I’m one of those people who tries not to go near a doctor unless I’m bleeding or broken in some way. I was raised in the day when house calls were normal and I detest with a passion beyond purple the bureaucracy and indifference typical of the “modern” physician’s office. At the same time, however, I do realize that these people really can’t practice medicine as they might choose to because they’re too frightened of legal action, namely malpractice suits.

I also realize that the more of that kind of thing that goes on, the higher the cost of health care and the higher the cost of our health care insurance premiums. This opinion has only been bolstered by the results of a study released earlier this month by the Children’s Hospital of Philadelphia that convincingly proves the prevalence of what is now being termed “defensive medicine.”

Seventy-two orthopedic surgeons agreed to participate in the study and rate the reasoning behind the tests they ordered for 2,068 mainly adult patients. They worked with these people in a range of medical settings from emergency rooms to regular office visits. When the numbers were crunched, 20 percent of the total tests ordered were done so because in some way the patient seemed to want them or otherwise raised a red flag of potential “trouble” with the doctor.

It gets a little scarier when it’s broken down by individual test. Eleven percent of x-rays weren’t necessary, 39 percent of MRIs, 33 percent of CAT scans, 57 percent of bone scans, and 57 percent of ultrasounds. And never mind the cost on the MRIs and CAT scans. Those suckers come with a nice hefty dose of radiation as an added bonus. So what I want to subject myself to because I’m not sure the doctor who has seen 10,000 torn ligaments knows what he’s talking about when he looks at my knee and makes a diagnosis.

Now, understand, I am the original medical skeptic. But this problem is so potentially out of hand, the Obama administration has proposed alterations to state laws to in some way put a cap on malpractice suits. There has to be a decent balance between policing bad doctors and scaring the good ones to death. These are the kinds of studies that really reveal the complexity of health care reform in the United States. There is no on single problem, but a myriad of inter-related problems that all have to be addressed before the whole is going to get better.

At the same time that we’re seeing positive indicators that the recession has ended and jobs are coming back, we also have definite clues that this economic crisis has left a permanent imprint on the American psyche. For many of us, it was quaint to note Depression era habits in our parents and grandparents. I personally knew a man who could only write with a new pencil. He literally bought cases of pencils and gave them away when they’d been sharpened once or twice. Why? As a school boy during the Depression he’d been forced to write with the stubs of pencils other, more affluent children threw away. To him, a new pencil was a sign of economic security.

A recent study by Channel Harvest sponsored by Insurance Journal shows that at least 50 percent of small business customers have actively made cost-cutting decisions on the coverage they provide for their employees and are still demanding more options to save money. The amount these business pay out in insurance dollars has dropped 17 percent since 2007 compared to 8 percent for mid-size and larger businesses. The good thing is that they are still buying the coverage, the bad thing is that they’re doing away with extras and raising deductibles.

Ancillary coverage options, like dental care, are likely a thing of the past as a work-related benefit on the small business level. In fact, the Kaiser Family Foundation says that in 2010 only 71 percent of adults in the U.S. visited a dentist and the bulk of those appointments were not for regular, preventative care, but for an emergency.

What this all means is that the onus for ancillary coverage for things like dental and vision care is going to fall back on the hands of the consumer, who is going to be even more tempted not to pay for it as a cost saving option. Stop and think before you make that decision.

Unfortunately dental issues rarely appear in isolation and can become major very quickly. Vision is our primary sense and there are options for cheaper purchasing of eyeglasses once you have a prescription in hand. Online eyeglass production has grown by leaps and bounds in the past five years and consumer satisfaction with the products has grown steadily.

The point is, there’s always a way. When you begin to consider cutting ancillary coverage options, really look at how much of the average expenses of the service — dental fillings and cleanings, for instance — that you can carry on your own, reserving insurance options for big “disasters.”

You’re probably not going to get help from your employer in these areas, but don’t cost cut yourself out of preventive care. That decision can come back to haunt you in the future.

According to findings by the Kaiser Family Foundation, Americans are neglecting their dental health more than ever. When people start whacking things off their health coverage to lower premium costs and control deductibles, dental benefits are the first to go. Consequently, only 71 percent of adult Americans saw a dentist last year. The problem is as bad or worse for children. In California, for instance one in four children have never seen a dentist — a problem worse for minority kids and low income families.

The problem is also worsened by a shortage of dentists that mirrors the shortage of general practitioners. This is especially the case in small towns and rural areas where a trip to a dentist in a neighboring town is even more expensive when the cost of fuel and lost work time is added to the actual dental bill.

This issue is of particular concern as poor dental health can lead to other health issues. Many dental schools offer clinics where people can get free cleanings, the application of sealant, and occasionally even fillings. More complex procedures that require a specialist are hard to come by for people who can’t pay, but often serious problems can be avoided simply by attending to regular cleanings.

When broken out by state, people in Connecticut have the highest attendance rankings at the dentist — 80.2 percent of adults — while Oklahoma residents are in the worse shape at just 57.9 percent. While it’s understandable that people are doing everything than can to save on health care expenses, find a way to take care of your teeth, even if that just means brushing and flossing regularly. Generally, with dental issues, neglect leads to major problems that can not only effect your general health and quality of life, but can also seriously deplete your pocketbook in an emergency.