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The Great American Eye Exam Scam
- massysett 7y agoWhen I got to the end I couldn’t tell if the author is being serious.
- zaptheimpaler 7y agoThe US version reminds me of the bad kind of Java.. `GetGlasses` must implement `AbstractMedicalProcedure` with mandatory `waitAroundForAppointment`, `getOpaqueBillFromShittyWebsite`, `checkIfCoveredByInsurance`. `GetGlasses.get()` takes ONLY `AbstractOfficalPrescription` as input, which of course you CANNOT construct directly from the left and right lens power - must go to an 'OptometristFactory`. Probably like 200 lines atleast. Meanwhile everyone else is like: #pass in left_power and right_power directly if you know them. def get_glasses(powers=None): if not powers: powers = eye_exam() (left_power, right_power) = powers return add_frame(make_lenses(left_power,right_power)) #make_lenses takes optional args for rarer eye conditions
- deleted 7y ago[deleted]
- naniwaduni 7y agoThis pseudocode reveals another truth: it can be surprisingly hard in many places to get lenses for rarer eye conditions. If you have e.g. mild astigmatism (actually extremely common!), you can expect to be persuaded to leave it uncorrected.
- eru 7y agoReally? I have astigmatism and got glasses made in Germany, Britain, Singapore and Australia. Never had anyone trying to convince me to leave it uncorrected.
- twic 7y agoI'm astigmatic - -2.50 right, -3.25 left - and i have never, ever, had any optician in the UK suggest leaving it uncorrected. When i wanted contact lenses, i asked about leaving it uncorrected, so i didn't need toric lenses, which come in fewer variations (i don't think there were daily disposable torics at the time, for example). They weren't having any of that.
- dbtx 7y agoYeah, that expired proper prescription wasn't for toric lenses like I (supposedly) had decades ago. That first time they didn't even tell me the lenses had to be inserted at some correct orientation, and I don't remember seeing the marking on the lens, either... though they did tell me the lenses would cost a bit more. What was the point?
- raverbashing 7y agoOh wow Yeah, that takes a while, even with someone explaining it to you theoretically they should rotate to match the axis if they're slightly out of position, but if it's way out of position it won't. Not to mention manufacturers have different ways of indicating this (with different degrees of weirdness)
- Tenoke 7y agoDoes it really matter much? I have it, recently got glasses and it annoys me that in my peripheral vision and while moving things get a little distorted. Glasses without astigmatism correction seem like a valid choice.
- zmk_ 7y agoI apparently had a very mild case of astigmatism that went undetected for years. It was so mild that it was easy to 'correct' for it by increasing the strength of the lenses. Now that I have the lenses with astigmatism correction life is much better. My eyes do not tire as quickly and I see more clearly at far distances than I used to. Granted I am sensitive to these small differences, but life quality improvement is vast.
- benibela 7y agoIt is even worse with strong astigmatism. I have over 3 diopter according to multiple wavefront aberrometer and photokeratoscopy measurements, but the opticians always want to put a 2.5 or even 1.5 cylinder, because they do not believe it can get that high.
- ryanmercer 7y agoI'm -3.25 cylinder for each eye, plus need a prism of 0.5 down in one and 0.5 up in the other. I feel your pain.
- ryanmercer 7y ago> it can be surprisingly hard in many places to get lenses for rarer eye conditions. Indeed, ZenniOptical sunglasses simply don't come in m prescription. It flat out tells me to select their regular frames and pay for the tinting. Between my astigmatism and my prism in each eye I'm fairly limited. Or it just gets expensive. Last Friday I was curious about the new Oculus but hate how VR headsets like my friend's Vive shove my glasses into my face or just simply don't fit and looked at inserts for it, the cheapest I could find from the companies that manufacturer the lenses were 98$ per eye.
- corporate_shi11 7y agoWhen I was in China I wanted to get a cheap pair of prescription glasses. So I did, in an underground subway mall. Took 30 minutes. They (definitely not an eye doctor, more of a small shop owner) used a small handheld device to measure my prescription and then told me to come back in 30 minutes after I had chosen frames. I paid $40.
- mncharity 7y agoNeat - it looks like handheld ophthalmic auto refractometers are $4k-ish on alibaba.
- canada_dry 7y agoDitto. In Beijing there's a multi-story building full of stores selling glasses. I walked around until someone spoke to me in English, they used a gizmo to automatically measure my prescription. I picked out a brand name pair of frames. The salesman told me to come back in an hour. Voila a cheap (~$40US) spare pair of glasses. A former optometrist of mine once gave me a 5 minute lecture on how I must buy my glasses from him because he makes no money from doing exams. Cry me a river... guess ya should have gone into dentistry.
- seanmcdirmid 7y agoI found that the lenses quality wasn’t as good when buying in Beijing. They have (or just use?) better tech in the states for churning out lenses that aren’t overly heavy or thick. Perhaps it’s just an artifact of the glasses costing a few hundred kuai.
- conductr 7y agoI’ve seen US based manufacturing. There is a mix of material type selection. But there is also a lot of machinery and automation being used. Also stringent QA. Nothing done in an hour was done well, this much I know.
