Posts Tagged ‘Health insurance’

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

Thursday, August 8th, 2013

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 webmd.com: “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].

Webmd.com 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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