Universal Health Care in the US

[rbaker]

Universal Health Care in the US

What effects will a possible universal health care plan have on the eye care business in the US and how will your business adapt? What are some features that you would like to see incorporated into this legislation? Should it cover appliances such as glasses and contact lenses?

[For-Life]

Universal health care in most nations never covers glasses. Of course, like the US, we do have glasses coverage through welfare and disability, but that is all. Our plans are all private, just like yours.

For exams, very little of it is covered now. All Provinces pretty much had total exam coverage, but all have gotten rid of it. In Ontario, we will cover Seniors and Children annually (65+ or under 19). It will also be covered if you have a disease that needs exams, like diabetes or glaucoma. Our Ophthalmologists exams are covered, with the exception of refractions. All medical surgeries and that are covered, except elective, like a better cataract lens or lasik. We do have some private MDs providing cataract surgeries and such, but only in the cases of where the cataract is not ripe.

Dick, you will see that pretty much no nation (except communist or socialist, which contrary to belief Britian, Canada, Sweden and such are not) do not cover 100% of health care services. For instance, in Canada 70% of health care services are covered, but eye exams, glasses, prescriptions and dental services are not. In the US that number is 40% (Source: Ontario Government and WHO).

[Oedema]

I would only add that the government in the USA already has their foot into eyecare by way of exams, and eyeglasses then any of the above aforementioned countries. Be it Medicaid or Medicare there is I already more government into it then I've experienced living in Canada. (Much more of a sense of entitlement among people too! )

[HRubin68]

Universal health care in most nations never covers glasses. Of course, like the US, we do have glasses coverage through welfare and disability, but that is all. Our plans are all private, just like yours.

For exams, very little of it is covered now. All Provinces pretty much had total exam coverage, but all have gotten rid of it. In Ontario, we will cover Seniors and Children annually (65+ or under 19). It will also be covered if you have a disease that needs exams, like diabetes or glaucoma. Our Ophthalmologists exams are covered, with the exception of refractions. All medical surgeries and that are covered, except elective, like a better cataract lens or lasik. We do have some private MDs providing cataract surgeries and such, but only in the cases of where the cataract is not ripe.

Dick, you will see that pretty much no nation (except communist or socialist, which contrary to belief Britian, Canada, Sweden and such are not) do not cover 100% of health care services. For instance, in Canada 70% of health care services are covered, but eye exams, glasses, prescriptions and dental services are not. In the US that number is 40% (Source: Ontario Government and WHO).

This is true.

[Jacqui]

Dick forgot to add the VA. It is limited to veterans, but is a wonderful example of socialized medicine at it's best.

[Jubilee]

I definitely agree with Jacqui on that as well.

The eyeglass industry is one that wouldn't be affected as much as the medical portion of the industry. The way most countries who have a universal health care policy is they do not cover except in certain cases of age and disease, and Eyeglass/routine vision is something you can either get through a private supplemental/replacement plan or pay out of pocket.

The only thing I can forsee if perhaps less problems with rx changes because of disease because maybe certain conditions such as diabetes and hypertension can be caught earlier though routine physicals/screenings that a huge number of people do not get now due to costs.

[For-Life]

Only thing is when exams were covered here, most people still never got an exam. Thing is, people associate eye exams with rx changes. Never for the health of their eyes.

Now that exams are removed, I do not find it any less busy.

[Johns]

Dick forgot to add the VA. It is limited to veterans, but is a wonderful example of socialized medicine at it's best.

Wonderful example? That statement was tongue in cheek right?

http://www.washingtonpost.com/wp-dyn...030401394.html

I've worked in VA Hospitals, as well as in their dispensaries. If that's the best, I don't want to see the good, let alone the worst.:o

They do the best they can, but I would by no means say they are doing a great job.

[Johns]

Dick forgot to add the VA. It is limited to veterans, but is a wonderful example of socialized medicine at it's best.

Oh, and I'm also a vetran that has the right to use the VA facilities, due to a condition caused by my service, and I wouldn't use their sevices regardless of how free they are.

I'm sure that other vets on the board will disagree, and it varies by location, but buying my own insurance allows me to make the choice as to where I go, and to which physician I am seen by.

