payer to pay the bill because your mate is a stupid dirty grub who eats and drinks like shit and doesn't know what a toothbrush is

    Riiiigghhtt …

    Claim denied

    • I guess you could think of it as me wanting taxpayers to foot the bill, but ultimately I just want my friend to be happy and confident enough to smile at people because I think he's a good egg regardless of his poor past decisions

      We have one of the best medical systems I could hope for (outside of long wait times and doctors that refuse to see you for more than 2 issues in an appointment). It already covers plenty of poor lifestyle choices and I don't believe people are inclined to (profanity) up their body "because the taxpayer will pay to fix it". I'd like to think our country is one that tries to bring people up and improve them, not kick them to the curb because they are downtrodden and someone deems them as so stupid as to deserve their fate

      I didn't mention his eating habits and he knows what a toothbrush is. A person that calls others a dirty grub whilst knowing nothing but a few sentences about their life, and seems to delight in the experience seems like a far worse individual than my friend who didn't brush his teeth, and I still wouldn't want you to be without medical treatment if you needed it

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