Since it is an election year, everyone has been bringing up the high cost of health care. The liberal democrats, Clinton and Obama, are promising reforms which would inevitably fail and/or turn our country into a socialist/communist state. Then I read an article in Rush Limbaugh’s April 2008 newsletter entitled, “Health Care Diagnostics: Why Doesn’t Anyone Talk About Lower Costs?”
Rush brings up an ABC John Stossel report about Dr. Robert Berry who stopped accepting insurance, including Medicare and Medicaid. His office visits are as low as $40, yet his salary is typical of a primary care physician.
Well, I wish Rush would have also shared what hundreds of Wal-Mart optometrists do. We deliver eyecare for a fraction of the private practice fees. Private eyecare practices in my market of Cache Valley, Utah offer routine eye exams from $70-125. My Wal-Mart practice offers the same routine eye exam for $45-55.
Insurance companies have created this health care conundrum. Employers or individuals who buy into vision insurance are really getting scammed. My $45 exam is about what most vision insurances pay doctors anyway. So…why give any money to the middle man? And then there are a couple snobby vision plans that only let private practice doctors on their panels. The beneficiaries of these plans get doubly ripped off because sure, the exam might be covered, but when they want premium coatings or progressive lenses, they get stuck paying the balance over the basic lens. At private practice opticals, this balance can be more than the total price they might pay at Wal-Mart. So again, what good is paying money into this vision plan?
Buying vision insurance makes about as much sense as buying oil change insurance or hair cut insurance. The only people that win are the insurance companies, unless you got the coverage at no cost to you and can use your plan at Wal-Mart so that even if you do have to pay over a balance, at least you will get the best price.
In my former private practice my wholesale cost for lenses were just barely under the retail price of Wal-Mart lenses. As a doctor concerned about the welfare of my patients, I can’t continue to sell overly expensive products when Wal-Mart sells the equivalent premium products 30-50% less than what I could in my own optical shop.
So Rush, please add to your list of professionals doing what they can to control rising health care costs the excellent professionals at Wal-Mart Vision Centers.
Dear Dr:
In reading your blog, I must commend you on your lack of fortitude and your ability to completely devalue your education and sellout your entire profession[by sellout you mean rent space from Wal-Mart? So...how is joining the future of optometry selling out? And I devalue my education...how?].
Simply put, your practice went under because you went too far in debt too quickly without having the foresight to grow your practice slowly. [Amen, brother. That is exactly one reason my practice went under. No argument there, other than it's not the only reason.]
In that same vane, you make yourself out as a martyr for the public by affiliating yourself with Walmart. [That's not the definition of Martyr that I'm familiar with.] If you think Walmart lenses are equivalent to private practice, that is certainly where you[r] marketing failed. Walmart lenses and coatings are nowhere near as effective as Hoya’s SuperHi Vision or Summit ECP, Varilux’es Crizal Alize and Definity, and Kodak’s CleAR and Unique. [Okay, check your facts. If you investigated your competition better, you would know that Wal-Mart sells the Essilor Accolade Freedom with Crizal Alize ClearGuard-sure they call it Nikon Customized with Anti-Static Technology, but it's the same lens, for over a hundred dollars cheaper than any private practice optical.]
Your practice tanked because you sold the same s[uper stuff] as Walmart, when you could have just as easily explained to the patient your superior product. [This last sentence doesn't make any sense to me, besides my practice sold only Definity with Crizal Alize ClearGuard.]
Alas, another bright optometric mind bites the dust. You poor pathetic man. [Hey, at least I'm man enough to put my name behind my honest opinions.]
I think the thing you neglect to mention is that the average vision insurance pays $45 BECAUSE there is a volume of doctors charging such low fees. It’s a vicious circle that perpetuates the devaluation of a service as important as we provide. The other thing you neglected to mention was that most patients can use their health insurance to pay for their eye examination. The problem with not mentioning this is your assertion that vision plans pay $45 for an eye exam. The average medical insurance pays well over $100 for the same exam and even medicare (which is basically the government telling you what you’re worth) is over $100. We’ve created this idea that an eye examination needs to be valued at such a low rate and this is sad. I respectfully submit that an examination of your most valuable sense that detects blinding diseases and conditions as well as making sure that a person can enjoy life to it’s fullest is worth more than an oil change or hair cut…or to keep it medical, I think it’s interesting that the average person spends 4 times as much to have their teeth cleaned in a year than you think it’s worth to preserve their sight! This at least bears some discussion.
I respect the point of overhead vs expense, but that shouldn’t make the service worth less simply because we were smart enough to choose a better business model.
[Another thing that bears discussion is how all health care costs a lot of money, and one reason is that providers are charging too much because their overhead is too much. My point is that Wal-Mart optometry is leading the way to lower costs. As the saying goes “Save money. Live better.”
My question is how much is too much? My routine eye exam is $85. My comprehensive medical visits start out at $120. Do you consider that to be too high? If so, on what basis? Do you honestly believe that the service you provide based on 4yrs of optometric training and the potential life-altering damage you prevent by your examination is only worth $45? If so, where did you come up with that number? If you ask me, keeping someone from going blind is worth considerably more than treating someone’s cold that will go away ANYWAY…yet your PCP will charge approx 4 times what you assert is the worth of an eye exam.
Again, if helping your patient save money, why not make the effort to take their insurance so that they only have to pay a co-pay?
[People with insurance, depending on their plan, can get reimbursed so they aren't out money anyway. Plus if I can collect my fees the same day, it keeps cost down. If I have to bill insurance, my costs go up and so would my fees. Insurance is not the answer for keeping health care costs down.]
I agree with you, David, insurance is NOT the answer. I do not bill insurance, and I tell patients if I did then I would raise my fees to cover the higher cost of dealing with the insurance HA’s.
I actually am looking for a way to take my daughter to get her eyes examined and was seeking to find a way that I could actually afford it. It seems that those who are angry with you for working at Wal-Mart, which is affordable eye care, are just mad that they might have to cut their prices to compete.
I’m glad to see that Wal-Mart is offering exams in the $50 range. My daughter needs a new prescription as she has needed every year or so since she was 8 (she is now 18). I have no insurance and we barely get by, so I’m glad to see that I can afford the exam.
As for certain brands of contact lenses being “superior,” that’s all marketing BS.
BTW – Wal-Mart has to be better than Lenscrafters. Although I paid for Eye Insurance at that time, they didn’t cover the exam, and the cost of the contact lenses (that I had to wait forever for) was very high, even with the insurance.
Thanks for printing this.
@ Michell R:
I will have to disagree with you about your view on contact lenses being all the same. Several studies confirm that some brands with their individual characteristic material properties as well as lens curve design and optics are better (more comfortable, better vision, healthier on the eyes) than other brands.
If all contact lenses seem the same to you, then consider yourself lucky. I have have many, many patients whose eyes only seem to tolerate certain lenses. The newer technology lenses are more expensive, but in general they are superior.