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Bluegrass Beacon - Eye bill’s focus: Keep online examiners out

Editor’s note: The Bluegrass Beacon is a weekly syndicated statewide newspaper column posted on the Bluegrass Institute website after being released to and published by newspapers statewide.

As House members struggle to unite on serious issues involving public-pension reform and budget cuts, they’ve had no problem coming together with shutter-speed agreement to pass legislation protecting the powerful optometric industry from online innovators.

One reason – and it’s not the first time we’ve seen this – is lots of cold hard cash.

Optometrists’ political action committees in 2010 alone gave $141,700. They also gave a whopping $253,323 as individuals to get controversial legislation passed the following year letting optometrists perform surgeries previously – and strictly – limited to ophthalmologists, including injections and laser procedures.

Ophthalmologists claimed the legislation put patient safety at risk. After all, they noted, ophthalmologists must have 17,000 hours of training and perform hundreds of surgeries before being allowed to perform on their own while only 32 hours of training is required for optometrists, who simply must show they can do the procedure once before being allowed to use lasers.

However, the optometrists poo-poohed such concerns. It’s just the ophthalmologists protecting their turf, they claimed.

Optometrists stressed incessantly in their lobbying efforts that two-thirds of Kentucky’s counties don’t have an ophthalmologist and that the legislation meant rural Kentuckians who otherwise would be left in the dark would gain access to affordable eye care.

But let’s not play make-believe. The bill didn’t pass because optometrists made the right policy argument – that government shouldn’t use its power to deny Kentuckians access to care or a choice of how and where they’re treated.

It passed rapidly because, as Kentucky Health News describes it, “optometrists have long been major financiers of legislators’ campaigns.”

But there’s also the matter of wanting to keep out innovative competitors. To accomplish that, the powerful optometrists’ lobby has adopted the same approach of protectionism and fearmongering during this year’s legislative session that they condemned in 2011.

They’re pushing House Bill 191, which would prohibit Kentuckians from being able to spend $50 to get their prescriptions for glasses or contacts renewed through a reliable online exam and instead forces patients to shell out $100 for an in-office visit to an optometrist.

Primary sponsor Jim Gooch, R-Providence, misrepresents the bill by claiming “it permits the use of safe technology.”

Conveniently missing from his statement is the fact that HB 191 effectively bans the use of online providers like Opternative or Simple Contacts, companies which provide eye exams to renew prescriptions for contact lenses and glasses for healthy Kentuckians with a computer and smartphone, by burdening them with impossible-to-meet, medically unnecessary regulations.

Forbes contributor George Leef wrote that optometrists “see phone apps for eye prescriptions the same way the Luddite handweavers saw the development of power looms – they must be shut down.”

Even though more people who never have or would go to a doctor’s office will likely get care? Even though it would lower health-care costs for poor rural Kentuckians? Even though Simple Contacts only gives exams to healthy people who have received an in-person exam in the last four years? Even though these online providers deny exams to as many as 30 percent of applicants, requiring them – based on extensive questioning – to physically see an eye specialist, demonstrating patients’ health is a high priority? Even after the same this-is-about-turf arguments made by the optometrists themselves a few years ago? Yep, yep, yep, yep and yep.

With open eyes, state senators, who now must consider HB 191, can clearly see: it has little to do with public health and everything to do with protecting established businesses from economic competition.

“When you look at these fights, it’s always the same underlying phenomenon,” said Robert McNamara, a senior Institute for Justice attorney fighting South Carolina’s ban of online eye-exam providers. “It is always a legislature kowtowing to a powerful, private interest group at the expense of some new entrant, some entrepreneur, some innovator.”

Jim Waters is president and CEO of the Bluegrass Institute for Public Policy Solutions, Kentucky’s free-market think tank. Read previous columns at Contact him at and @bipps on Twitter.

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