Frustrated by free eyeglass policy, ODs picket Blue Cross building

Issue: February 1998

photograph Seventy-three optometrists, other doctors and union representatives picketed the Independence Blue Cross building in Philadelphia Dec. 23 to protest the insurer's new plan to provide enrollees with a free pair of eyeglasses and frames.

PHILADELPHIA - Angered by a new insurance policy that offers customers free eyeglasses, an optometry-led group of medical professionals conducted a protest in front of the Independence Blue Cross building here.

Blue Cross insures 2.6 million people in Philadelphia and its suburbs. "They are destroying our profession and destroying other professions as well," said Aaron Chasan, OD, one of the organizers of the Dec. 23 event. "It's corporate greed. Where does the money go? Right into their own pockets."

This frustration, of not only optometrists but opticians and optical retailers as well, was evident on the picket line, where 73 people marched and chanted labor slogans such as "What do we want? Fairness!" and "What do we want? Choice!" Protester Sandra West, OD, a recent graduate of the Pennsylvania College of Optometry, said, "the plan may cause me to shut down. I refuse to allow corporate entities to dictate to medical providers."

Davis Vision to provide eyeglasses

The new plan, which became effective Jan. 1 and was introduced by Blue Cross in conjunction with Davis Vision, allows members to choose a free pair of Davis eyeglasses and frames. Last December, patients received letters, Dr. Chasan said, that informed them of the new program and also told them of their automatic enrollment in Lens 1-2-3, a mail order contact lens program.

"We didn't have the courtesy of a letter," Dr. Chasan said. "I never knew of such a program until my patients said, `Hey doc, are you going to be on this program?' This is a dirty trick, and it's unfair to both patients and doctors."

According to Richard Davis, president and chief executive officer of Davis Vision, provider applications and program overviews were sent to providers 3 to 4 months before the plan start date. Mr. Davis said the program is a point-of-service design, where subscribers can opt for services in or out of the network, including the choice of noncovered frames in-network.

According to John Mattiacci, DPM, a podiatrist for 28 years and president of the National Guild of Medical Providers, in 1996 Pennsylvania Blue Shield purchased Davis Vision and then merged with Blue Cross of Western Pennsylvania, becoming Highmark Inc. Dr. Chasan said the purchase and merger have effectively given the company a vertical monopoly, controlling delivery, examination, frames, optical laboratory and contact lens mail order.

Dr. Mattiacci said, "the optometrists have lost control of their profession. The insurance companies control everything now."

Mr. Davis added that Independence Blue Cross is independent of Highmark/Pennsylvania Blue Shield or Blue Cross of Western Pennsylvania.

Doctors, unions unite

The optometrists - uniting with other doctors and union representatives - fought back with the Dec. 23 picket. Dr. Chasan, outgoing president of the Philadelphia County Optometric Society (PCOS), spearheaded the move for optometrists by founding the Pennsylvania Optometric Guild, of which he is currently acting president. More than 100 optometrists in the Philadelphia area joined the guild, which was organized with the help of Dr. Mattiacci under the National Guild for Medical Providers, a branch of the Office and Professional Employees International Union (OPEIU)-AFL-CIO.

The OPEIU national president, Michael Goodwin, helped lead the picket. Also present was Robert B. Sklaroff, MD, president of the Pennsylvania Society of Internal Medicine (PSIM). PSIM has sued the Pennsylvania Insurance Commissioner over the consolidation of Pennsylvania Blue Shield and Western Blue Cross and has lent its support to the optometrists' fight against the insurer.

"The Pennsylvania Optometric Guild is an offshoot of the PCOS and is designed to do things the city and county societies cannot or are unwilling to do," Dr. Chasan said. It also helps address problems specific to medical providers who run the risk of antitrust and collusion simply by discussing contracts, he said.

In a prepared statement, G. Fred DiBona Jr., president and CEO of Independence Blue Cross, said of the free eyeglass program, "The new program we are making available to our members through Davis Vision offers our customers expanded benefits including eye glasses at little or no cost. This is an excellent example of the initiatives we've aggressively taken that have contributed to our record membership growth."

Jim Panyard, senior director of corporate communications for Independence Blue Cross, said more than 950 optometrists in the Keystone Health Plan East have agreed to participate in the program.

Dr. Chasan said while Mr. DiBona is supposedly cutting costs, "He's cheating the public and selling a product that is not quality."

According to Mr. Davis, Davis Vision's professional services and materials are unconditionally guaranteed, including a full 1-year warranty on frames and lenses provided through a special collection.

'They're limiting my income'

Protester William Putterman, OD, in private practice in Philadelphia, said, "The new plan is killing us. Our profits are being cut significantly, and we're becoming order takers."

Dr. West added, "We have a right to exist and determine what products go into or are dispensed from our offices. They're limiting my income."

S. Yale Cutter, OD, a retired opto-metrist who practiced for 60 years, said, "The plan is another example of how a nonprofit organization betrays its mission. It's a conspiracy," he said, "to deprive private enterprise by a nonprofit institution."

Lacking in public support

The comments of passers-by during the protest illustrated the specific problems medical providers encounter in their efforts to organize. One man who hustled by on the chilly day said, "Look at this. This is people making hundreds of thousands of dollars complaining." Another man looked at the picket signs protesting corporate greed and shrugged, saying, "Corporate greed? This is America."

Dr. Chasan agreed that it is difficult for medical providers to get good press. He said, "Patient care is affected. You can't cover your chair costs. Why see patients when you lose money and you can't make it up on volume? But this is not what the public wants to hear," he said. "The guild is a rallying point to help get the word out that, for instance, under the Blue Cross-Davis plan, optometrists receive a $15 dispensing fee to service a patient for 2 years. It's predatory. And Davis said if not enough glasses are being sold from the Davis tower, an office can be terminated. There is also the threat of Davis opening retail outlets to further compete against participating doctors."

According to Mr. Panyard, "Patient benefits remain the same. As before, they can go anywhere, plus receive free frames by using the more than 950 optometrists participating in the Davis plan. Also, the fee for exams has been increased 60% from $25 to $40."

Protester Stephen Schmerling, an optician, said the picket could bring about positive change. "Hopefully this will be the start of something good," he said, such as the three professions - optometry, ophthalmology and opticianry - coming together as a group.

For Your Information:

Aaron Chasan, OD, can be reached at (215) 338-8833; fax: (215) 338-5616; e-mail: chasana@juno.com.

John Mattiacci, DPM, can be contacted at P.O. Box 299, Camp Hill, PA 17001; (215) 739-0299; fax: (215) 739-9330.

William Putterman, OD, can be contacted at 6155 Ridge Avenue, Philadelphia, PA 19128; (215) 483-3400.

Sandra West, OD, can be reached at 5512 Rising Sun Avenue, Philadelphia PA; (215) 455-7773.

S. Yale Cutter, OD, can be contacted at 8226 Cadwalader, Elkins Park, PA 19027; (215) 635-1344.

Stephen Schmerling can be reached at Normandy Optical Company; (215) 295-0444; fax: (215) 295-6161; e-mail: optician@Dynanet.com.

Independence Blue Cross can be reached at 1901 Market St., Philadelphia, PA 19103-1480; (215) 241-2400; fax: (215) 241-4746.

Davis Vision can be contacted at 159 Express St., Plainview, NY 11803; (800) 328-4728; fax: (516) 932-2063.