Reforming Vision Care in the US: A Prescription for Change

As she stood in front of the mirror, staring at her reflection, Sarah couldn't help but notice the faint lines etched around her eyes. It was a subtle reminder that she was getting older, and her vision wasn't what it used to be. But what really caught her attention was the stack of insurance cards on her kitchen counter - her medical insurance card, her dental insurance card, and her vision insurance card, each one a separate entity with its own premiums and deductibles. It was a system that seemed illogical, even to Sarah, who had worked in the healthcare industry for years. The eyes are indeed a window into the soul, but they can also reveal a lot about what's happening in the rest of the body. Yet, in the US, vision care is often treated as an afterthought, a separate entity from medical care. This is reflected in the way we pay for it - with separate insurance cards, premiums, and deductibles. It's a system that's been in place for decades, and one that many experts argue is in need of a major overhaul. According to the Bureau of Labor Statistics, less than 30 percent of US workers are offered vision benefits through their employer. For those who do have access to vision insurance, the costs can be prohibitively expensive. A study by the National Association of Insurance Commissioners found that the average annual cost of vision insurance is around $200 per person. And for many Americans, vision insurance simply isn't an option - whether they're on Medicaid, have a pre-existing condition, or are simply priced out of the market. But why is vision care treated as a separate entity from medical care? The answer lies in the way our healthcare system was designed. In the 1960s and 1970s, as the US began to shift towards a more employer-based healthcare system, vision care was often left out of the equation. It was seen as a luxury, something that people could afford to pay for out of pocket. And so, vision insurance became a separate entity, with its own premiums and deductibles. But this system has its drawbacks. For one, it creates a two-tiered system, where those who can afford vision insurance have access to regular eye exams and corrective lenses, while those who can't are left to fend for themselves. This can have serious consequences, particularly for children and older adults, who are more susceptible to vision problems. Dr. Christine Curley, an ophthalmologist at the University of California, San Francisco, has seen firsthand the impact of this system on her patients. "I've had patients who have gone years without getting their eyes checked because they couldn't afford it," she says. "And then they come in with a serious eye problem that could have been prevented with regular exams." So what's the solution? Many experts argue that vision care should be integrated into our existing healthcare system, with vision exams and corrective lenses covered under medical insurance. This would not only make vision care more accessible, but it would also help to identify and treat underlying health conditions that can affect the eyes. In some parts of the country, this is already happening. In Oregon, for example, vision care is covered under the state's Medicaid program, which has led to a significant increase in the number of people getting regular eye exams. And in some private insurance plans, vision care is being integrated into medical coverage, with promising results. For Sarah, the solution is simple - she wants to see a world where vision care is treated as an integral part of our healthcare system, not a separate entity. "It just makes sense," she says. "Our eyes are a part of our body, and they deserve the same level of care as the rest of us." As the healthcare landscape continues to evolve, it's clear that the way we pay for vision care is in need of a major overhaul. By integrating vision care into our existing healthcare system, we can make it more accessible, more affordable, and more effective. It's a change that's long overdue, and one that could have a profound impact on the health and well-being of millions of Americans.