- 7y ago
- jelliclesfarm 7y agoI don’t get the point of this article. Essilor Luxxotica is a monopoly and they pretty much control the eye glass frames market. This is rather old news. https://www.vox.com/the-goods/2019/3/6/18253555/eyeglasses-cost-lenscrafters-essilor-luxottica https://www.vox.com/the-goods/2019/3/6/18253555/eyeglasses-c... [..] Essilor is a French optical company that’s been around since the 1800s but has spent the past 20 years acquiring some 250 companies. In 2017, Essilor bought Luxottica for about $24 billion. Although it got approval by regulators in the US and the EU, and even passed an antitrust investigation by the Federal Trade Commission, business experts have called the merged EssilorLuxottica a monopoly.[..] Also: how does one be ‘in charge’ of their own exams. Walking around and operating with impaired vision is a danger to public safety. Is this a joke article?
- 9nGQluzmnq3M 7y agoEssilor Luxxotica is a separate scam that explains why you pay so much for frames in most mainstream retailers, regardless of which brand of shop you go to. > Walking around and operating with impaired vision is a danger to public safety. Surely this is an argument for making it easier to get glasses? Better a slightly wonky/old prescription for glasses than none at all.
- jelliclesfarm 7y agoOf course, that’s true. They are two different issues. Its expensive because it’s a cartel system. That it’s mandatory to test before issuing new prescription grade eye glasses is sensible. Eye exams ought to be cheaper, but that doesn’t mean that it shouldn’t be mandatory to get an eye exam before filling a new order. Isn’t it a business liability to hand out glasses that’s supposed to make someone see better but without necessary preliminary testing? Imagine if they did it with pharmaceuticals.
- cyphar 7y agoEye exams ought to be free, not just cheaper. Here in Australia, eye exams are free. Applying a cost to eye checks results in people being dissuaded from regular checkups and results in both more serious eye problems and possible road accidents. This is all part of our universal healthcare system -- and is something the US should really adopt (though, Sanders' proposed Medicare-for-All is actually even better than what we have here).
- ajdlinux 7y agoIs it normal in the US to refer to optometrists as "doctors"?
- sneak 7y agoIn the US, even chiropractors (who are pseudoscientific quacks) are called “doctor”.
- war1025 7y agoChiropractors may be psuedoscience quacks, but they sure as hell can make your back feel better if it's out of place.
- war1025 7y agoCurious why the downvotes on this? You don't have to buy into their magical alignment aura junk to objectively know that it feels good having your back aligned. It's just a fancier version of having a friend or family member push on your back until it pops whatever was out of place.
- Retric 7y agoJust a guess, but the feeling better part and out of alignment part are unrelated. Simply stretching muscles tends to provide short term relief of a variety of issues. The alignment bit does not seem to be related in any way. For example, muscle cramps often feel better after a stretch. However, eating a banana is more likely to help by dealing with a common underlying cause.
- cannonedhamster 7y agoBecause chiropracty can be very dangerous if the person performing it is not trained on basic human physiology. There is literally nothing other than magic for a chiropractor. Everything useful is just basic massage techniques, which is a field with proven benefits.
- war1025 7y agoGlasses are available online from many places, to name a few: eyebuydirect.com zennioptical.com visionpros.com
- diego 7y agoWithout an official prescription, shipped to a US address?
- war1025 7y agoyes. you just need to know the correct numbers. I've personally bought from eyebuydirect several times, and vision pros once. Vision pros was $200 for a pair of glasses. I found EyeBuyDirect later and I think the glasses I ordered were closer to $40 a pair.
- Nasrudith 7y agoYes - I have done them already. The "prescription" isn't actually legally binding. Your eye doctor is legally obligated to give you the numeric prescription on request for no additional charge.
- sujNansnam 7y agoIt’s easy to get glasses without a prescription.
- 7y ago
- mirimir 7y agoThe hearing aid scam is worse.
- pkaye 7y agoThere should be some changes coming to the hearing aid market next year. You will be able to able to self fit hearing aids for the simple cases of mild or moderate hearing loss. https://www.aarp.org/health/conditions-treatments/info-2019/otc-hearing-aids.html https://www.aarp.org/health/conditions-treatments/info-2019/...
- mirimir 7y agoThat's great news. A few years ago, as due diligence, my GP referred me to an audiologist. She found moderate high-frequency hearing loss in one ear. Which isn't surprising, given my love for screaming guitars. But no way am I spending thousands of dollars on a hearing aid. I'm the sort of guy who'd always be turning it off. And her office just wouldn't give up. They sent periodic reminders for at least two years.
- johnnyo 7y ago100% this. Also, that prescription is only good for 1 year, many times I’ve wanted to get a new pair of sunglasses, but have been prohibited since my prescription was out of date.
- garren 7y agoThat's wild. This is the first I've heard about mandatory eye exams and I've worn glasses all my life. I've picked up frames and new lenses, both online and in local stores, without having anyone point out that my prescription was at least a decade out of date. The frames that I generally go for are pretty pricey anyway, and maybe that's a factor, but I've never been prohibited from buying an new pair. I've also had older lenses re-cut to fit newer frames, all without issue.
- adventured 7y agoYou can order new glasses - sunglasses or otherwise - from numerous sites online without needing to concern yourself with the date on a prescription. Assuming the prescription in question still works for your eyes of course.
- georgeburdell 7y agoYep had this problem except it was only for 6 months. Trying to get glasses for the first time, had an eye exam in April, and last week Costco would not fill my prescription
- russdill 7y agoWhich makes zero sense. Whether you buy a new pair or not, you would still be wearing an out of date prescription.
