Washington State Shouldn't Ban Ocular Telemedicine

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Dear Senator:
On behalf of National Taxpayers Union, I respectfully urge you to vote against SB 5759, a bill to ban ocular telemedicine in the State of Washington. NTU is the oldest non-partisan taxpayer advocacy group in the United States. We are dedicated to taxpayers and the belief that citizens make the best decisions about their own money. We have consistently advanced policies to lower taxes, streamline government, promote free markets, and more.
As currently written, SB 5759 would prevent consumers from making safe, affordable decisions about their vision care. The bill would take away the ability of consumers to obtain contact lens and glasses prescription renewals online as well as their ability to obtain online vision exams. Additionally, Washington State consumers and taxpayers will be burdened with higher costs, less competition and fewer choices should this bill be passed.
Online vision testing services have been available for approximately four years in Washington State. Washington is one of 37 states to allow consumers the choice of online exams with careful oversight that preserves safety while providing savings in time and money. Nationally, over a million online vision tests have been performed without a single adverse event, malpractice claim, or customer-initiated medical board complaint. 
Should SB 5759 pass, Washington would be taking a huge step backwards. It is unfortunate that certain interests in the optometric community in your state are working to block healthy competition with their convenient arrangement of being able to sell the eyewear they alone prescribe. 
Not only will SB 5759 financially strain the pocketbooks of patients and consumers, it will also place an enormous burden on all Washington taxpayers. The recently released Fiscal Note estimates taxpayers will be saddled with $1 million in operating costs to regulate services that have been offered to Washingtonians for four years without a history of consumer complaints. This does not include the regulatory compliance expenses that providers must somehow accommodate, likely through higher prices or by providing fewer services to Washingtonians.
Successful health and fiscal outcomes will continue to depend upon wide-scale innovation in everything from medical services to program management to payment systems. This is certainly true with ophthalmic services and devices. Technologies such as online eye exams and the freedom to purchase corrective products from a variety of sources are vital to fostering such innovation. Through telemedicine, underserved populations become better connected with providers. At the same time, long-term costs such as treatment for eye diseases are avoided because preventative care can be accessed more conveniently. The challenges of providing health care that is effective and affordable to consumers, providers, and payers continue to confront policymakers in the State of Washington as well as Washington, D.C. According to the Centers for Medicare and Medicaid Services, projections indicate that combined state and federal Medicaid expenditures between 2018 and 2027 will far exceed inflation or population growth, and will even slightly exceed overall total national health expenditures. And while Medicaid does not cover most conventional eyewear prescriptions, the convenient availability of ocular services and corrective products online can prevent other eye health problems down the line for which Medicaid might be liable. 
The dividends of ocular telemedicine to taxpayers extend well beyond the scenario described above. Like many employers in the private sector, states and localities must contend with controlling the costs of health benefits for their workers while maintaining quality and consumer choice. According to a Pew Charitable Trusts report, utilizing data from the Milliman Atlas of Public Employee Health Plans, in 2013 states and their employees spent $30.7 billion to provide health coverage to 2.7 million households of active state-level employees (not including local government employees, even those who could join state-level plans). State governments – i.e., taxpayers – covered $25.1 billion of this cost (the employees themselves covered the remainder). This is probably the smallest universe of expense attributable to state and local employee insurance. Taxpayers cover more than 70 percent of the premium cost associated with the Federal Employee Health Benefits Program, which pays out over $40 billion to current workers and retirees. Vision care is available through most of these government plans. 
It is therefore imperative that the State of Washington continue to be a leader, rather than a laggard, in online vision care innovation. We strongly urge you to resist the overtures to protectionism being propagated by some members of the optometric community. Their interests are primarily anti-competitive and will only deny consumers, taxpayers, and governments the full benefits of ocular telemedicine. 
Health and wellness cannot, and should not, be boiled down to solely to dollars and cents. Still, virtually every discussion of public policy involves to some degree the matter of how consumers, providers, and taxpayers can choose to put resources to their most effective use. SB 5759 will not lead to better outcomes for the hardworking constituents you represent. We emphatically urge you to vote against this measure. 
Leah Vukmir
Vice President of State Affairs