Thursday, June 18, 2009

Little Things Can Change the World

I was a coauthor on a paper recently published in the Bulletin of the World Health Organization ( about the burden of uncorrected refractive error (i.e. needing glasses but not being able to get them or having an outdated prescription). The Johns Hopkins Bloomberg School of Public Health put out a press release (, so I don't need to restate either the whole article or the press coverage. The article described how many people around the world don't have needed glasses and projects what the loss of productivity associated with it might be.

What I do want to mention is how easy (and how relatively inexpensive) this would be to fix. Here in the United States we talk about spending $1 trillion over 10 years to insure an extra 16 million people. The team with whom I worked on the paper that in the Bulletin of the WHO has not yet done the "down to the penny" calculations of the expected cost of fixing the problem of people who do not have the glasses they need, but I'll do a back of the envelope calculation here and then update when we have real numbers.

In the United States we can get glasses for as little as $50 for a cheap pair of glasses or spend hundreds of dollars for a fancy pair with lots of bells and whistles. However, there are places around the world where people can get glasses for as little as $5 or $10 per pair--perhaps a total of $30 by the time you pay the labor to fit them. We estimated a total of 158.1 million people didn't have the right glasses--if they had any. Even if we had to spend $100 per person, this would be a total of only $16 billion. And, this would not need to be done every year. At lower costs per person it may be less than $1 billion to solve the entire problem that affects more people around the world than the total number of uninsured in the United States.

So, there are some problems that have the potential to be solved for relatively small amounts of money in comparison to what we have been discussing in the United States for the health care system. Sometimes we would do well to think about the small problems we can solve (but that may be less exciting) in addition to struggling to solve some really big problems.

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