- ryandrake 7y agoIf you want to know why anything is the way it is in the USA, it’s easy: the answer is always money. In this case, lobbying from optometrists and opticians leads to regulatory capture and a market we are forced to use.
- fzeroracer 7y agoUnfortunately this is what happens when companies are allowed to operate completely unabated. They'll gladly build up a monopoly and try to make it as invisible as possible while lobbying behind the scenes to reduce regulations for them and add regulations to prevent challengers. We have multiple markets like this in the US which have occured as the result of consolidation and lobbying and we're just...not doing anything about it. While they exercise rent-seeking behaviors in order to gouge customers.
- PixyMisa 7y agoRent-seeking is the opposite of companies being allowed to operate completely unabated. It's government intervention on behalf of specific companies.
- zdragnar 7y agoThis is the opposite of completely unabated. The government created a regulatory burden against consumers, ostensibly for their own good, forcing brick and mortar stores into complying. Unabated would imply that such regulations are not enforced or in place, and you're starting to see that with online retailers that will sell you anything eye-wear related with a little warning that you're agreeing you do have a valid prescription, which noone believes anyone will get in trouble for lying about. (I.e. zenni) The same is starting to be true for cpap machines and other things as well. You can blame certain companies, you can blame certain politicians and bureaucrats, but you cant blame all companies or that companies are running "unabated". It is disingenuous, facile and simply incorrect.
- thomk 7y agoA-f*cking-men. Everything. Law, politics, markets, culture, everything.
- hardwaresofton 7y agoTitle: > The Great American Eye-Exam Scam Subtitle: > Why is it so difficult to get a new pair of glasses or contacts in this country? It’s easier pretty much everywhere else. First line: > On a beautiful summer day a few months ago, I walked down to the part of the Connecticut River that separates Vermont from New Hampshire, and rented a kayak. I pushed myself off the dock—and the next thing I remember is being underwater. Somehow, the kayak had capsized as it entered the river. I'd much rather read a concise, 3 paragraphs outlining what is actually wrong with the system than this author's personal life story. If this trend continues the rise of summary generation add-ons/sites is inevitable and I for one will gladly give them my money when they ask, super tired of click bait titles that lead to winding narratives.
- anewguy9000 7y agothe atlantic is literature, not twitter.
- PixyMisa 7y agoIf by literature you mean drivel, sure.
- greggman2 7y agoI thought LensCrafters, and places like Costco, (Walmart?) had easy cheap access to glasses. Did that change? Jins is a big chain in Japan and they now have 5 locations in the USA. At least in Japan it's like the article described Peru. Walk in, get free example, buy glasses under $99
- adventured 7y agoNo, nothing has changed, places like Costco still provide cheap access to glasses. There is a lot of incorrect information floating around. I don't know how to explain the article seemingly intentionally ignoring the various options for getting inexpensive eye glasses.
- Benjammer 7y agoWell they are writing a scathing expose of “the great American eye exam scam.” If they acknowledged existing options their story wouldn’t be as “hard hitting.”
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- usefulcat 7y agoI've bought frames and lenses from LensCrafters multiple times in my life (though admittedly not in the past 5-7ish years) and I would never have thought they could be described as "cheap".
- astura 7y agoLensCrafters has very expensive frames and they try to upsell you on coatings, etc.
- argonaut 7y agoThose places all require a prescription in the USA. Which means you still have to pay for an eye exam. The fact that it's easy in Japan is the whole point of the article. It's easy in most countries outside the USA! (Costco, at least, charges a membership fee, so that can hardly be called a cheap option. And 99$ is also hardly cheap considering that glasses cost less than 5$ to make: https://www.vox.com/the-goods/2019/3/6/18253555/eyeglasses-cost-lenscrafters-essilor-luxottica https://www.vox.com/the-goods/2019/3/6/18253555/eyeglasses-c...)
- purplezooey 7y agoNote this also part of why Lasik is so expensive. You basically have to buy out your optometrist.
- philwelch 7y agoWhat? LASIK practitioners are opthamologists (not optometrists!) who, typically, do nothing except LASIK procedures. LASIK is "expensive" because there are plenty of people who are willing to pay $3000 for permanently better eyesight, LASIK equipment is expensive (especially the best and newest equipment), and because there's really not much of a low end to the market (because people generally only want the best available options in the "shining lasers into your eyes to permanently reshape them" market). Also, LASIK isn't that expensive compared to other surgical operations. Here's a price list from the Surgery Center of Oklahoma, which specializes in low-cost, out-of-pocket surgical procedures with transparent pricing: https://surgerycenterok.com/pricing/ https://surgerycenterok.com/pricing/ And here's the pricing from the LASIK specialist I went to: https://sharpe-vision.com/pricing/ https://sharpe-vision.com/pricing/ Notice how LASIK is pretty cheap compared to other surgeries--and this is from a cash surgical center in Oklahoma as opposed to the higher-cost locations Sharpe Vision operates from. I mean, there are cheaper surgeries out there, but probably because they're simpler and require less expensive equipment. For example, a local urologist in my area, "Dr. Snip", charges $1000 for a vasectomy: https://www.drsnip.com/getting-started/#billing https://www.drsnip.com/getting-started/#billing
- Scoundreller 7y agoI think the price is LASIK can be inflated by the costs it’s saving you from: often a couple decades of contacts and solution purchasing. That’s my main argument against getting the procedure done: my work benefits cover my lenses/contacts, so the $thousands doesn’t yield any out-of-pocket savings. If it saves me several hundred a year, it would be a good ROI. But I also stock up when chickpeas are 20 cents off/can. I do always think about going overseas though.
