Comment: Cross-subsidy costs

Anti-blindness campaigners are right to point out the high cost of sight loss to the economy but will governments finally take a long-term and joined-up approach to the cost of sight loss?

The study (see news) coincides with our report on the ABDO webinar hosted by public health guru Professor Darren Shickle (page 24). His work also seeks to reduce sight loss with the emphasis being on getting people to have an eye exam.

Professor Shickle points out in the webinar, which can be viewed on the ABDO website, the short-term thinking behind the optical business model. Currently the Department of Health relies on high street opticians to subsidise eye exams through the sale of optical products. The DoH pays just £20.90 for an eye exam to be conducted, so those patients who pay for their exam, spectacles and contact lenses are subsidising those who don’t. Given that it is the taxpayer who funds the NHS, it could be argued that those who pay for exams and spectacles actually subsidise many of those who don’t twice over. The NHS and the DoH are happy with this situation as they appear to be delivering an eye care service at a knock-down price. The result of this cross-subsidy is that people are deterred from attending an eye exam as they fear being sold to, he argues. So the knock-down price service leads to fewer attending exams, which leads to greater sight loss and higher costs. Not such a bargain after all.