For instance, I am supposed to redo my sleep apnea test every so often. But it's out of pocket? Why bother, I know mine is due to my genetics (I'm not overweight). So why am I subjected to reproving my need for a prescription?
For eyeglasses, if someone wants to continue the same prescription they can't.
It's like healthcare in the USA is a damn subscription model with yearly fees to keep getting things just prescribed (let alone treatment on top).
They said that an auto-PAP is not the first choice. A CPAP is a better choice, if it will work for you at the pressures you need. But they only work up to certain levels of pressure.
An auto-PAP will work to higher levels of pressure, but then it has to continually adjust the levels of pressure that it applies based on the resistance it senses, and that is not as good for you as constant pressure.
And there’s no way a CPAP or auto-PAP is going to wake me up at night, short of causing me to go into an apnea condition and potentially die.
Thank you, but no. I’ll stick with my CPAP.
What? You don't need a medical prescription to order glasses online. You can put in whatever numbers you want and they'll happily make them.
You'd be an idiot to do so, however, as your vision can change with age.
Not to mention, getting an eye exam is more than just clearing up your vision. It can reveal other issues (and not just eye related! They can often see other problems, like say, cholesterol issues, for example.)
[0] Some places will reject it just because they don't want to deal with your complaints about a new pair not working. Other places will read what's on your current pair and match that. It really depends on who is making the glasses.
I just use reading glasses but the desired strength can vary day to day depending on what you are doing and my eyes vary too. This can be dealt with easier by having a number of pairs of reading glasses and seeing which works best rather than doing prescription stuff. You can buy reading glasses for £1 here so I tend to get a few.
I'd still recommend going to a good optometrist occasionally in case there is something more worrying up with your eyes.
Crude but realistic: There is a pretty high number of (often but not always overweight) undiagnosed/untreated people suffering from obstructive sleep apnea on the roads every day. They are causing a number of avoidable accidents every day.
I think it's criminal to make CPAP as unaccessible as it is in the US.
I refuse to sleep a single night without it.
On a whim I asked at a glasses store in the mall if they could measure mine. They happily did it for free. Your milage may vary on that of course, depending on the person you interact with.
(Yes, I'm exactly one of those people sensitive to "minute variations".)
https://www.ftc.gov/enforcement/rules/rulemaking-regulatory-...
To the contrary, it is very clear: regulatory capture.
On the flip side it used to be very easy to get antibiotics without a prescription there. I'd be surprised if this is still the case.
I, for one, am glad to see this bill.
Just a note, but optometrists are "doctors" (because optometry is a doctoral degree), but not doctors in the colloquial sense, ie people with MDs who work in hospitals.
Ophthalmologists are the MDs that specialize in eye disease, and are the ones that treat infection and do surgery.
Here, the machine results are used as a starting point, validated by A/B but I don't know if the human part is effective or just theater.
iCare Tonometer
*Edit, saw your comment about not referring to the entire checkup.
Only one of those parts can be done without a doctor or highly specialized equipment.
Extending your logic to other areas would end up with absurdities like needing a doctor to measure your waist size before you can buy clothes. "You should visit your doctor regularly anyway, what's the value of allowing people to buy pants without a prescription?"
Also, if someone feels they would get better vision correction working with a trained professional, I'm fine with that. I only object to _requiring_ a doctor's prescription to get glasses.
If it's important, then it's important for everyone.
I think this influenced the ability to see characters which greatly impacted reading ability.
Apparently the need for this gets more important as you get older:
https://healthy.kaiserpermanente.org/health-wellness/health-...
Yes some office have fancier equipment, but here it’s unclear if that’s actually better for patients and public health or just a way to bill more. Doing a basic exam and then referring those to true specialists is generally the model followed by nearly everything else in healthcare.
We're supposed to go EVERY YEAR?
Ordinary GPs aren't experts and the equipment for doing vision checks is expensive and consumes space.