- philwelch 7y ago
- nsedlet 7y agoYes! It's so infuriating. I usually go to Chinatown where they will sell you contacts without an exam or prescription. I asked my optometrist once why a prescription was necessary to buy glasses or contacts, and why prescriptions expire so quickly, and she gave me the reason offered in the article: that it forces people to be screened early for treatable eye diseases. But I can't think of any other area in healthcare where your care is held hostage unless you pay them for some unrelated diagnostics you don't want. It's hard to see it as anything other than a cynical ploy to extract money from people.
- quotemstr 7y agoMedical paternalism was the norm until surprisingly recently. See https://en.m.wikipedia.org/wiki/Medical_paternalism https://en.m.wikipedia.org/wiki/Medical_paternalism
- arcticbull 7y agoI can see the case for it, I mean, I don't go into a car dealership and approve or deny which parts are to be replaced or which procedures are necessary. I have no basis for knowing.
- eru 7y agoYes, but if you insist, your mechanic will probably still do what you ask them, as long a you pay up.
- Scoundreller 7y agoI’m 50/50 on this. The dealerships can be mindless flow-chart followers: It’ll say “When A occurs, try replacing X” and they’ll do that, even though my notes stated that I switched all the Xs around and the problem didn’t move with them.
- eru 7y ago
- justinph 7y agoAmericans can order contact lenses from abroad without a prescription, legally. I have purchased from the UK for about half the cost, with international shipping, compared to what any U.S. based seller wanted. Not to mention less hassle. I do think it makes sense to get a checkup every few years, but the 1 or two year prescriptions optometrists want are absurd.
- darkmuck 7y agoDaysoft.com
- droithomme 7y agoWhen I switched to the WalMart optometrist not only did glasses and exam suddenly cost 1/5 what I was paying from a private practice, the prescription was better too.
- mncharity 7y agoOh, it's worse than that. With an app and a phone with a high-res screen, a simple device[1] (BOM of a few dollars) could give you spherical and cylindrical numbers. Nice for the developing world and, err, other nations with impaired health care systems. Of course, MIT patented it, and SV made it into low-order-hundred dollar devices, with mandatory annual per-person subscriptions, but oh well. Looks like there's a current indiegogo, fwiw.[2] Amazon reviews are mixed. At least it's apparently no longer necessary in the US to pretend it's not used to get glasses - yay progress. An optical trial lens set is another option.[3] [1] https://www.eyeque.com/pvt/ https://www.eyeque.com/pvt/ [2] https://www.indiegogo.com/projects/smartphone-vision-tests-order-new-glasses#/ https://www.indiegogo.com/projects/smartphone-vision-tests-o... [3] https://www.amazon.com/s?k=optical+trial+lens+set https://www.amazon.com/s?k=optical+trial+lens+set
- Thorentis 7y agoSolve both problems (ease of access to eyeware, and screening for eye disease) the Australian way: - One free eye exam each year covered by Medicare (to obtain your latest prescription, and check for all eye disease). - Ability to go into an optical store and buy contact lenses/glasses if you tell them your prescription.
- eru 7y agoAbout the first: why not just give poor people money, so they can spend it on an eye exam or whatever is more urgent for them? (And for non-poor people we can cut out the middle-men: just let them pay for their eye check out of pocket. Instead of having them pay a levy, have some layers of bureaucracy, and then give it back to them in the form of eye checks. (Note: this is not an argument against medical insurance as insurance against unforeseeable, big events. It's only an argument against indirecting payments for small-ish, routine and predictable items.))
- hannasanarion 7y agoWhy not both? There's no good reason for healthcare that everybody needs to be locked behind a prohibitive money gate.
- eru 7y agoDoctors and nurses don't work for free. Neither do bakers. So what's the argument that suggests poor people need to be given healthcare, but not bread? I suggest to just give them money, and then they can buy the bread and healthcare they need. (And that's a general principle. However giving goods and services directly does make sense for non-excludable public goods. Eg don't give poor people money to procure national defense. Just provide national defense directly with tax payer money.)
- tom_mellior 7y ago> So what's the argument that suggests poor people need to be given healthcare, but not bread? You (deliberately?) misread the parent's comments. It was not very long, and it centered on the word "both". > I suggest to just give them money, and then they can buy the bread and healthcare they need. Elsewhere you wrote that "unforeseeable, big events" should still be covered by insurance, but I don't think you understand that if people don't have enough money, even getting regular checkups and medication can be pretty "big" from the affected person's perspective. If two people are scraping by on a universal basic income that is enough for basic shelter and food, and one of those people regularly needs checkups or medication for some chronic condition, then you are screwing over one of those people. This isn't about the freedom to choose not to be chronically ill, because there is no such freedom. Neither is it about the freedom to choose not to be treated for chronic medical conditions. There is no such freedom, the word for that "choice" is "torture".
