Consider it a Health Investment
Posted on July 28, 2009
Filed Under Politics | 1 Comment
I’m one of the lucky .00001% of employees who get ‘free’ medical care from my job. I don’t pay any monthly or per-paycheck fee it’s just kinda factored in. Normally, and really over the last few years I’ve been here, I’ve never had any problems, the service kinda sucks and there’s co-pays on everything but at the same time I’ve never really used much beyond the dental/eye benefits.
I didn’t like the last eye doctor I went to so I went looking for one closer to where I live and have discovered a place that offers “optomap”, a digital print of your eye used to make sure you don’t have anything wrong with your eyes and then some. It can detect things like diabetes and glaucoma before they even start without having to trust that silly human putting funny eye drops into your eye. This optomap, despite being high tech, super cool, and much better than dilating your eyes to check for these problems is not covered by my insurance provider VSP. Over the phone VSP made clear their being an insurance for “routine check ups” and not emergency care. They don’t cover optomap because it’s not necessary for routine check ups of your eyes, however more beneficial it may be to your overall health is irrelevant because if I get sick VSP doesn’t pick up the bill.
So Broadway Vision offers optomap for $29 and pitch the plan like this.
“The dilating drops may trigger adverse reactions, such as acute angel-closure glaucoma, and hypersensitivity. This is extremely rare and treatable with immediate medical attention.”
So aside from the obvious ‘don’t drive for a few hours’ after they dilate your eyes now you have to worry about glaucoma from using these pre-computer methods of care. When I spoke with VSP about this the guy was stunned, he had no idea who or what may have ever suggested such an outlandish thing, he said dilating your eyes was perfectly fine. Broadway Vision made clear it was “rare” (so they’re just trying to scare me) but the benefits of the optomap was so great and everyone’s doing it. Then later in another paragraph they mention that either would be an acceptable form of treatment to them, even after they just railed against dilation because it could harm you!
I’m in a pickle, I don’t feel like I should have to pay for this shit because I’m supposed to be covered, I pay an insurance company every month to take care of me and now I’m having to reach into my own pocket to take care of myself. On the other hand if I stick to my morals and something is wrong with me and they don’t catch it I’ll likely be out sick for a while, but it also carries with it the possibility to give me glaucoma something the test is supposed to help detect (further searches on the internet show no link between these 2 points beyond how you test for glaucoma, so apparently this is only rare at broadway vision). It’s just 30 bucks, but what was the point of having eye insurance? Where does it stop? What service will I have to pay for next in order to stay healthy despite the payments I already make to some company who’s job it’s supposed to be is to take care of me! What a useless system.
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One Response to “Consider it a Health Investment”
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Chris,
Perhaps I can help. I’m an optometrist in Tennessee. I own my own practice, and we use the Optomap for our patients in two ways.
The first way is for diagnosis and treatment of disease, such as glaucoma, macular degeneration, and diabetic retinopathy. Second, for patients without these diseases, we still offer the Optomap as an adjunct to a complete eye exam. I say an adjunct, because we still use dilating drops on every patient. I think it is the best way to get the most complete examination of the retinas.
Personally, I would not trust the Optomap alone to give me a full clinical picture of the inside of a patient’s eyes, as it only images 270 degrees. With dilation, I can see much more, but in less detail. It is the detail that makes the Optomap so valuable to me. And, I will admit that the detail it provides has allowed me to catch disease that I would not have detected with dilation alone (note that there have also been diseases that I have found with dilation that did not show up on a patient’s Optomap). Additionally, the Optomap image is stored for future use and reference. So, both techniques complement each other.
As for insurance, it should be remembered that large insurance companies are about the bottom line. Whether the bottom line is what’s best for patients is another story. We have a variety of value-added services (those that are not covered by vision insurance) that we feel make a complete exam, and we offer them to our patients with the understanding that we are going above and beyond the standard of care and therefore there will be an additional out of pocket expense.
We do not use scare tactics. In over 15 years of dilating patients, I have never caused an acute angle-closure glaucoma attack. As I said, we prefer to dilate all patients.
A similar thing happens in our eyewear gallery: when a patient with VSP wants a nicer pair of eyewear than the plan covers, they pay the additional expense, because VSP will not. We do not limit a patient’s choice to what VSP covers. We offer the patient what is best for their visual needs, and then allow them to decide what they want.
So the question is this: how well do you want to take care of your eyes? My suggestion (and I would opt for this myself even if I were outside this business) would be to have the Optomap performed, and insist upon dilation as well. If you are told that this would be redundant, find an optometrist who agrees with your point of view.
Finally, I agree with you, although perhaps not for the same reason since we are on different sides of the exam equipment, so to speak: the system needs fixing. But remember, by your own admission, you don’t even have to pay for most of your care. By any standard, you are most fortunate indeed.
Thanks for your time. I hope I have helped.
Feel free to email me if you like, and have a great day,
Andy
Andrew W. Howard, O.D.
LaFollette Eye Clinic
LaFollette, Tennessee