The great American eye exam scam

As Barbara Horn, O.D., the president of the American Optometric Association (AOA), told me, “Today, at least 2.2 billion people around the world have a vision impairment, of whom at least 1 billion have a vision impairment that could have been prevented or has yet to be addressed … That’s why it’s clear to health experts, policymakers, the media, and the public that increased access to eye exams and eye doctors are needed to safeguard health and vision.”

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But this argument rather begs the question. After all, the added cost of having to see an optometrist presumably stops many Americans from accessing the corrective lenses they need to improve their vision. Is the desirability of an eye exam performed by a medical professional a sufficient reason to prevent Americans who would rather not—or cannot—visit an optometrist from buying glasses and contacts? We can only answer this question by acknowledging a trade-off between competing goods.

On the one hand, some number of Americans who visit an optometrist to get a new prescription will indeed discover that they have a serious condition that requires immediate care. On the other hand, it is likely that a much greater number keep wearing glasses that are too weak—or won’t wear glasses at all—because they want to avoid the cost, time, or stress of a visit to a doctor.

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