Concern for WI Opticals

[TEC]

State Health Care is killing the independent opticians. In the last few months, we have seen a huge increase in "state Insurance" also known as Badgercare or Medicaid. Just an example, last month 10% Increase in eye exams( with reduced reimbursment) but 45% decrease in eyeglass sales. Here is why. The people that came to us last year with no insurance paid cash for the eyeglasses they bought, and they bought regular frame choices and lenses. Now the same people are on the "state Insurance" and get the eye exam paid for and get to choose from a limited choice of frames and lenses contracted by the state. We can't make the glasses here in our lab because of the contracts, so my 25K edger is collecting dust. Our pay back is $21.00 on the glasses for disp and paper work.
Do the math. $300.00 last year, is now $21.00. Sorry but it takes a lot of $21.00 dispensing fees to make up $300.00 sales. I don't see how this will be good for any store in the state of wisconsin.
I would be interested in getting a group of WI opticians together to help voice our opinions. It will not get better.
PS. as of today Governor Doyle announced:
"Governor Jim Doyle signs into law Senate Bill 484, the BadgerCare Plus Basic Bill. This bill creates a new, entirely self-funded health care plan option for nearly 43,000 adults without dependent children who are on the BadgerCare Plus Core Plan waiting list."
He also was asking for money from the federal government 3 days ago because our health care was going broke in the state of WI

[Jacqui]

I'm glad I moved to Minnesota

[Uilleann]

Welcome to the joys of taking insurance. This is sadly, an old tune sung by many health care providers. So how do you make up for your massive losses if you choose to accept one or more plans? By charging everyone else even more to hope to make up the difference. Some plans are certainly better than others, while there are a few that really should make you question the validity of continuing to remain paneled. Unless the state is willing to subsidize your practice and help to make up that massive disparity, perhaps it's time for your practice to re-evaluate your current insurance participation model.

While it's always great to have a warm body in the chair across from you - it's not so great if you're drowning in expenses and no income to survive as a business. At some point, you'll have to make a choice.

[jefe]

As a Wisconsin native (Appleton, Madison, Janesville), I feel your pain. The Medicaid situation in MA is similar: a state-run lab, Massachusetts Correctional Industries, makes the glasses, and the optical dispensary gets a small dispensing fee.

[Johns]

Welcome to the joys of taking insurance.

That's not really the case here. TEC is not making the choice to take or not take insurance. Rather, thousands of TEC's customer have been drawn out of the system with the enticement of free glasses. Whether the plan is accepted or not, it's a lose/lose.

We are seeing the same thing in our area w/Sight for Students through VSP. The school nurse hands out vouchers to the families that used to pay cash. It doesn't matter that 18 yr olds that have graduated and hve full time jobs are getting them. Then, to take it one step further, opticians can't take VSP, so they are closed out of it for good. Again, it's not about wanting or not wanting to take a plan, but the glasses are being given to the patients gratis, and they're going where the plan is.

It's all about creating a dependence on the system, and so far, they are doing a very good job of it.

[jdf]

Minnesota had been going in the right direction - allowing opticals to use their own labs, frames, etc. until this past spring when they chose to contract with one lab for the Medical Assistance program. And to top it off they chose an out-of-state lab! I've heard that some legislators were contacted after the fact and acknowledged that they didn't know what they were signing.