03 December, 2010

A visit to the opticians and the aftermath

I finally got around to having an eye test and ordering some contact lenses. Much of this experience was identical or thereabouts to a visit to a British optician. I saw a man who used various standard ways to test my eyes. You know the drill - look up, look at my ear while I shine a light in your eye, can you read the bottom line, is this clearer or that? Then I used my insurance to cover the cost of the eye test, though not the complete contact lens test which cost me $55. I was a bit surprised about that as $55 is a bit more than I would have paid in the UK, where I didn't have insurance. What I wondered was the full price of the eye test?

Well today I found out because I got a sheet of paper from my insurer showing what had been spent in full. And sit down if you're British to read this. The full cost of a standard eye test and a contact lens test was nearly $300. That's just the test. The lenses were extra.

Are they mad?

If you're American and you're reading this, the reason I am incredulous is because having your eyes tested in the UK isn't part of the NHS unless you are a child, on benefits or elderly. I have never needed insurance for my eye examinations before because the cost of the test, with no subsidy, no NHS involvement, no insurance, is less than $50 (actually right now you can get a professional eye test at Boots the Chemist for £5 or $7.50). And I haven't noticed any opticians with begging bowls or sleeping on the streets. They make this work for them. They sell their frames and their contact lenses and so on and sometimes if you buy your lenses from them then you don't have to pay for the tests at all. So how is it that Americans have to pay nearly $300? What if you don't have insurance?

Oh and before you ask, this was a not particularly swish opticians or whatever you call them here, on Mission Street at the foot of Bernal Heights. I wasn't in Pacific Heights or even Noe Valley. And he really didn't do anything my Welsh optician didn't do.

Seriously. America. You are being had. Big time.


Gretel said...

Ouch! As a poor artist, (with life long poor vision) I am very thankful I live in the UK for so many reasons...I'd be stuffed if I was ill in the USA.

Alison said...

Yeah, we know. And we still won't do what it takes to change it.

The reason it's so expensive is, in part, because of insurance. I worked in the billing dep't of a hospital once, and here's the kind of "conversation" that happened on paper b/w the hospital and the ins. companies:

Hosp: You owe us $845 for anesthesia.
Ins: We'll pay you $204.
Hosp: Ok.

Totally random. Often, though, doctors will charge less for those without insurance. Probably because they know they won't get the higher amount! Also, I wonder if the reason British opthamalogists survive on lower prices is either because they pay way less in malpractice insurance, or perhaps they are subsidized by the government.

(I've been enjoying your perspectives on our country!)

Eliane said...

PG - you would. Cannot imagine what the additional stress would have been over your arm.

Flartus - I wondered about whether the NHS subsidised all customers. I know many people in the UK are entitled to free tests paid for by the NHS but that cost to the NHS is under £50 per patient. And I can't find any information showing that the NHS pays towards those of us who pay for eye tests. Seems to me that the British opticians use the discounts they offer on the tests to entice customers to come and then buy frames, lenses and so on. Our market is also pretty much tied up by about 4 main chains of opticians and I know it is hard for the independent to compete. But as for the cost to the patient/insurer - I really cannot see how that can be justified. It is absurdly expensive.

Soilman said...

It's definitely because of the insurance problem.

My uncle is an insurance broker who arranges lots of insurance for US healthcare practitioners. The sheer quantity of health litigation in the US makes everything – drugs, treatment, professional care – much, much more expensive for the simple reason that everybody has to insure themselves up to the eyeballs. This is just not necessary in Europe, for the most part.