IMO, medical care should be completely re-organized. Get rid of GPs as a profession (outside of cruise ships and the military) and GP practices entirely. Instead, have community clinics for everyday medical needs spread out over the country that have a team of skilled nurses for triage with a number of subject-expert doctors at the second level, and large/university clinics for everything the community clinics can't deal with (urgent/trauma care, oncology).
That would also shorten training times and effort for new doctors by a significant degree - e.g. in Germany, an ophtalmologist requires a full medical degree (over six years, not counting waiting times because medical study places are short in supply) followed by five years of specialized training. Realistically, training any expert doctor now takes at least twelve to fifteen years... and that's frankly absurd, and part of why medical costs are so sky-rocketing. Not many students make the ridiculously high entry requirements, many don't survive that time (and sometimes literally - suicide rates among medical students are way above average!), and those who have their MD are left with fifteen years worth of student debt which means they have to charge extraordinary hourly rates simply to be able to pay back the loans.
Medicine is not tech support with tier levels :( I would stick to talking about things you know, because medicine is not one of them.
Some physician groups fought that tooth and nail… not because there was any real evidence of people dropping dead from mis-prescribed vaccines but because it was a good stream of easy revenue for their office billing insurers for giving the shot. This change was much better for consumers and for public health overall by making vaccines more readily accessible.
Even though it's probably not that complicated, it's probably beyond the scope of a regular doctor to do proper checks - and - it's probably more expensive than getting your eyes checked by an optometrist, which is usually pretty cheap.
In fact, the optometrist model i.e. regulated specialization for something that we don't need very expensive doctors for, is probably a good model for hearing. If there's something more complicated, then they refer you to the ophthalmologist etc..
We should be trying to do this with everything i.e. get people into 3 year specialization programs which make basic health things affordable, and leave more complex cases to MDs.
You can take virtual eye exams, which are reviewed by doctors to issue a prescription.
The real issue isn't the basic care of glasses, instead it's the screening of your eye health.
When you go to Urgent Care, say for a laceration, they do a quick work up, including taking your temp, blood pressure, blood o2, weight and height.
Having your eyes checked out in person with a comprehensive eye exam annually is a good habit. And tying it renewing an Rx for Contacts / Glasses just makes it easier to do.
Really, isn’t it all areas?
This is not really the case. Online, warby Parker, etc. have built scale but the traditional retail still makes a significant portion of their profits here. And it’s a healthy business by most standards. The staff and employed OD are typically compensated heavily through variable compensation. The primary industry metric is “capture rate”, the percentage of people that buy eye wear after the exam. If I recall correctly it’s about 65-70%. From an incentive perspective, the doctors and staff are salespeople through and through.
Like all segments of healthcare, it has really started to consolidate. The independents/regional brands operating now will likely sell to PE roll up play when the foundering doctor retires. PE will exit to conglomerates. Most of these are boomer’s and this form of consolidation is well under way. The already high margins can easily be improved by centralizing back office, etc.
The vertical integration in the industry is insane. Luxottica for example leads retail, frame manufacturing, lens fabrication (laboratory), and owns the #2 insurance provider (of 2 main players). They have such power they can and do “force” independent retailers to use their POS software.
Warby Parker has some hipness and definitely grew quickly. But, they hardly put a dent in the market. There may be some evidence that they expanded it, as happens with fashion. They would be more akin to Blue Nile in the jewelry space. Independent jewelers still dominate that market.
Vision care is another area I’d expect to see more changes and disruption coming down the pipeline. Vision care is very important and advanced cases require special skills, but it’s also unclear why many routine checks couldn’t just be done by a family doctor.
The US requires one to see a “doctor of optometry” to get a basic single vision prescription. That industry used to make its money turning around and selling you glasses from the same office but that whole industry has been turned upside down by online retailers like Warby Parker and such. Why the US can’t follow the models followed most elsewhere in the world is unclear, but it would remove a lot of extra steps and costs in getting a basic care of glasses. Ophthalmology (medical doctors) are still very much a thing but most countries don’t have this model of needed a “prescription” from an optometrist for a basic pair of single vision specs.