Not that I'm entirely unsympathetic mind you, but routine dental maintenance is actually pretty cheap, cheaper on average if you properly maintain your teeth to pay out of pocket then have insurance, really. National dental care is definitely not something I favor, since I can only see it driving up costs, there's nothing like having a bill for a few thousand dollars to remind yourself to brush and floss regularly. The dental industry has an annual revenue of about 70 billion in the US, which is about $250 a person. Some of that is elective/cosmetic, a lot of that is checkups, but most of it is work done that any dentist will tell you is primarily the byproduct of neglect. If we all pay for it together, out of income taxes, do you think that neglect cost will go up or down? Not trying to lecture you on your life choices but most cavities result from neglect, the equivalent of not changing your oil and burning out your engine. I've had a couple cavities, got a couple fillings, and I know they resulted from laziness on my part, though I'm not saying since I can't know if that's true for yourself. As for budgeting, can't help you there, we all have limited means and have to make sacrifices, some more than others. I smoke, that is expensive as you know and bad for your teeth too, I bet I spend way more on cigs then dentistry a year. I could easily pay for dental insurance by quitting the habit. Ideally, we'd save a lot of money if everyone went in for a regular checkup and bushed and flossed properly, paying for it out of the collective till makes sense, except people being people... well it takes a lot less time to get a filling then to brush your teeth a few hundred times. If you're not paying for it yourself, where's the incentive to do it? Lowest common denominator and all, I don't want dental revenue to go from 70 billion to 140 because 1 out of 10 people slack off oral hygiene.