An Optometrist’s Journey
Dr. Jay Bailey owns Professional Eye Associates in Raleigh, North Carolina. It is a family-owned and -operated business where Bailey has accrued 23 years of experience in both practicing optometry and running his own business. Since 1987, Bailey has been committed to following his passion of helping others overcome debilitating vision deficits and difficulties.
He believes that sight is a gift from God and he receives much satisfaction from helping people regain or preserve that gift. He noted that some of the highlights of his work are helping both the young and old: “It is very moving to help a child see for the first time and also to help preserve the sight for people who are aging.”
Bailey also likes his optometry business because it allows him a degree of flexibility, since he is not on-call 24 hours a day like some in the medical field. There is undoubtedly tremendous hard work that goes into running a business, but there is also an amount of flexibility and freedom for entrepreneurs like Bailey.
Barriers to Entry and Onerous Regulations
Starting a business is not an easy endeavor. Entrepreneurs must consider, among numerous other things, the regulatory climate. New business owners must be prepared for the heavy expenses surrounding regulatory compliance.
For Bailey, it was difficult to start his business. For instance, incorporating his business was a challenge. Becoming credentialed by insurance companies (especially in regard to government programs like Medicaid and Medicare) was also extremely cumbersome. “You have to jump through the insurance regulatory hoops mandated by government. You have to buy computers and programs to handle the complexity of the codes for claims to file insurance, as well as security for the patient’s HIPPA rights,” he said. He summarized his business creation experience adeptly by saying that “it is a maze of paper and computer files that make your head spin.” He was sure to note that all the costs of starting his business and complying with numerous regulations came directly out of his own pocket.
Regulations Abound
Like other fields in the healthcare industry, optometry is subject to state and federal regulations. Bailey said regulations imposed by Medicare are among the most intrusive into his practice and to the optometry field in general. Bailey revealed some of the regulatory and licensure protocols by which optometrists must abide. For instance, prospective optometrists must pass multiple board examinations before gaining a license to practice: three examinations given by the National Board of Examiners in Optometry and a North Carolina Board of Optometry examination all must be passed – and paid for.
One area of particular regulatory burden for Bailey and his business pertains to ICD-10 codes (ICD-10 is short for International Statistical Classification of Diseases and Related Health Problems). These are diagnostic codes used by private insurance companies and Medicaid and Medicare to classify medical conditions, diseases and symptoms. According to Bailey, complying and keeping up with these codes is extremely burdensome, even to the point of almost requiring him to hire a full-time employee simply to keep up with the regulations. Interestingly, he considers the codes to be tantamount to the burdens placed upon him by tax laws. If he had his way, he would remove the “gazillion” regulations produced by the ICD-10 codes and simplify the system. Furthermore, he would seek to make insurance more user-friendly for the patient and doctor.
Bailey indicated that regulations have increased vastly since he started his business in 1987. Insurance regulations were not as cumbersome back then, and the only government intrusion to his business pertained to the State Board’s examination and requirements for optometrists to have 20 hours of continuing education. Things have certainly changed over the years, and the change has not been for the better.
As for the matter of taxation, Bailey hires a tax accountant who makes sure his business is complying with the strict guidelines of the IRS. He noted that this incurs a significant cost to him, but he stated that, “there are only so many hours in the day and I can’t be burdened with the [complexities of the] tax code.” Numerous other small business owners can sympathize with this sentiment.
Overall, Bailey says that our state is a great place to practice optometry, but there is definitely room for improvement. While North Carolina was one of the pioneering states for optometry in therapeutic drug laws, Bailey believes the optometry industry would be better if practitioners did not have to “keep up with all the changing coding of insurance claims, and also if we could treat our patients with less intrusion from the government.”
