Service of Full Measure II: Pay more and get less for health insurance, education and toilet tissue

August 8th, 2013

Categories: Education, Full Measure, Inflation, Medical Care, Retail

I first wrote a Full Measure post in 2010, a topic very much related to the Service of Inflation series launched the year before and I risk little in predicting there will be more to come. An eye doctor appointment, results of New York city and state student tests and a newspaper article inspired today’s post.

Insurance strikes another black eye hitting doctors and patients where it hurts

Before seeing my doctor and his staff for my annual eye exam the receptionist gave me an agreement–a first. I would check one box if I was willing to pay $75 to be tested for refraction; another if not.

In a nutshell the form explained that most insurance companies will no longer pay for a doctor to test for eyeglasses.

This was the wording: “Refraction is the testing done with lenses to determine and correct the errors in the eye causing problems with both distance and near vision. This information is required to prescribe glasses. Insurance carriers do not consider refraction a medical procedure. Medicare and most commercial carriers will pay for covered benefits only. When you receive a service that is not a covered benefit, patients are responsible to pay for it.”

But guess what? Staff told me that if you go to some optometrists–they mentioned a rip-off eyeglass store chain I’ve been warned by friends and colleagues to avoid–the insurance might pay for the test.

It’s easy to forget the precise differences between the training and expertise of an ophthalmologist and optometrist but it’s pertinent so I checked out “Ophthalmologists are physicians. They went to medical school. After school, they had a one-year internship and a residency of three or more years. Ophthalmologists offer …..Vision services, including eye exams; Medical eye care — for conditions such as glaucoma, iritis, and chemical burns; Surgical eye care — for trauma, crossed eyes, cataracts, glaucoma, and other problems; Diagnosis and treatment of eye conditions related to other diseases, such as diabetes or arthritis; Plastic surgery — for drooping eyelids and smoothing wrinkles.” [I didn’t know about wrinkles….hmmmm]. continues: “Optometrists are medical professionals but not physicians. After college, they spent four years in a program and got a degree in optometry. Some optometrists undergo additional clinical training after optometry school. They focus on regular vision care and prescribe eyeglasses and contacts.”

This course doesn’t lead down a healthy road. It means that the physician who chooses to become an ophthalmologist will soon be left only with treating eye disease, severely cutting into his/her income and customer traffic. I also wager that the nations’ eyes will suffer. On the rush to the $500 eyeglass frame counter in the chain, diseases that should be diagnosed and treated/controlled early may be missed. How shortsighted.

Taxing information

New York City spent $25 billion on education, the state $74 billion according to research by WOR 710 NYC radio producer Michael Figliola for the John Gambling Show, yet the results are not equally stratospheric. The state spends more on education than anything else.

Lisa Fleisher wrote in The Wall Street Journal, “Less than 30% of the city’s third- through eighth-graders scored proficient in math and English Language Arts on the new exams, which are an attempt to measure whether students are on track to do higher-level work when they graduate and start their careers.”

Yoav Gonen of The New York Post reported: “The eye-opening passing rates for third- through eighth-graders of just 29.6 percent in math and 26.4 percent in reading reflected the first real measure of how many students are considered to be on the path to success after high school.”

Gonen continued: “Last year, before the exam standards were significantly boosted, 47 percent of city kids passed the reading exams and 60 percent passed math.” In a bulleted list he noted “New York City outperformed the state’s other ‘Big 4’ cities by leaps and bounds. Second-place Yonkers only had 16.4 percent of students pass in reading and 14.5 percent in math.”

What else is there to add?

Nothing to Sneeze At

Desheeting doesn’t relate to making beds, operating sailboats, rain [in sheets] or drinking too much [three sheets to the breeze]. It’s how the tissue and toilet paper industry describes fewer sheets of tissue in a box or roll.

Serena Ng reported in “Toilet-Tissue ‘Desheeting’ Shrinks Rolls, Plumps Margins” that Kimberly-Clark’s Kleenex packages contain 13 percent fewer sheets simultaneously claiming that each one is “bulkier” by 15 percent. Guess they know folks who want bulky tissue instead of lots of it when cold or allergies strike.

While on the subject, here’s some toilet paper trivia brought to us by Kimberly-Clark research via Ng: In five bathroom trips/day, Americans use some 46 sheets of toilet paper and according to Euromonitor International, companies sold $10.6 billion of tissue and toilet paper in the US in 2012.

Mayor Bloomberg, who watches NYC’s waistlines, would approve of some of the additional information in Ng’s article though as a consumer even he might expect the price to reflect less product which I’m certain it doesn’t. “Cereal boxes and bags of chips have in many cases become lighter over the years in what the food industry refers to as taking ‘weight out.’ A regular Snickers bar now weighs 1.86 ounces, down from 2.07 ounces in the past, which Mars says was done to cut calories to 250 per bar. Tropicana Pure Premium orange juice is now sold in 59 ounce bottles, versus 64 ounce cartons prior to 2010.”

I didn’t notice a decrease in my insurance premium to compensate for one less essential covered procedure. Does this new wrinkle smack of lobbyists at work along with insurance greed leaving men and women with limited incomes, their children and another specialty of doctor yet again in a reject pile? Have you examples of paying for and receiving full measure lately or the opposite–which seems to be increasingly in fashion?