- kaiwen1 7y agoMy insurance covers glasses in whatever country I buy them, so I never buy them in America. Get the same glasses cheaper and zero deductible or nonsense on the insurance. Just submit a receipt. Done. It's not just glasses. America's entire Healthcare system is designed to jack up prices in every conceivable way.
- vinay427 7y agoWhere are the same glasses cheaper? In the country I live in, they're almost always much more expensive than in the US, and this seems to be the case in many other European countries as well. The newer breed of stores like Warby Parker and JINS also doesn't exist where I live so there's no quick and reasonably priced alternative.
- distances 7y agoRule of thumb for the European countries I've lived in: stores expensive, online cheap. You can just give the numbers you want for your lenses, though if buying from a brick and mortar store the sight examination in included for free.
- emmelaich 7y agoSimilar in Australia. Ironically, we can just buy from USA online! Cheaper and almost as fast.
- diogenescynic 7y agoSimple—it’s a racket.
- sailfast 7y agoIf eye exams were really that necessary, they wouldn’t be selling readers in every drug store in the country. Should you get an exam? Yes. Should you need to if your vision hasn’t changed? Nope. This whole “gotta have a two-year current prescription” nonsense has got to go.
- Broken_Hippo 7y agoAlternatively, they sell readers because folks can't afford eye exams and/or proper glasses. I'd guess that the majority of people I sold readers to working in retail pharmacy were this group. All that said, a number of folks were told to simply get some readers by their doctor - because they only needed the glasses for such things. And honestly, if this is what you need, more power to you. I'm of the subgroup that finds readers absolutely useless: I am nearsighted. Glasses help me greatly with night vision, driving, watching TV, and other such things but I take them off to read. I do agree that folks shouldn't need to update their prescription every year or two, mostly because it is silly. If we want medical checkups for the eyes, then we need to cover the exam as a medical exam through regular health insurance... even if we don't cover the glasses. Of course, I think dentistry should be covered similarly as well.
- angry_octet 7y agoDisclaimer: Don't take medical advice from HN/The Internet. Especially advice not to get qualified advice.
- sailfast 7y agoFair point after re-reading my above as if it were out of context of the article. I am not trying to say you should not get qualified advice - you should! But if my prescription is working for me 2-3 years in and I lose my glasses, there should not be a barrier to getting the glasses. I brought up the readers sold without a prescription to illustrate the point.
- angry_octet 7y agoI get it, it's like two bad things (out of pocket health care for preventative medicine, and optician profit lobbying) have combined to make it worse for everybody, to make sure rich people have regular eye exams. But the solution should be eye exams every 12-24 months; for everyone earning above a tax threshold, the Govt takes $50/year whether you have an exam or not (okay, with an exception for those without eyes/sight). When you go to get lenses you can get an exam without any extra cost. If you want to get lenses with an old prescription you can.
- dvfjsdhgfv 7y agoIn Europe, I get a free medical check-up every few years, paid by my epmployer, and it includes eye examination by an eye doctor. But when I need a new pair of glasses, I go to an optometrist. They don't do pachymetry or fundoscopy, their job is to match a perfect set of lens. This kind of arrangement makes perfect sense to me.
- rishabhd 7y agoIn India, its easy to get contacts, walk into your favorite chain/ store, get your eye examination done for free on the spot, get contacts. Simple. I bought high index, anti scratch, photochromatic, smudge resistant prescription lenses with frame for my father for around 125 USD very recently. Comes If there is a more persisting issue, you may see a doctor, but for buying contacts, its a non issue. Edit: updated details
- ggm 7y agoI have some from-birth conditions in my eyes which makes opticians invest time in me with wierd and wonderful machines. Separately I went to see the professor/specialist who trains them all. He used a newer, one-click device which works with pre-literate children, pressed two buttons and reproduced my script in 20 seconds without the flim-flam. I did ask him, and he did smile. There's what you can do and there is what the industry is built around and they aren't the same thing. Btw the check for intra-ocular pressure, posterior vitreous detatchment, glaucoma, signs of cateracts are all highly valuable. Don't ditch the baby with the bath-water.
- revscat 7y agoCapitalism is great for what you want, terrible for what you need.
- elamje 7y agoI like the catchiness of the phrase....but....A lot of this has to do with regulation, and how there is very little pricing transparency in health care. Same service at the same place costs 50 different prices for 50 different people. You need transparent pricing to enable competition. Right now that’s hardly the case, and eye care is hardly a big issue compared to most other medical procedures.
- harry8 7y agoCapitalism is fine. Much of what big business captured politics claim is capitalism is in fact, cronyism. This problem under discussion is not caused by capitalism but by regulatory capture.
- revscat 7y agoHumanity is going to go extinct because of capitalism. In what world is that a successful system?
- PeterStuer 7y agoIn some countries everything is for sale, and that includes the people that should have your health above profit.
- threwawasy1228 7y agoThis thread is really long, so sorry if I missed it, but as someone who does not currently know what their expired prescription was. Is there some way to tell or measure what prescription the glasses I am currently wearing are? My eyesight hasn't changed at all and I need another pair, but I don't know my prescription.
- dangrossman 7y agohttps://www.glassesusa.com/scan https://www.glassesusa.com/scan can supposedly tell you using your cell phone and computer.
