Prevention of Blindness

I am all for the prevention of blindness and the provision of services for those who have uncorrectable vision impairments to make individuals with this situation as self-sufficient as possible. I have been involved in estimates of the costs of vision impairment around the world and in the United States. My colleagues have done great work in Australia, in the UK, and now in Canada. A description of the recently completed work in Canada (done by an excellent set of researchers from Australia) can be found at http://www.cbc.ca/health/story/2009/06/23/vision-loss-cost.html.

The story is similar to what has been found in other countries with aging societies. The number of blind individuals or individuals with vision impairment will increase as society ages. The costs per person are high, and the costs per person are distributed between direct costs of medical care, costs of support, and costs due to lost productivity.

The news article points out that Canada made a commitment in 2003 to develop a national vision plan by 2005 and implement by 2007. Interestingly, they have not completed that task. We, in the United States, are not the only ones who take a long time to implement policy.

Finally, the report called for a plan with four criteria, the first of which is "Cost-effective preventive measures". A key thing to recognize when academic types talk about cost-effective preventive measures is that they will not always be cost saving. Certainly, for the person for whom something is prevented--it saves them costs. Certainly, for society as a whole, we'll end up paying less for costs related to a given condition. However, the costs of prevention (particularly if it is not well targeted) may exceed the cost savings.

Does this mean we should only adopt measures that save money? I don't think so. I do think that we need to be aware of whether money will be saved and whether we think that spending more money is worth the benefits. And, before you think that I am picking on vision problems, I can assure you I am not. I would ask the same question about HIV prevention, flu prevention, or vision problem prevention.

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