Government Expansion Impedes on Small Businesses
With the U.S. Supreme Court’s recent ruling affirming the constitutionality of much of Obamacare, many business owners are left contemplating what the law’s far-reaching implications will mean for their businesses. As previously mentioned, one of Bailey’s largest burdens and hindrances in operating his business was purchasing expensive computers and software used to comply with various regulatory codes from insurance companies and the government. Bailey said that “Obamacare will increase the amount of codes and computer requirements, and access the government has to our practice, which makes a burden on small business.” Moreover, he noted that he will have to spend a significant amount of money to comply with all the new regulations that will come into existence as a result of Obamacare. This money spent will most likely not be recouped. In a revealing statement, Bailey said that many of his business associates and personal friends who own businesses are “talking about retirement rather than acquiescing.” In light of ever-increasing government interference and increased regulatory burdens, the future is filled with uncertainty for many small-business owners. As for now, though, Bailey hopes to continue following his passion and faithfully serve his customers for as long as possible.
The Mind and Heart of an Entrepreneur
Why does an entrepreneur seek to create a business? There can be numerous responses to that question, but the answer typically boils down to two reasons. First, there is a desire and passion to use one’s talents and abilities to create something of value, a beneficial product or providing a valuable service, for others. As humans, we need many things to sustain and improve life. The free market is designed to efficiently allocate scarce resources (time, labor, and materials) to produce and provide these needed products and services at competitive prices. Second, along with an individual’s innate desire to follow his or her passions, entrepreneurs start businesses to create wealth and something of value for themselves, their families, and, in turn, society. The free enterprise system has allowed people like Dr. Jay Bailey to use their God-given talents and abilities to help improve the lives of others. And not only is there the reward of feeling satisfied for being productive and providing a service people value and need, there is also a financial reward for the producer of the product or service. The free market creates a “win-win” situation that no competing economic system can rival. If people are allowed to be free, to be productive and creative, and to pursue their natural self-interest (which is not selfishness), individuals and society as a whole will not only survive but thrive.
Scott Blakeman was recently an intern at the Civitas Institute in Raleigh.
The deal is this. If business conditions get to the point where you are not making a return on your investment, you must quick that business. The regulations, laws and standard practices are required to insure proper service to customers, proper taxes paid to local, county and federal government and proper accounting of services to insure fraud is not being committed. Insuring all of the above is very important for health, safety and reducing fraud. If a business owner can not handle that, they should not be in business. It is very telling that Civitas had and intern with no business experience write this piece on Dr. Bailey’s practice. A good business person weighs the pros and cons of continuing their business every month and year. I’ve had a business for more than 25 years, have met city, state, federal rules, paid for healthcare for employees, gladly paid my taxes and was successful. Why is Bailey in business if he is unhappy. He clearly making money or he is one of those 47% that Romney talks about being on the state or federal welfare.
Mr. Dowling is missing the point. Dr. Bailey is not unhappy with his business, only on the conditions that intrusive government has put on his business. Not only has it cost him money but also his time not being able to see his patients. Many government regulations are needed and make sense. But many do not. Often burdensome regulations are products of politicians with an agenda or government workers trying to justify their positions. Is there cost benefit analysis on these regulations?? Often not. It would lower highway deaths if we dropped the speed limit to 10 mph..But look at the cost to reach that goal. I’ve been in business for over 25 years as well. I’ve had property forcibly annexed, property taken by condemnation for a sewer line that cost my business 100K, and been forced to fix a non-existent problem by a gov agency. I’ve also paid my taxes, payrolls, employee benefits, etc. as well as supported local charities, schools, etc. Money wasted on intrusive government not only takes from the business owner but also hurts the very communities in which we live.
The government cares little about complications or rectifying them. Beaurocrats are paid to cover every base possible without considering cost to consumers or priivate staffing required to meet requirements. In the end the consumer PAYS for all of it with higher prices.
Insurance Fraud: Hmmmm seems it may be cheaper to permit some fraud rather than adopt policies that attempt to stop all fraud. Like the 10 mph example above; it’s better for all consumers, in some cases, if a simplified sytem permits “some” walking around the hoop (cheaters) rather than have everyone jump through the hoop (honest payers) at higher costs differential amounts where everyone is a looser! Let’s not strain the camel through the eye of the needle.