Thread by @Yascha_Mounk

Last week, I argued that Americans should—like people in nearly all other countries—be able to buy a pair of glasses or contacts without a costly doctor’s prescription.

It caused quite a stir. Especially among optometrists.

Here’s my reply.

[Thread.]

theatlantic.com/ideas/archive/…

Virtually all of the responses I got consisted of one simple argument: eye exams often uncover dangerous diseases.

This is an important point. Indeed, I make it myself in the piece.

To avoid all misunderstandings, let me be crystal-clear:

Eye exams are a good way to check for a range of dangerous diseases, from progressive blindness to brain tumors. If you have the time and money to visit an optometrist, go make an appointment today!

But…

…there are plenty of medical exams that are not mandatory even though they often help to uncover dangerous diseases.

Do you need to see a dermatologist to buy a simple skin cream?

No.

Do you need to get a prostate exam to buy drugs against incontinence?

No.

So the question, as I pointed out in the original article, is one of *comparative* benefits.

Eye exams are useful.

But is it proportionate to ban Americans from buying glasses or contacts unless they get an exam, thus making it more difficult for them to access vision care?

What’s remarkable is that virtually none of the dozens of emails, Facebook messages and Instagram DMs I’ve received from optometrists bother to address this question.

Instead, foul-mouthed abuse was far more common.

This may seem like "nutpicking."

But the official letter from the President of the American Optometric Association was remarkably ad hominem as well.

The letter also contained some outright falsehoods.

In this passage alone, it implies that most countries require eye exams (false) and says that the AOA provided me with a host of information I requested (definitely false).

So let me publicly repeat the questions I did send the AOA without ever receiving an answer.

Perhaps @AOAConnect will bother to send a response to them now?

@AOAConnect When deciding how to feel about trade-offs, facts matter.

Is there evidence that Americans die from relevant diseases at significantly lower rates than, say, Germans?

If so, how do those benefits compare to the cost of stopping some Americans from having adequate vision care?

@AOAConnect The American Optometric Association could have bothered to engage those questions when I first asked them for comment; it didn’t.

It could take these questions seriously now; instead, it denounces anyone who asks them.

@AOAConnect This says a lot about the insiders who profit from the “license raj” that holds sway in big parts of the U.S. economy.

Like the privileged classes of yore, they don’t feel the need to justify themselves; instead, they just denounce anyone who challenges them.

@AOAConnect So until someone shows me compelling evidence that the burden imposed on disadvantaged people by the cost of a compulsory medical exam is justified by the benefits, I stick to my position.

Abolish mandatory eye exams!

Please spread the word...

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theatlantic.com/ideas/archive/…