Why is health care so messed up, but our teeth are in such great shape? Why do I wring my hands trying to understand my incredibly expensive and complex health care policy but don't feel the need to insure my mouth?

Why does my dentist insist that I come in regularly, while my doctor's office only reacts when I call with a complaint?

And why is my dentist always so chipper, and my doctor seemingly hassled?

We may be about to launch into a brave new world of health care and, frankly, just about anything has to beat the weird system that we have now. But before we federalize, universalize or standardize health care, it seems worth asking: Why can't doctors be more like dentists?

Here are a few of the things I like about my dentist:

1. I hardly ever see him. Why? Because his dental hygienist hauls me in every six months to clean my teeth, look for problems, remind me to brush correctly and floss, and make sure my kids to the same. That is, my dentist's office is all about preventive care. As a result, my family rarely needs more expensive procedures.

2. My dentist gives me a price for his offices services. I can actually compare his prices to other dental offices. And his prices are reasonable - probably because as good as he his, there are ready alternatives around town. Oh, and he doesn't have any of those oddball price schedules that are different for those paying by check, credit card or the occasional insurance reimbursement.

3. My dentist does not work on a sprawling "health care campus." He owns his business - er, practice - with another partner, and they employ some well-trained hygienists and records staff in a homely shop with an aquarium. For some reason, they have not felt compelled to band together in an ever growing care-delivery campus, all to better "integrate" their services with other dentists and dietitians and oral surgeons and whatever.

4. Because my dentist is not a "gatekeeper" for anyone, he can see a reasonable number of patients a day, and he can see someone quickly on the rare occasion of a real emergency.

5. Finally, my dentist can prescribe medicine, but rarely does. Dentistry doesn't seem caught up in the pill race that seems to constitute medical practice for most doctors. Imagine a dentist rushing in, eyeballing your mouth, pinning a prescription on your chest and dashing. Doesn't happen.

Yes, I know. Of course there are differences between dentistry and other types of medicine. Except maybe cosmetic

surgery. And chiropractic. And psychology. Or the guys that run that MRI van that runs around offering specials. Practitioners in those areas also seem able to provide ready prices for their services, stress (at least in the last few cases) preventive care, and work out of homey, "unintegrated" offices (or vans).

When I was a kid, my family's doctor practiced much like them. Why not now? No one seems quite sure, but I suspect it has something to do with the fact that a community needs an emergency room that can handle the things that happen to parts of us other than our mouths.

Somehow, we decided that the place that housed the ER was a good place to house a lot of other specialized equipment that people might want to use occasionally, even for non-emergencies. And then someone figured out that if they conditioned access to all that specialized equipment, they could sort of unionize doctors into one big local business and thereby better deal with those ever louder demands from those profit-seeking insurance companies and unreasonable government bureaucrats who sought to dictate prices and terms to real caregivers.

And once that happened, Big Government, Big Insurance and Big Hospitals could only resolve their differences one way - by raising health care premiums on those citizens who could pay for health care. And once that worked, none of those three saw reason to stop doing it.

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