- twic 7y agoI've been to opticians in the UK where they have a machine that will do that. I remember once i'd bought cheap glasses online, then a year or so later went for an eye test; my prescription hadn't changed, but they measured the glasses, and found that they weren't quite right for the prescription, so i got a new pair. An effective sales technique, and assuming that they weren't lying to me, a useful service for me.
- victor106 7y agoFrom the article "According to the Center for Responsive Politics, for example, the AOA spent $1.8 million on lobbying and another $1.4 million on campaign contributions in 2016." I agree 100% with what the author but the combined $3.2 million does not seem like much compared to how much Google, Amazon, Facebook, Microsoft and Apple spent on lobbying:- $63 million. Source:- https://www.bloomberg.com/news/articles/2019-01-22/google-set-2018-lobbying-record-as-washington-techlash-expands https://www.bloomberg.com/news/articles/2019-01-22/google-se...
- listenallyall 7y agoPerhaps you're a plant intending the minimize the impact of lobbying by comparing to FAANG, comprised of the wealthiest companies on the planet. But 3.2 million goes a long way in U. S. politics, especially when there's nobody lobbying against you, and you aren't really asking for anything new, just to prevent the existing, burdensome, anti-competitive laws from being repealed.
- wiredone 7y ago“We have the best healthcare in the world” - freedom Such a living contradiction
- conductr 7y agoI work for a PE backed roll up in this space. And have some broad healthcare background. Margins are healthy, but the store fronts easily close without the product margins. That’s why the hard push to buy in store. It’s called capture rate in the industry. In the US, much of the healthcare regulation like this has been to ensure widespread access to care. In this case, by an optometrist not an optician. Remember, historically and maybe even today, we’re a pretty rural and sparsely populated country and the government is giving doctors a reason to open stores in every tiny town. Not saying I agree, just that is what is at play. If reverse this, access will be reduced significantly and US regulators have track record of not liking actions that reduce access.
- gdebel 7y agoFrench Ophthalmologist here. The part that describes how easy it is to obtain glasses without a doctor's prescription is totally false. People do need a prescription made less than 3 years ago (and optometrists do not exist here, you have to go to the doctor). As an ophthalmologist, I may not be objective on this subject; however I can confirm that I find everyday health problems in people that "just want a prescription". This can be a simple cataract, as well as a diabetic retinopathy or a glaucoma. I especially remember a 50 years old woman who had the habit to go to an optician, have her refraction measured, go to her family doctor and ask for the according prescription (with no eye exam). After 10 years without seeing a doctor, I diagnosed her with an advanced glaucoma. She was almost blind. Glaucome is the worst disease: totally asymptomatic and irreversible. Checking your eyes at least every 3 years after 40 is usually a good idea.
- hydraxis 7y agoYou need a prescription only if you want the social security/insurances to pay for the the glasses. If you pay for them yourself, there is no need. Additionally, many opticians consider themselves and act as optometrists.
- insickness 7y agoAre there any dangers associated with wearing the wrong lenses or no lenses at all when they are necessary?
- EForEndeavour 7y ago> Are there any dangers associated with wearing [...] no lenses at all when they are necessary? The dangers associated with not being able properly come to mind.
- t0ddbonzalez 7y agoReminds me of this story from a while back: https://news.ycombinator.com/item?id=21156637 https://news.ycombinator.com/item?id=21156637
- christkv 7y agoIn Spain you get the eye test in store (using some fancy equipment) and order the glasses at the same time.
- dandare 7y agoAre you not able to buy cheap (but high quality) contact lenses online in the US?
- kristofferR 7y agoCan you do that anywhere? From what I've been able to gather contact lenses are stuck in patent hell, the only cheap ones are low quality ones using 90's materials. Alcon and Coopervision are the only manufacturers with high quality contact lenses, and they charge a ton for it. 6 pairs of Biofinity's is ~26USD ($2USD per lens), totally absurd.
- tomerbd 7y agoIt's the yearly iphone upgrade that you don't need. The test always show I need to replace my glasses because prescription changes, I found that after 2 months of wearing new glasses I see the same way as before replacing glasses, so it's like a yearly upgrade that you dont need.
- mattlondon 7y agoFor what it is worth in the UK in a lot of high-street opticians they will sometimes try the hard-sell after the exam too. They also recommend that you get it checked every 12 to 24 months as well (at least they suggest that to me). After the exam ends its somtimes "Let me hand you over to <person> who will take you through the options" and the next thing you know they are trying to make you look at £350 frames, suggesting exotic coatings to the lenses etc. You're legally entitled to the results of your exam - you are not obliged to buy from them. The exam itself however is usually free so I guess the psychology of it is you feel like you need to get glasses from them since you got the free eye exam from them. Personally I usually just say "I am in a bit of a rush - I'll come back at the weekend with my partner to help my choose". We both know I'll never do that :-) There are places where you can order your glasses + lenses online though. Enter prescription and so long as it looks "normal" (i.e. did you enter it right) there are no questions asked. I've had pairs of glasses that have lasted for several years of use that cost £6.99 (no typo: six ninety-nine) including delivery. (from goggles4u if you are wondering - no connection, just a satisfied customer)
- Sharlin 7y agoAround here (Finland) the exam is (almost always) complimentary if you also buy glasses or contacts. Otherwise, they charge you something around 25 € for the exam.
