Glimpse of American Healthcare thru an Expat's Eyes

January 16, 2022

For the first week of the year, I went on my second snowboarding trip this winter season at Stowe Mountain Resort in Vermont. Every day, the conditions were different. One day, the weather forecast said it was going to be a sunny day but upon getting to the ski resort, it started snowing. Then it just snowed and snowed all day. This meant the goggles I brought for the day were not going to be optimal for my already, knowingly, bad eyesight.

This wouldn't be such a big issue if this was not an East Coast snowboarding trip, but it was. 

It's not dubbed as the Ice Coast for nothing. Despite having fresh snow, this part of the US has always been known for its icy conditions for snow sports. People who have skied and snowboarded here all their life would have no issues but for someone like me who's still learning to snowboard, not being able to spot icy parts of the mountain from a considerable distance meant it made it even more difficult to progress.

Long story short, I finally decided I wanted to get an eye checkup so I can get contact lenses. The nearest town that had eye clinics was an hour away. It had two clinics and a Walmart with an optometrist. 

Clinic #1 was a bust. They were not taking any new appointments until end of February. Clinic #2 was also a no-go as they didn't have any appointment slots until March. The Walmart optical shop had a slot... on Saturday morning, which also happens to be our last ski resort day. It was a Thursday and I asked why I couldn't be seen by the doctor when there was more than 30 minutes left before she had to go home and had no appointments. I was told it was going to take an hour and the doctor leaves at 4pm sharp.

Here are several things I learned as someone not well-versed in the American healthcare system:

  1. Eyeglasses and contact lenses cannot be bought without a prescription. This is not the case in the Philippines and in Singapore. If you go to any Optical Shop, they have an optometrist that will perform the eye exam on-the-spot, usually for free, and will give you the prescription and sell you the glasses/contact lenses on the spot. Because I didn't have a US prescription, I couldn't get any walk-in slots in both the optical clinics and thru the Walmart optical shop.
  2. Despite actually having a prescription from Singapore, all US pharmacies and optical providers cannot accept international prescriptions. It's illegal for them to sell glasses or contact lenses even if you know your eye grade and even with an existing prescription. So if you don't have a US-issued prescription and need one urgently, tough luck--you'd need to wait and get an eye checkup from a US eye doctor performed to get a prescription. 
  3. Prices depend on where you're getting the eye checkup. In Walmart, it was $75 for the eye checkup and a fee of about $25-45 for a contact lens check. In proper clinics, it will cost somewhere from $120 to $200. Some of them will charge extra for a prescription. All of this sound absurd to me, as someone who used to get this service for free from all the optometrists and optical shops in Asia.
  4. Whatever brand that the doctor prescribes, that's the only brand that can be sold to you.
  5. If you have never worn contact lenses before, some eye doctors are not allowed to perform an eye checkup. This is likely a liability preparedness measure. I got turned down when I showed up at my Warby Parker eye checkup appointment in the Meatpacking District. For the curious, there is only one doctor in the many Warby Parker branches in New York that can do a contact lens checkup for first-timers and it's in the Rockefeller branch. The appointments are backed up by at least two weeks.

Anyway, I ended up having to wait a week until I got back in New York to get my appointment with an optical doctor in Hell's Kitchen, which was even more convenient at it is near my place. My insurance ended up covering some portion of it but I still ended up paying $150+ out of pocket as my insurance co-payment, on an 80/20 split. In New York standards, this is cheap. But again, if all of these are services that are provided in a first world country (Singapore) and a third world country (Philippines), it makes me feel that this is more of a systemic issue and a blatant attempt at funnelling money into Big Pharma.

On one hand, I feel sorry for all Americans who have never experienced life outside of the US. On the other hand, I'm appalled that this has been the case and nothing is being done to make optical health more accessible to everyone. Are there no politicians that stand against these? And if there are, why aren't they being voted into office?

I know all this sounds like a massive rant. And it absolutely is. 

I get it--it's just part of living here. Part of the American Dream somehow involves really inefficient and expensive healthcare. Personally, I have watched enough American TV shows and Patriot Act so I knew what I was signing up for. That said, I think this needs to be talked about more, especially by people who dream of moving here before they move here.

In an effort to end this post on a good note, it should be said that at least now I have my prescription for both eyeglasses and contact lenses. My optical clinic only charged for the eye exams, including a test for Glaucoma, and the prescriptions and the Fiji water were free. I also ended up being cleared for Glaucoma. And the next time I go snowboarding, and hopefully soon, I will be able to see better. 

All in all a good exercise and I'm happy I got this done early into the year.

You Might Also Like