August 20, 2007
What Does Your State Require You to Do To Prepare For the First Day of School?
Posted by Christine Hurt

Happy First Day of School!  Today is the first day of Fall classes at the College of Law, and also at my kids' school.  Everyone was excited and happy, and I am relieved to have a stable schedule for awhile!  Preparing for the first day of school always gets me a little feisty, though, especially now that we have moved to Illinois.  In Wisconsin, enrolling children in school required a lot of forms, most of them duplicative, and of course the required physician/immunization form.  Although our children were immunized (actually over-immunized, because we had come from Texas), I was relieved that parents that did not want to immunize could at least check a "conscientious observer" type box and still send their kids to school.  (Of course, there are some negative effects of this policy, including an outbreak of mumps in MIlwaukee public schools, etc.  But this post is not about the cost/benefits of an individual choice to immunize one's children or on the cost/benefits of mandatory immunization policy.  I'm sure there are many other blog fora for that conversation.) 

However, in Illinois, vaccinations are mandatory and so is (drumroll, please) a dental exam.  Children enrolling in kindergarten and other selected interval grades must have a dentist sign off on a recent dental exam.  OK, this reallly bothers me.  Not because I don't send my kids to the dentist.  My kids have gone to the dentist since they were three, gotten sealants on baby teeth, gotten fillings on baby teeth because a laser showed a "weakening" of the enamel, etc.  This is my choice, and I fortunately have the wherewithal to pay for it.  I also sign them up for sports programs, feed them 100% fruit juice and organic milk, and pay for music lessons.  These are things that I think might make them healthier but that I know come at a cost.  I'm willing to pay the cost.  However, I don't think the state should mandate expensive dental care for baby teeth or even for adult teeth.

When I've ranted about this to other Illinoisans, they have countered that because the dental exams are mandatory, government programs provide them for free.  So, I have been watching the paper for these free programs.  I have seen both public programs and private ones run by dentists in private practice.  These exams are free for children on Medicaid and children without dental insurance.  Well, I pay for dental insurance for my kids, but my bill for 2 examinations was $130 and change.  So, this mandatory requirement creates an indirect taxpayer cost and a direct out-of-pocket cost for me.  And for what?  What are the benefits?  Some individual dental benefits -- I do believe in dental hygeine, I'm not a caveman.  But societal benefits that would support the costs?  Unlike communicable diseases, a kindergartener who has never been to the dentist isn't going to create a cavity epidemic in Champaign-Urbana.  What's next?  The dermatologist lobby is going to get the legislature to approve mandatory dermatological exams to enter middle school?

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Comments (4)

1. Posted by wingsandvodka on August 20, 2007 @ 12:23 | Permalink

Not sure about dermatologists, but I wouldn't be surprised if your post inspires an enterprising Delaware law firm to draft and market a Special State Law Opinion of Outside Counsel for Public Primary and Secondary School Matriculants opining, based, of course, solely on the information provided by the parent, and assuming that all such information is completely truthful and accurate, and only with respect to the laws of Delaware, that your five-year-old child is, in fact--at least within the limited scope of the opinion and assuming that there exists no provision in any document that counsel has not reviewed that is inconsistent with the opinions stated therein--a five-year-old child.

(Though I suppose that even the five-year-old part might be a bit strong.)


2. Posted by Anthony on August 20, 2007 @ 16:06 | Permalink

I think this link (hope it's good for awhile): http://abcnews.go.com/Health/story?id=2925584&page=1
addresses the need for schools to be intrusive in this manner, albeit indirectly. Ann Althouse had a post this winter about why the University of Wisconsin never has school called off on account of snow. Her reasoning was that we're grown-ups, and should be able to dress ourselves, whereas minors are at the mercy of their sometimes stupid parents. Thus, if we can't trust parents to put hats on their kids, better to call school off then to have 5% of them show up with frostbitten ears.
I'm imagining it's the same for Illinois regarding dental care. While it's not ideal to use school as police to make sure we're parenting appropriately, it's about the only "compulsory attendance" gig we've got for minors.


3. Posted by Jake on August 20, 2007 @ 21:48 | Permalink

Christine, from personal experience, I can say that it gets no better when our fledglings head off to college in search of undergraduate degrees. Physicals are required, if for no other reason that the kids have to enroll in at least one mandatory PE course to get a diploma (sort of a trumped up reason if you reflect on the matter). But I must confess that none of my kids has had to present dental records as part of their ticket to college. That's surreal.


4. Posted by MarkStacy on August 22, 2007 @ 11:04 | Permalink

This is probably in response to the case of Deamonte Driver, a 12 year old who died due to complications from an abscessed cavity. The Washington Post covered it here:
http://www.washingtonpost.com/wp-dyn/content/article/2007/02/27/AR2007022702116.html

Deamonte's mom, being a rational consumer, prioritized her purchases: she was saving money to get his brother's six cavities fixed. Economic tradeoffs were made, somebody died, society paid the price, in dollars and lost opportunities.

The dental exam requirement is a pretty efficient incentive for uninsured/underinsured families to seek out the free programs that are targeted to them in order to prevent this kind of thing. The fact that it presents as a type of tax to you is an unintended consequence, albeit with a silver lining: you benefit directly from the spending, unlike other tax revenues.

Anyway, the best thing about health exam requirements is that they reduce a very particular kind of risk: that students don't die* from easily preventable causes. The risk is low, but the cost is very, very high. (And people are very bad at estimating those kinds of risks.) The potential cost even to you is great: you may take good care of your daughter, but her classmates might not be so lucky, and it would be aweful for her to have to cope with that kind of thing so young. There is grief enough in all our lives.

*or become disabled, or miss lots of school, etc.

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