- valdiorn 7y agoI go to specsavers, and I've never had anything other than an awesome experience there. Sure, they do lightly pressure you into buying a new pair (definitely far from a bad experience, though), but if you do, the test is free (otherwise it's about 20 pounds I think). Also, the coatings are actually very good, I have coated and uncoated glasses, and the coat is definitely worth the money. My mom came over last christmas. In my home county, glasses are very expensive and getting an opticians appointment can take months. She walked into Specsavers on a Monday, and by Thursday she had two new pairs of glasses, all for under 300 pounds. Just the appointment would have cost that much back home. After she talked about the experience with our family, I've been getting a steady stream of relatives coming over for a visit, just to buy glasses.
- 7y ago
- khazhoux 7y agoThis article and all the comments here are describing a Bizarro world I didn't know existed. Myself, I got my first eye exam a couple of years ago (with all the high-tech equipment and the blurry eyedrops, etc)... on my way out of the office they wrote down my numbers. I went home and looked around a few websites, and wound up ordering a great stylish set of glasses for $20 base ($60 after upgrades and tax+shipping). That was it. Here people are talking about actual prescriptions, which expire? And hundreds of dollars for glasses? Bizarre.
- fiatjaf 7y agoPretty much anywhere in Brazil, today, without government subsidies or health insurance: - Exam: ~80 BRL = 20 USD - Glasses without the lenses: ~100 BRL (of course there are all sorts of prices above this, but this is a very reasonable model) = 25 USD - Lenses: ~100 BRL = 20 USD
- fiatjaf 7y agoI thought the eye scam was going to be that every time you do an eye exam you get _completely_ different results. I'm talking about cases of people doing 3 or 4 exams in the same month with different doctors and getting 3 or 4 different results.
- yukistar 7y agoOptometry student here. The field of optometry is trying to move towards optometrists being like "primary care providers" for the eye. To me it makes sense that while we are refracting (providing a glasses prescription) we also look at the general health of the eye. It doesn't take much longer and the signs and symptoms of pathology can be quite subtle and we are very of ten the first people to notice eye conditions. Many people come in for check-ups to follow up on common conditions such as glaucoma, macular degeneration, and diabetic retinopathy. Glasses and contact lenses are only a part of what we do. I'm only a second year student, but the nuances that you see in the field are really quite incredible. I agree that most times a person's prescription is fairly straight-forward, but having an understanding of the optics of the eyes and lenses allows us to tailor glasses or contact lenses for an individual's personal needs. This is particularly important for higher prescriptions where the patient may experience discomfort if the glasses are not made for their particular face due to the optical centers of the lenses not being directly over their pupils (prismatic effect). There have been a lot of disruptive new businesses in the area of optometry, but I personally am not worried. I am convinced that the services that optometrists provide are far superior to anything these new services provide. I do worry for consumers when it comes to cheap contact lenses (such as Hubble), because the materials they use are not as good at letting oxygen penetrate them as the well-known brands. I just learned that HIV patients can wear contact lenses but we must tell them to avoid these brands! Online eye exams to me seem OK but definitely a compromise on time vs quality and would not work well for people with more complex problems. As far as money goes, I'm fairly ignorant as of now about how billing/insurance plays into all this. I know that some medical insurance plans cover glasses and contact lenses. As long as your optometrist has your insurance information they should be able to tell you how much your exam will cost!
- skizm 7y agoFYI: visiondirect.co.uk will sell Americans contacts without a prescription.
- dade_ 7y agoI assume Americans can buy them online in Canada. Quite a self-serving agenda for optometrists, but good work by their professional association.
- jonahbenton 7y agoNot mentioned in the piece but would expect the monopoly Luxottica to be involved in this at the regulatory/lobbying level as well.
- chrisbennet 7y agoI’d heard that they will give you the prescription (here in NH, USA) but won’t give you the PD (Pupillary Distance) I.e. distance between eyes.
- ryanmercer 7y agoIn the United States they have to, by law, give you your prescription if you ask for it. Pupillary distance is not part of the prescription though but you can easily measure it yourself in a mirror with a ruler that has MM (or use a service like ZenniOptical that has a printable ruler that you use a credit/debit card to make sure it is printed to the correct scale). https://www.ftc.gov/tips-advice/business-center/guidance/complying-eyeglass-rule https://www.ftc.gov/tips-advice/business-center/guidance/com...
- astura 7y agoCorrect, because PD isn't part of the prescription and isn't measured by an optometrist or opthalmologist during an eye exam. The PD is measured by the optician later as part of the glasses fitting process.
- twic 7y ago> In every other country in which I’ve lived—Germany and Britain, France and Italy—it is far easier to buy glasses or contact lenses than it is here. In those countries, as in Peru, you can simply walk into an optician’s store and ask an employee to give you an eye test, likely free of charge. If you already know your strength, you can just tell them what you want. You can also buy contact lenses from the closest drugstore without having to talk to a single soul—no doctor’s prescription necessary. I don't think this is true of the UK. I couldn't buy contact lenses without a contact lens prescription. That might be because i'm astigmatic and wanted toric lenses, but i didn't think so. I can buy glasses online, and there's a note that says i must have a current prescription to do that; i doubt they check, but the principle is there. Oh, and eye tests aren't usually free. They are cheap, though, around £25. There are free eye tests for children, people over 60, diabetics, people with various chronic eye disorders, and prisoners on parole (!). Also, if you buy glasses from the optician who gave you the test, they will usually credit the cost of the test towards the price of the glasses, so it sort of works out free (except you have to buy overpriced high street glasses rather than cheap internet ones). This doesn't seem like a bad rule, to be honest. Glasses and contact lenses are medical devices. They're important to their wearer, and to the safety of people around them if they drive a car etc. Eye tests are cheap and easily available. The article's take earns a "this ain't it, chief" from me.
