Biography/Disclosures
Biography:

Edmonds is a senior medical advisor and chief eye care officer at United Healthcare, co-director of the Low Vision/Contact Lens Service at Wills Eye Hospital in Philadelphia and a member of the PCON Editorial Board.

March 14, 2017
2 min read
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BLOG: What about children’s vision care?

Biography/Disclosures
Biography:

Edmonds is a senior medical advisor and chief eye care officer at United Healthcare, co-director of the Low Vision/Contact Lens Service at Wills Eye Hospital in Philadelphia and a member of the PCON Editorial Board.

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With the train on the fast track to “repeal and replace” the Affordable Care Act, what will happen to the children’s vision care program? This question is on the minds of many optometrists this winter as we follow the media reports.

The inside track seems to suggest that many of the children’s programs will get scrapped in the quest to save costs. States like Arizona, with KidsCare, and California, with Covered California, that built programs around the ACA may have to close them down. Social programs are, by definition, a form of Socialism, and it is clear that we are moving away from this mindset toward a more Capitalistic society.

But, have no fear. I just saw 10-year-old Jack Bonneau pitch his lemonade business on ABC’s Shark Tank. If he can do it, all of our nation’s children should be able to do it, and then our kids can afford their own health insurance and can stop freeloading off of their parents.

To be fair, however, the children’s vision program in the ACA did not work very well. The tiered program in the health care exchange sacrificed the vision coverage with every step down from the platinum product. With the most common bronze product, there was virtually no eye care coverage. The eye care benefit was defined in the product language and appeared to meet the ACA standard, but the fine print accounted the payment to the high deductible, which, for children, was virtually never met. So, the parents ended up with the full bill for the eye exam and glasses and were then unwilling or unable to pay.

We have an opportunity to do it better. Repeal and replace, with the replacement program maintaining the “good” things in the original law, could be the same as repairing the current law. In fact, hard core right wing conservatives are calling the new law “ObamaCare Lite.”

The question for lawmakers is related to what is considered “good” in the ACA. Is an annual eye exam and glasses a good thing for our nation’s children or is it another example of Socialism that should be defeated at all cost?

It seems that an affluent country like the United States of America should build a society that can take care of the young, the old and the sick. We need a health care system that promotes wellness, health education and maintenance.

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But what about taking care of the poor? That would depend on how you define “poor.” If people are poor because they are sick, then they would be included in our basic premise. If they are poor because they are uneducated or untrained, that should be a solvable problem, but one unrelated to health care. If people are poor because the system makes it easier to not work, declare poverty and then enjoy the same benefits as the middle class, then we have a different problem and one unrelated to the health care debate.

Unfortunately, once we open the door on the health care debate, we usher in the problems of education and poverty in America and cloud the issue of basic human services. We argue about Socialism vs. Capitalism, right vs. left, Democrats vs. Republicans, all while our citizens are opting out of health care coverage, cannot afford the co-pay and deductibles, and are dying or becoming disabled from preventable health problems like obesity, diabetes and hypertension.

In the grand scheme of things, it may be that children’s vision care gets left on the cutting room floor. So, little Johnny won’t be able to see the blackboard, (sorry, Smart Board), he won’t get educated, he will end up in poverty and will become part of reason that the next generation won’t be able to have affordable health care. Welcome to the “circle of life” here in America.