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I tend to harp on the perils and pitfalls of free-market medicine. But there’s one area where it seems to work, at least in my own life. So I figured I should give dentistry some due.

Last November, my dentist told me I needed $300 worth of work based, essentially, on readings given by a laser beam that a dental assistant shined through my teeth. This red beam allegedly showed the existence of unseen cavities caused by pinhole cracks. I balked. After all, my teeth felt fine (my gum line is another story). But the dentist insisted on the additional work. I told him I would get a second opinion. He graciously allowed that such a move was “my prerogative.” Thanks.

So this month, I went to a second dentist who doesn’t use the laser-pointer and said my teeth looked fine. He even said he would refrain from drilling unless really necessary. After all, dental procedures don’t always turn out as planned. And he told me what I could do on my own to arrest — and even reverse — any problems that might be stirring behind the enamel. The old dentist did no such thing.

As you can imagine, I now have a new dentist. He costs more per visit, $78 versus $55. But there are several key differences that make the extra cash worthwhile, even if it comes from my own pocket — which it does.

My new dentist does the cleaning himself rather than assigning it to an assistant. Second, he doesn’t push expensive procedures. The old dentist had TVs in the treatment rooms showing crooked and yellowed teeth turning white, shiny and straight, kind of like those ads showing Democratic candidates morphing into Osama bin Laden. I’m willing to pay more if I don’t have to resist that kind of marketing pressure every six months.

Dental care is unique in that regular care is relatively affordable and necessary, at least on a middle-class income. It also feels good to have a nice clean mouth for a day or two. And the more expensive-but-routine procedures are relatively limited. For the most part, it’s easy to compare.

Nonetheless, it was a fairly wrenching decision to change dentists. It wasn’t easy to disagree with a medical professional. They have a certain authority that’s hard to reject. I happen to be stubborn enough and didn’t have a long history with my first dentist. It would be tougher to reject a dentist or doctor I’d been seeing since childhood.

Some dentists certainly push what could be unnecessary care, and that could happen in the wider medical market. Maybe we could learn something from dentists, though. Where the sales tactics are too heavy-handed, it could encourage more people to get second opinions. It’s nice to see that where choice is available and exercised, there’s often a better one.

Give John McCain credit for a healthcare plan that goes beyond the traditional conservative mantra of “tort reform.” It’s actually a decent plan if you agree a free market is a good prescription for our healthcare woes. I for one would love a tax credit for buying my own health insurance, which I have to do because I’m self-employed. Too bad the market fails in reality.

It’s fun to dream of consumer power over healthcare decisions. But it’s ultimately a fantasy. I know this firsthand. My second son — who’s looked perfectly healthy on the outside during his 11 months so far — has a suspicious heartbeat that requires occasional and expensive tests to make sure it’s still not a problem.

We have a health-savings account, so we pay most of this stuff out-of-pocket. We could decide to forgo these tests, considering there appears to be little wrong with our son and he’s otherwise perfectly healthy. But, the doctors tell us there’s an outside chance of something bad cropping up. Do we really have a choice in spending the money? I guess. I do often suspect the doctors are being overly cautious and the tests may not really be necessary.

I could get a second opinion — for another couple hundred dollars. Or I could decide I’d rather spend all the money on iTunes and Amazon. What if I spurned the tests simply because I didn’t have the extra couple hundred dollars to spare? What’s good for the bank account may not always be good for the heart.

I know money should play a role somewhere in the healthcare equation, and something has to happen to rein in spending. But I can’t imagine complicating already-excruciating decisions for parents by forcing them to weigh family finances against a child’s health. Maybe the advocates of free-market healthcare think that’s a good thing, and they may even have a rational argument to support it. But the argument needs to be at or near the center of debate.

That’s the unspoken straight talk about consumer-driven healthcare.