Up until 4 months ago, I only had an HSA, which means I paid cash for anything medical the family needed and, if I had paid enough in, was reimbursed. It was great in terms of negotiating power (my routine physical went from $680 to $190 when I offered cash). Of course, it did take a little budgeting, and I know there's no room for that when we're talking about health care.

[For-Life]

John, but don't most vision plans there tell you where you have to get glasses from? With it being Universal, and if it was covered, you would have the freedom to choose dispensaries. Not that I am advocating that, it is just an example of the other way around.

[rbaker]

Oh, and I'm also a vetran that has the right to use the VA facilities, due to a condition caused by my service, and I wouldn't use their sevices regardless of how free they are.

I'm sure that other vets on the board will disagree, and it varies by location, but buying my own insurance allows me to make the choice as to where I go, and to which physician I am seen by.

Up until 4 months ago, I only had an HSA, which means I paid cash for anything medical the family needed and, if I had paid enough in, was reimbursed. It was great in terms of negotiating power (my routine physical went from $680 to $190 when I offered cash). Of course, it did take a little budgeting, and I know there's no room for that when we're talking about health care.

I too am a veteran and spent eleven months as an inpatient in a VA hospital and rehab facility in 1967. Subsequently I have used them off and on as my primary care providers although for the past fifteen years I have only utilized their pharmacy services. Over the years I have received medical care in three distinct geographical locations and yes, Johns, you are correct; the services that you receive do depend on the geographical area. And, now that I am retired I am also working with veterans groups and frequently fly veterans to VA facilities particularly in Oregon and drive patients in Massachusetts. I gets to see and hear a lot.

I can tell you for sure that both of these hospitals have the finest staff – the majority of the specialists are from the leading teaching hospitals in the area. Now granted, some of the facilities are showing a little wear and tear but on the whole the treatment that I have had and observed is superb. And, quite fittingly, the eye care services do stink. Most of the Optometry schools use the VA as a training ground. But, real medical services do not suffer in the least.

It seems that the Veterans Administration is held up in the public eye while the private hospitals are able to keep their dirty linen out of sight. The VA is currently delivering medications for 75% less than your local pharmacy, they mail you three months worth of meds at a time with a maximum co-pay of $8.00. All of my medical records are on-line and can be accessed from anywhere in the US.

Johns, check with your local veterans agent at your city hall or the DAV and volunteer to drive some vets to their appointments. You may find it a refreshing experience and it will do your heart a lot of good.

If we do find ourselves in a universal health care system you can be sure that the VA will be a major contributor, particularly in its organization and implementation. They are technologically ahead of most civilian health care delivery systems.

If anyone has any questions concerning the VA please feel free to contact me off line.

[Johns]

John, but don't most vision plans there tell you where you have to get glasses from? With it being Universal, and if it was covered, you would have the freedom to choose dispensaries. Not that I am advocating that, it is just an example of the other way around.

Oh yeah, you're probably right on that, but that's if it's not good stuff (like what some medicaid pts. get), what difference does it make where you are getting it from?

If you could order Spam from Morton's Steak House, it would still be Spam.

But really, I was addressig Jacqui holding up the VA as an example of what we should strive for in terms of our health care standards. (And I really think she was just joshing anyway:p)

[Johns]

Johns, check with your local veterans agent at your city hall or the DAV and volunteer to drive some vets to their appointments. You may find it a refreshing experience and it will do your heart a lot of good.

That's an excellent suggestion. If I were to attend my VFW Post meetings, besides just showing up to flip pancakes in March, I probably would have known about that need.

I'll definitely look into it.:cheers:

[For-Life]

Oh yeah, you're probably right on that, but that's if it's not good stuff (like what some medicaid pts. get), what difference does it make where you are getting it from?

If you could order Spam from Morton's Steak House, it would still be Spam.

But really, I was addressig Jacqui holding up the VA as an example of what we should strive for in terms of our health care standards. (And I really think she was just joshing anyway:p)

Well some places, for price, still offer better stuff than other places.

FYI - I heard VSP is trying to come to Canada. Reason 422 why I left the industry. Right now, our private insurance allows you to go to any licensed professional.

[Jubilee]

My husband now works for the VA facilities.. in their optical labs.