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8 Responses to “Service of Full Measure II: Pay more and get less for health insurance, education and toilet tissue”

  1. Kathleen Said:

    It’s not only toilet tissue, but ice cream, cereal and a host of other staples that have fewer ounces or sheets or whatever, but cost the same. No warning, just overnight you’re getting less for your money. Only Stewart’s ice cream is still a gallon.

  2. Jeanne Byington Said:


    The containers are designed to look the same size though and producers do whatever they can to fool the eye**. I wonder if Hagen Daz is smaller than it used to be–or do I eat more of it?

    Funny, **trompe l’oeil painting style is one of my favorites–I love William Harnett’s pictures! But as a shopper, I’m neither charmed nor amused.

  3. Lucrezia Said:

    We are already being ripped off by insurance companies, and have been for years. I am unqualified to comment further other than grousing over the situation. Same goes for the eye scene – I just hope the eye doctor knows what he’s doing.

    I have used the same toilet paper for years and its quality doesn’t seem to have deteriorated. I buy enough so as to be able to wait for the sales.

  4. Jeanne Byington Said:


    I was hoping someone would tell me whether or not their toilet tissue seemed “bulkier.” Oh well. I buy towels and tissue in bulk packages and notice that often the bargain ones of the same brand are quite small. Some tout “Eight rolls equivalent to 12” which I also doubt.

    I know I am spoiled but I prefer getting injections at a doctor’s office and not at the pharmacy and anything to do with my eyes handled at a place where a doctor oversees procedures. As an Air Force wife an airman made a mess of a vaccine I’d had all my life with zero problems–I couldn’t lift my arm for weeks and was scared to death what would happen next. I am not a guinea pig. Re my eyes, should there be some disease lurking–there’s glaucoma in my family–I’d like a doctor in the mix from the start.

  5. Grant Little Said:

    Miscellaneous thoughts:

    The “robber barons” of the 19th century got rich by wiping out the small fry by lowering prices, bankrupting them, then raising prices and lowering quality/quantity. Walmart, Duane Read, Home Depot, Johnson & Johnson etc., are the “robber barons” of today.

    A sure indication of a declining civilization is a debased currency. Remember when quarters were silver? Debased products, legal or otherwise, are the same thing.

    For a complicated problem, I see a specialist MD who was recently named best in the country in his field by his national association. The government recently lowered the fee he charges for 15 minutes from $135 to $89. Another younger, far more obscure specialist I saw four times this year for an average of 15 minutes a visit (I didn’t go back for a fifth appointment.) for a no big deal bum shoulder, charged me between $215 and $380, of which I got back maybe half from the gov’t and insurance.

    60 Minutes had piece on $750 eyeglass frames a year or two back. You can buy just as good ones retail off the shelf for under $25. The problem is the lenses.

    I could go on endlessly. It’s disgusting.

    Thanks for the post.

  6. Jeanne Byington Said:


    I should ask you to write the next chapter in the series. Your examples add nails to this coffin but what does the public do about it?

    I clearly recall boycotting beef when the prices reached the moon. I was not the only one and the beef industry figured out how to lower its prices. We can’t do without insurance or the cosmetics and drugs sold by some of the stores you mention. I see many of us in a giant vice that’s slowly but surely closing, a tool over which we have no control that others are turning at will.

  7. Jeremiah Said:

    I was taken by your excellent post and, as well, by Grant Little’s examples. I’d like to touch on one thing he didn’t, namely “education.”

    In the middle of the night last night, the obvious dawned on me; the problem with education is not the schools but us.

    I thought of a conversation I had with my wife about British sitcoms and how difficult it has often become to understand the accents and dialects of the actors. Then I thought of how often, in public places in New York, in the movies or even on TV, it is hard to understand what one hears. Finally, if kids are on a steady diet of an array of sounds, which they themselves understand, use and like, far afield from the language they are being taught to read and write in, how can anyone expect them to learn much, far less then do well on tests?

    The basis of math is arithmetic. We had to do sums and memorize multiplication tables, but now there are calculators everywhere. It was painful learning the stuff, but I can still do an awful lot of calculations in my head. How can you begin to grasp more intricate math, if you rely on a calculator instead of your brain to do basic arithmetic?

    I haven’t mentioned drugs, mental deficiency or motherless, fatherless, even family less and conversation-less homes, where eating is a fast, casual passing event or done before a TV set.

    Much of that education money you talk about is being wasted. If kids aren’t going to, or just can’t learn, why not teach them a trade and concentrate on educating the talented and receptive? You’d save a lot of money and anguish.

  8. Jeanne Byington Said:


    I think that the system you suggest is what they used to do in France–and may still do. At an early age a child was identified as a candidate for the baccalaureate and then on to University or a trade school. Trouble with this is that late bloomers are lost in the middle. But what system is perfect?

    I see little relationship between being talented and receptive. Some of the dullest people I know who were great at memorizing information were receptive and very good at school. Talented at much? I’m not so sure.

    I also don’t think that a child knows what’s best for him or her and some need more prodding than others to get going….Like someone learning how to ride a bicycle, all of a sudden they are sailing down the street though it may take some longer than others to do so.

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