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Letters: Which expenses are "expensive"?

January 20, 2015 I ran across an article about per-capita expenditures for dental care ("Dental Spending Remains Flat-lined," Jan. 20 ADA News). Nationally, the total expenditure was $111 billion in 2012. A few years ago, I tried to see if more was spent on soda pop (carbonated beverages) than on dentistry, and it started to add up to that number, by what I could see.

The ADA's Health Policy Institute might want to research this and compare expenditures for dental care versus discretionary products such as these:

  • Soda pop.
  • Candy.
  • Alcoholic beverages.
  • Starbucks and all other coffee products.
  • Others?

People like to complain that dentistry is expensive. Do they complain about the price of those nonessential consumables? Clearly, their dental expenses would go down, if they were to spend less on the items I listed.

By the way, as a half-Swede, I won't call my own coffee "nonessential," and I take it black, no sugar.

Stephen L. Kirkpatrick, D.D.S.
Olympia, Washington

Editor's note: The ADA Health Policy Institute considered Dr. Kirkpatrick's question when using the Personal Consumption Expenditures dataset1, data that contain information about expenditures on goods and services in U.S. households. Soda consumption is part of a category that includes soft drinks, mineral waters and vegetable juices purchased for off-premises consumption2. HPI compared inflation-adjusted dental services spending to other categories of household spending and found that, over time, dental services spending increased from $71 billion in 1995 to $86 billion in 2011, while spending on soft drinks increased from $49 billion to $62 billion. Dental services spending includes out-of-pocket payments as well as contributions from third parties so it is not truly a measure of cash paid by the household.

Unfortunately, the data does not allow for a more refined breakdown. Focusing on the period 2008-11, dental service expenditures declined by 1.4 percent per year while expenditures on soft drinks increased by 0.25 percent per year.

For alcoholic beverages, the annual increase was 3 percent, while for cellular telephone services it was 7.3 percent. HPI says it will analyze this data more comprehensively, and appreciates the suggestion.

1. Bureau of Economic Analysis. National Income and Product Accounts.  Personal Consumption Expenditures. Available at:

2. Personal consumption expenditures by function is classified into broad categories such as health and food and beverages purchased for off-premises consumption. BEA also prepares estimates at a greater level of detail but does not include these detailed estimates in the published tables because their quality is significantly lower than that of the higher level categories of which they are a part.