The fake tooth fracasPolitical windfalls can land in unexpected places. Osstem Implant, a local manufacturer of dental implants listed on the technology-heavy Kosdaq market, is the latest beneficiary. The stock that traded at around 10,000 won ($9.22) around the time of the general election last April now hovers around 35,000 won thanks to President Park Geun-hye’s campaign promise of enhanced entitlement programs for Korea’s population of senior citizens.
The stock has merely been muddling along for the last five years. The dental implant market has reached saturation since local versions were first introduced some 10 years ago. Controversy over excessive surgical implants also damped investor appetite in the stock.
But the company received an overnight boost during the election campaign after the ruling party candidate promised public insurance coverage for dental implants. The stock’s prospects blossomed with a new market of potential patients among Korea’s 6.26 million senior citizens.
Nowhere else in the world provides public health coverage for expensive cosmetic dentistry. The idea is a bit exorbitant. But the opposition is in no position to criticize. In fact, the bizarre idea first came from the opposition camp. When running for South Gyeongsang provincial governor in 2010 from the opposition camp, Kim Du-kwan wooed senior votes by promising to make artificial implanted teeth affordable.
During the last presidential campaign, the liberal camp attacked the ruling party’s campaign promise of dental implants, saying it would cost as much as 20 trillion won. It did a rough calculation of the total number of missing teeth of our senior population. The Saenuri Party insisted the budget would be no bigger than 300 billion won. The Ministry of Health and Welfare estimated that it would come to around 1.83 trillion won. In fact, the presidential transitional committee toned down the program to incremental 50-percent coverage for a molar implant starting from the age of 75.
Any plan to spend public money for dental implants should take note of a precedent that involves full sets of dentures. Since 1996, all aspiring presidential candidates have been hawking a promise to pay for denture sets for the elderly. The promise finally came through last July. Dentures were included in the public health care program.
Many had worried that fake teeth would chew up the national health insurance system. The National Health Insurance Service actually estimated that denture coverage would cost 328.8 billion won. But entitlement only amounted to 26.5 billion in the second half of last year. Senior citizens have not rushed to remove their old teeth because they still have to pay at least 500,000 won and the elderly are used to living with some discomfort, said one official of the public health authority.
It is totally unclear how many senior citizens would visit dentists to get implants. Surgical implants are, in fact, not really recommended for people over 75 because they need to have enough jaw bone to support the device. Not many poor, elderly people can afford to pay 700,000 to 800,000 won to replace each worn-out or missing tooth.
Many who can afford and want them would already have them by the time the new insurance coverage is offered. But we can’t know for sure. Of an adult’s 28 teeth, molars number 16. The health ministry will first supplement the two molars at the very back and incrementally increase the scope of the implant coverage.
Everyone gets old and is entitled to the right to chew and enjoy eating in their later years. But the sudden interest by politicians in the dental health of the senior population is nevertheless strange. Following full dentures last year, partial dentures and teeth cleaning will be covered by public insurance starting July and implants from 2014.
Of course, the dental supplement in public insurance should be raised from the current mid-30-percent level. But we cannot neglect the fact that public dental insurance outlays will triple from next year from the current 1 trillion won annually. We may be venturing out way into the kind of disastrous fiscal mess that Japan is in.
Behind Japan’s colossal deficit is medical care for senior citizens. Of 14.2 trillion yen in annual spending on senior medical care, the citizens themselves paid 14.3 percent - or 2 trillion yen. The remaining 12 trillion yen has been subsidized by the state, eclipsing the combined government spending on education, science and pork-barrel projects.
People over 60 now account for 38 percent of Japan’s population and their voter turnout rate exceeds 84 percent. It’s no wonder Japanese politicians must please senior citizens. Politicians decided to raise the individual health cost burden for people aged 70 and over to 20 percent, but have not been able to act on the decision for six years. People under 40 go largely neglected in policies and in spending.
Japanese economist Takero Doi of Keio University listed two major policy failures of the Japanese government. First, the country has not prepared well for an aging population due to miscalculations of birth and death rates over the last 20 years. Second, the government dragged its feet on revamping health care and the pension system. He strongly called for cuts in public health coverage for senior citizens.
The warning should apply to Korea, where the aging of society is advanced. A generation gap and the conflicts it brings are deepening in Japan. Faced with financial disaster, Japanese Finance Minister Taro Aso bluntly said that the government and country should let old people “hurry up and die.” There is a saying that the worst form of politics is the kind that aims to please everyone. Politicians promising old people anything they want, including new teeth, can leave a bad taste in the mouth.
*The author is an editorial editor of the JoongAng Ilbo.
by Lee Chul-ho
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