Dentists, Free-Market Theology, and Saving South Dakota

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KJAM is a wealth of information this morning (and every morning, right, Matt?): over breakfast they warn us that we may need to be worried less about the cavities in our teeth (mmm, pass the Marshmallow Mateys, dear) and more about the cavities in our dental labor force. Dentists are already few and far between, says the report, and many are getting ready to retire ["Lack of Dentists in SD Silent Epidemic," KJAMRadio.com, 2007.10.10]. With no dental school of our own, our legislature has resorted to tuition reimbursements (also known to some as government handouts) just to get out-of-state dental students to come do their internships in underserved areas of our state... which soon will be the entire state.

The dwindling pool of dentists is one manifestation of an overall demographic trend of boomers graying and young people not replacing them fast enough. Teachers, farmers, you name the profession, you'll see the trend: our practitioners aging and retiring, our young people either not going into the field or going into it but seeking higher wages out of state.

The free-market argument would say let it ride. Things will right themselves, labor will follow the market, everything will work out the way it should. But the free-market seems to be saying that South Dakota, like an inefficient firm, should simply die. Not enough dentists want to come here; not enough manufacturers want to stay here; small farms and stores struggle to stay in business here (and really shouldn't, since bigger is better, right?). Small schools closing down, small-town shops folding, everyone moving to Sioux Falls -- don't cry, but celebrate the victory of the free market!

Some people preach the free market like religion. It becomes their theology. Faith in the free market allows them to rationalize the loss of family farms (real family farms, not the ag-industrial complexes Ag United likes to pretend represent family farms), small-town culture , and other things we value as inevitable changes we cannot and should not resist. The free-market theologian would say the state shouldn't spend tax dollars trying to coax young dentists into the state. Don't interfere with the Market's will; just let the Invisible Hand carry out its Supreme Plan.

The free market would say small-town South Dakota is like the Studebaker Corporation: nice while it lasted, but an anachronism in a changing market. Dentists and doctors don't want to move in? Too bad. Better jobs and cheaper groceries in Sioux Falls and Minneapolis? So be it. Little schools like Rutland and Montrose cost more to operate per pupil? Pull their state support, mash them into one big warehouse school.

The only value the free-market theologians care about is dollars. To rationalize their faith, they would denigrate government efforts to preserve other values, like the sense of place and community small-town South Dakota promotes. Free-market theologians who still want to keep small-town South Dakota alive need to remember that our very state was founded on government largesse -- i.e., the Homestead Act. Our freedom-loving state continues to subsist on government support, receiving $1.53 from Uncle Sam for every $1 we pay him.*

Should the South Dakota Legislature interfere with the free market by reimbursing dental students' tuition? Should we build our roads and schools on subsidies from our friends in New York and Minnesota? That's an open debate. But if we truly love South Dakota -- all of South Dakota, not just Sioux Falls and the fancy tax shelters (oops, I mean houses) at Dakota Dunes -- we have to recognize that free-market theology will not protect the small communities that preserve a richer spectrum of values than money ever can.

*Update: see data from Commenter #1 below!