An estimated 45 million Americans in the United States wear contact lenses. Such a high demand should, in theory, create competition between manufacturers and give consumers a wide variety of choices regarding where they choose to purchase their lenses. In turn, this should also create competitive prices. Unfortunately, thanks to government regulations, contacts already cost more than they should, and because of government
cronyism, it may only continue to worsen.
The contact lens market is a one-off because it is one of the rare instances where the prescribers are also the sellers. This leaves extra room for corruption, given that contact lenses prescriptions are brand-specific, and optometrists can direct patients toward manufacturer brands they have a self-serving relationship with who offer kickbacks and incentives that they do not pass along to the consumer. The practice is highly unethical.
Optometrists are unique and enjoy an inherent conflict of interest, considering roughly 60% of their income comes from selling glasses and contact lenses instead of other services such as eye exams. Optometrists and special interest groups working on their behalf have fought to maintain control over the sales of contact lenses through anticompetitive tactics and limiting consumers' access to alternative channels. In recent years, optometrists and special interest groups have fought to maintain their monopoly. These groups create hurdles to prevent consumers from purchasing from other markets.
Consumers are free to buy contact lenses at will without a prescription in most developed countries, including many nations in Europe and Japan. The simple act of eliminating the middleman and the need for a prescription would lower consumer costs dramatically. But, optometrists here in the United States cite unfounded health concerns for their rejection of this practice and instead continue to find ways to limit consumer access to cheaper high-quality contact lenses.
In 2003, the Fairness to Contact Lens Consumers Act (FCLCA) was enacted to address the market problems and provide a level playing field for third-party sellers of contact lenses. This act, among other things, required prescribers by law to automatically provide patients a copy of their prescriptions. The law was supposed to protect consumers by allowing them to take advantage of comparison shopping.
Unfortunately, since the enactment of the law, there has been a repeated failure by many optometrists to comply. 1 in 3 patients are still not given their prescription following eye exams, and 60% of consumers remain unaware that optometrists must automatically provide them with a copy of their prescription. Optometrists want to do everything in their power to hide this right from consumers.
Currently, supporters are fighting to pass a bill, S.4613, the Contact Lens Modernization Act,, that will make it easier for optometrists to withhold notifying patients of their right to buy contacts from someone other than them, the prescribing optometrist. Proponents of the bill sponsored by Senator John Boozman, an optometrist, hope that the bill's moral sounding name will allow the bill to escape real scrutiny and pass without difficulty
during the Lame Duck session of Congress.
One provision allows an optometrist to post a sign in lieu of the automatic release of the patient’s prescription. Posting a sign does more than merely eliminate the requirement of informing the consumer of the right, it functionally eliminates the automatic release of the prescription. This legislation is a Trojan Horse to eliminate the requirement of the automatic release, through requiring a signed acknowledgement required today, using the
posting of a sign as a substitute for actual notice to the consumer.
The Senate Commerce Committee is likely to take up this legislation soon. The optometrists' lobby has tirelessly attempted to use the federal government's powers to make it more difficult for consumers to purchase contact lenses from third-party distributors. This legislation is cronyism at its finest, and the Republican-controlled Senate and White House should be steadfast opponents of this anti-free market legislation.
Stephanie Farmer is a former staffer for the Rand Paul 2016 presidential campaign.