When the interests of industry are in conflict with the public health: the case of myopia

Academy of Health Care Management Journal, Annual, 2005 by William L. Weis

Why on earth would you even wear contacts? If you had to take those wretched things out and put them back in thirty times a day the market for contacts would be non-existent. No consumer is going to pay that much money for such a hassle. In order to sell as profitable a product as contact lenses and their requisite care products, all that advice about not doing close work with long distance lenses on must be hushed up--for glasses as well as for contacts. So perhaps one of the reasons we no longer hear about the dangers of doing close work through distance lenses is the advent of the otherwise beautifully marketable contact lens phenomenon--the lenses that are sold at exorbitant profit margins.

To those of you who cannot move about the day without glasses, contact lenses, or even corneal surgery, it must be infuriating to learn that your vision is being sacrificed on the alter of irresponsible free enterprise. Your ophthalmologist knows that functional blindness can be prevented--but won't talk about it. The lucrative optical products industry and the burgeoning corneal surgery industry know you don't have to be dependent on their products and services, and will take any political action and spend any amount of advertising and public relations money to make sure this truth is never revealed to the general public. After all, a majority of the public are lifelong spigots pouring a constant flow of revenue into the coffers of this, one of the highest-margin industries in the world.

THE HIGH-MARGIN INDUSTRY EDGE = MIND CONTROL

Let's digress a few moments on this last point, because where we see extraordinarily high-margin businesses we tend to see enormous investment in mind control--that is, in promoting and preserving a conventional wisdom that accepts the status quo as normal, unavoidable and, in some instances, even desirable. "High margin" simply means the business sells a product at a price that is disproportionately high compared to the direct costs of production. The pharmaceutical industry and the optical products industry enjoy especially high contribution margins on sales because the direct costs of producing pills and glasses and contact lenses are miniscule compared to their selling prices. But the optical products people are truly in a league of their own. Drug companies are still investing heavily on research and development, looking for new and exciting "wonder drugs" to stage their next market killing. But optical products companies are spared this endless race to new and better products. Distance lenses (minus or divergent lenses) and reading lenses (plus or convergent lenses) are still employing the same fundamental technology that was used to put glasses on Ben Franklin.

What do you think a pair of standard-issue contact lenses costs Bausch and Lomb to produce? (Hint: The company turns out millions of pairs of lenses of each standard distance prescription every year). If you guessed "negligible" for the per-pair costs, you are obviously in the ballpark. Now how much would you wager Bausch and Lomb, or any of its fellow companies, makes in sales of these cheap products?