However, I know locally from both his perspective as an employee and my parents from the patient, the VA has come a LONG way in terms of the care and tech they provide.

Speedy access to records, their ability to negotiate pricing on pharmaceuticals (something medicare does not get to do) and partnering with some prestigious universities have taken them from ho hum to a top notch facility.

In fact, my dad was upset that he could no longer see the professionals he once was at the VA when they revamped some of their policies. He preferred to see "American" doctors and the convenience of the all in one setting.

[Jacqui]

I agree with Jubilee and her father, most have come a long way. I look at it from the perspective of former employee and as a past patient.

[fvc2020]

Dick forgot to add the VA. It is limited to veterans, but is a wonderful example of socialized medicine at it's best.

hahahahah That is one of the funniest things I have heard in long time....


c

[Jubilee]

But when I read this article on Slate.com I was reminded of this conversation.

http://www.slate.com/id/2216711/

In it the author discusses some of the success of the VA and why its not as well known by the masses. I found it an interesting read anyway.


Cassandra

[fvc2020]

Our local VA is terrible. My husband goes there and he never sees the same doctor, they don't listen ever, and the last time was referred for eye related disease(my doctor sent him for second opinion)the gentleman who worked him up was a previous lab employee of mine.

Here's another great example of how "great"the VA is. My husband was told he had severe high blood pressure. Put him on medication(he refused to take)and gave him a blood pressure machine to monitor at home. Come to find out that his blood pressure only rose when he was there(like most people). Had he taken the medication it would have seriously dropped his blood pressure. I hope they are not the model because honestly they s..ck

As for the local OD/MD/optical, I realize that the Vets can get free eyewear, but they need to stop what they are doing and let professionals handle it. Per one of my patients. You wait for hours to pick out the frame(no one helps with it), they take 2 measurements and then the mail you your glasses. 2-4 weeks at a mininum. You can not go back for adjustments or problems either...

Yep no faith in them at all

christina

[rbaker]

Our local VA is terrible. My husband goes there and he never sees the same doctor, they don't listen ever, and the last time was referred for eye related disease(my doctor sent him for second opinion)the gentleman who worked him up was a previous lab employee of mine.

Here's another great example of how "great"the VA is. My husband was told he had severe high blood pressure. Put him on medication(he refused to take)and gave him a blood pressure machine to monitor at home. Come to find out that his blood pressure only rose when he was there(like most people). Had he taken the medication it would have seriously dropped his blood pressure. I hope they are not the model because honestly they s..ck

As for the local OD/MD/optical, I realize that the Vets can get free eyewear, but they need to stop what they are doing and let professionals handle it. Per one of my patients. You wait for hours to pick out the frame(no one helps with it), they take 2 measurements and then the mail you your glasses. 2-4 weeks at a mininum. You can not go back for adjustments or problems either...

Yep no faith in them at all

christina

I really don't have the time or the energy to respond fully to the routine eye exam component of the Veterans Administration I will just sort of agree with you that the services are not of the same model that "civilian" eye care providers perform. But, a refraction and a pair of eyeglasses are not a medical procedure.

I will defend the VA for the high quality of medical care that many of my friends have received and are receiving on a daily basis. I am speaking of things such as cardiac issues and cancer. In both Oregon and Massachusetts the VA patient has access to the top people from such institutions as Mass General, Dana Farber, Peter Bent Brigham, U Mass and the University of Oregon.

In short, I can give you a list of civilian doctors and hospitals that I would avoid but can not think of a VA facility that I would not cheerfully enter.

To reiterate an earlier thought, please volunteer at a VA facility and then share your opinion.

[chip anderson]

Mostly those physicians and auxillary personel seem to fall in two catagories.
1) Those who are truly humanitarian and wish to be free from the influence of money an competition. Some of the best, most honourable people are there for this reason.
2) Those who are not capable of making the grade in a compeditive society and are like far too many employed by the state (here I mean society, not Mississippi) and thier sole is "working" for retirement. Far too many of which do as little as possible in the process of attaining same.

Having antagonised many with such statements some of the best and most concientious people I know work for the VA and other state jobs.
Unfortunately, some of the least concientious and least skilled are alos there.

Chip