- platelminto 7y agoYeah, you definitely need a prescription in the UK, though my eye test was free so I don't know about that one. Maybe it's because I'm a student? Not sure. But he is right about it in Italy - no prescription required.
- JeremyNT 7y agoThe cost and hassle of dealing with the American eye care bureaucracy was one of the factors driving me to have corrective surgery. Now a decade later without complication, I hope they've lost a customer for life.
- lbutler 7y agoWhen my wife needed new glasses, our benefits were capped at $400, including the eye exam. I can't remember the exact numbers, but after the exam, there was roughly $250 left, and all the glasses started around $400 in-store. After a few minutes getting the sales pitch and everything being framed as the gap payment, "Oh these will only cost you $150!" my wife said "Can I get my prescription, I'm going to go somewhere cheaper" and all of a sudden all the prices dropped in half. She ended up getting her pair without paying anything out of pocket.
- notacoward 7y agoThe thing I really hate is that even if you do get a prescription, most optometrists will try to leave out the inter-pupillary distance. This area is mostly governed by state law, not federal, and in my state they're explicitly required to provide that information upon request. I've always had to remind them of this fact before they'll comply. Then, the form on which they provide the prescription - unlike the one they use themselves - usually doesn't even have the space for that information. It ends up being written in the margin, usually unlabeled as one last act of defiance. It has always seemed rather scummy. That's why I've been buying glasses online for several years, tweaking it a bit based on actual all-day wearing experience each time because a measurement taken at any one time of day is sure to be wrong at another. So it's better as well as cheaper. Just need to find a site that doesn't play the optometrists'game, because some do and some don't.
- abstractbarista 7y agoIt's ridiculous. I've bought my contacts online from the UK for years now due to this. I know my prescription and I know it works perfectly. Just let me buy the damn contacts! Vision Direct is the company, and they always send candy along with. :) Anyways, my "vision insurance" actually covers a certain $ amount yearly towards contacts, so I send them the receipt (in pounds) and they actually cut me a check. Same contacts brand and model I'd get in the USA. I calculated it and using the insurance does indeed cost me less overall than buying the contacts straight. It's essentially just a discount program that hopes people will forget to use it.
- hansthehorse 7y agoThe VA will give me eye exams and glasses but it's the only service I don't use because the lines are so long and the waiting area is so crowded. My wife and I go to Costco for the exam and glasses. If I remember right the last pair came to about 110 dollars, exam included. Only drawback is it takes about a week to get them.
- listenallyall 7y agoThank you. The difficulty in purchasing glasses is so obvious to anyone who has traveled extensively. What wasn't addressed in the article is the accuracy of the typical eye exam. A 19th century idea: a single specified distance, no movement, perfect black vs white contrast, well-lit room, etc. Does it really measure "real-world" scenarios like driving at night, playing sports, or staring at a computer for 10 hours? I've received (mandatory, due to the U. S. laws described) prescriptions that were way off, that missed my astigmatism, or which switched the eye with the stronger correction. This is why being able to diagnose one's self, to an extent (buying glasses which vary 0.25 or 0.5 from the exact prescription) should be allowed, at the very least.
- xhkkffbf 7y agoYes! And I've been experimenting with the EyeQue. It's a great tool that turns your smart phone into an eye exam. All the better to take an exam regularly.
- drdeadringer 7y agoIt is news to me that I am "required to have a current prescription" to buy my eyeglasses. Sure, optometrists want you for an annual checkup as much as your regular doctor or dentist... but the eyeglass store? Never heard of it. Perhaps this is because I purchase my eyeglasses online, e.g. Zenni. I could pull out my prescription from last year or five years ago and they'd take it at face value along with my credit card.
- Jenda_ 7y agoCan someone explain whether it is actually illegal (e.g. the person who will cut the lenses and fit them to frames will be charged by some kind of practicing without a license), or they just don't do it? For the record, in the Czech Republic, I have entered strength, cylinder, axis and PD into a website, paid $18 and picked up the glasses a few days later, and I haven't noticed any problems with quality despite the rather high strength (-4D). We also have over-the-counter contact lenses widely available, though I have never used contact lenses. ($18 is a suspiciously cheap online service with basic lenses, glasses with lenses with higher refractive index and some oleophobic and anti-reflex coating usually cost around $150 here, but they will also make them for you without prescription, you just tell them the numbers)
- ilaksh 7y agoOne of the many reasons I am saving money living in Mexico. I said I needed new glasses and they just said "same prescription?". He figured it out by measuring my existing glasses and had me verify with a test thing that had swappable lenses. The last time I needed contacts I tried to save money by going to the one in Walmart but I think it still cost about a hundred dollars for the exam.
- ilaksh 7y agoApparently they only spent a few million lobbying? Maybe if everyone gets together with a few bucks we could hire a firm and create a $25 million lobbying campaign to change the laws. I mean if there are five million people who would participate then that's only $5 each. Seems like there should be a startup for this. Buycongress.org.com or something. Lol.