Remembering Rick Bay
We have had the privilege of working with hundreds of professional people over the years, but none surpass the joy of working with Rick Bay [publisher of Review of Optometry and Review of Ophthalmology, who passed away in December 2012]. While our annual Clinical Guide to Ophthalmic Drugs was the work of many people, Rick was always at the helm to oversee this annual project, and it was through our collaborative work on this project that we came to know him.

Rick was one of those people you just enjoy being with. He was funny, witty, had a great sense of humor, but was always focused on making good things happen for Review of Optometry and its many educational events. Rick was a man of impeccable integrity, steadfast reliability, and he always had a positive outlook on life. Though his last two years were compromised by his medical condition, it did not dampen his warmth or his spirit. He was always a joy to work with, and we will tremendously miss his ever-smiling face.

The continued excellence within the Review of Optometry team will be an ongoing reminder to all of us of the blood, sweat and tears that Rick put into making this publication the most popular within the optometric community.

Thank you, Rick, for the privilege of knowing you, and for sharing a bit of your life with us.

—Randall Thomas, OD, MPH, Concord, NC
Ron Melton, OD, Charlotte, NC

This letter was originally submitted in December 2012.

Lessons from Dentistry
AOA’s lobbying against stand-alone vision plans in the Health Insurance Exchanges has been nothing short of impressive. AOA often points to dentistry: “If there is a stand-alone dental plan in the Exchange, qualified health plans (QHPs) can drop their pediatric dental benefit … Is this an acceptable future for optometry?” Stand-alone vision plans would render the pediatric vision benefit optional, says AOA.

1. Clarification of the HHS rule. Within the Exchange, QHPs are required to offer the pediatric dental benefit, but purchase is not required. “Outside the Exchange, the rule requires the offer of all 10 benefit categories and purchase of the pediatric dental essential health benefits [EHB] by everyone in the individual and small group markets.” There is an “opt-out” only if there is “reasonable assurance” that there will be coverage through a stand-alone dental plan. Effectively, parents have the choice of either a stand-alone dental plan or a dental benefit “bundled” with their QHP. Will parents really opt out of an offered, covered benefit for their children? What about parental responsibility?

2. Affordability. For individuals and families who do not qualify for subsidies and those adults who do not have children, the choice to “opt-out” of the pediatric dental benefit will lower premiums. “The California Dental Association asserts the EHB pediatric dental benefit must be purchased by families with children, but also suggests the state provide flexibility for childless adults. This allows such adults to purchase products that meet their needs in a cost-effective manner. This is important because they will make up a great number of the ‘young invincibles’ whose engagement in the Exchange will be critical to its success.”

3. Medicaid. The American Dental Association is concerned that cost of care exceeds reimbursement, and that their providers cannot meet the considerable needs of that population while losing money on each encounter. “Data show that there is a direct relationship between the level of reimbursement and dentist participation in Medicaid... [The Healthcare Reform Bill] failed to provide basic adult dental benefits under the Medicaid program and failed to address inadequate provider reimbursement and disruptive administrative barriers ... ADA felt that the bill did not provide access to adequate oral health services for many low-income Americans.”  

4. Meager benefits. ADA has stated, “there are no assurances that this dental coverage will be substantial, and we fear that ... the benefit will be as meager as is currently found in medical plans that promise a dental benefit ... Medical plans have historically ignored or poorly run dental benefit programs, and only offered them to be competitive in the marketplace, not to materially improve oral health among its beneficiaries. They often focus on tactics to decrease utilization, not increase it.”

Sound familiar? We should not be surprised at the meager benefits of vision plans that will be bundled with QHP for pediatric vision. We should determine our level of participation. What will be acceptable for our practices?

—Lisa Shin, OD, Los Alamos, NM