> We all wish things we buy were cheaper, however the cost/value proposition on glasses is not that bad when you think of it this way. The final decision on how to spend your money is up to you, as the consumer, in the end.

I find this opinion to be abhorrent when applied to durable medical devices and medical treatment. Eyeglasses are a vision prosthetic, not an optional purchase. Many people must have at least one pair in order to function normally in society. If you're rent-seeking on that necessity, that makes you a parasite. If you're providing it at or below cost, that makes you a living saint.

~~These prosthetic legs will allow you to walk again. We have decided to charge you only slightly more than you can possibly afford for them. The difference will likely be made up by a charity of some sort, funded by people who would rather pay us to help you walk again than spend the exact same amount on independently making prosthetics and giving them away. But walking is so incredibly valuable in one's daily life, that the cost/value proposition is really not that bad for you. You're only paying us everything you have, in order to live like a normal person, and we also get to use your hard-luck story to suck some more money out of a few chumps that feel sorry for you, or maybe the government. We all wish things we buy were cheaper. You, of course, also have to option to scoot yourself around on an old furniture dolly with a junked riding-lawnmower seat strapped onto it with zip-ties. The final decision on how to spend your money is up to you.~~

Optometrists and ophthalmologists should cartelize ASAP, and erect a firewall between their eye exams and the opticians and eyeglasses manufacturers. If every supplier of eyeglasses prescriptions were to refuse to conjoin themselves to an optician business, Luxottica and VSP and their ilk could not extract money from that portion of the industry that supplies the most value. If I would pay $10 for an exam (copay, with VSP) and $120 for just one pair of glasses (from Luxottica, even after VSP allowance), I would almost certainly be willing to pay ~$200 (or $20/month) for a 30-min annual exam (direct to optometrist, without VSP), and 1-4 pairs of glasses at ~$40 apiece (from someone other than Luxottica). Pay the optometrist $50-80 per exam, and the rest on business overhead and support staff. Current US average is about 1800 patients per optometrist. So the cartel can refuse to sanction more than 1 member per 6000 in the local population, which sets a floor of about 1500 patients per optometrist, if they all distribute evenly.

So an average optometrist, in an average town, charging cartel prices, should be able to clear $100k per year personally, seeing an average of 6.5 patients a day, while still taking 4 weeks vacation, working only weekdays, and taking 9 holidays, while providing $250k to support their own business. That can probably support a $70k business manager, and a decent independent office--with no frame showroom taking up most of the usable space. Maybe also a lower-paid assistant. This is very reasonable for a profession which requires post-graduate education. There is no particular reason why an optometrist with two employees should not be able to operate as a small business, without also having to also sell overpriced eyeglasses, other than the manufacturer monopolist putting the squeeze on them, by paying some optometrists to put the rest out of business if they don't agree to join the scheme. Luxottica doesn't need to be the cartel enforcer; optometrists could create their own, and use it to benefit themselves--and maybe also the patients, just a little.