Does North Carolina Need an Optometry School?

“No one spends other people’s money as carefully as he spends his own.” So says Nobel Prize-winning economist Milton Friedman. Let’s keep that in mind as we consider a new spending proposal being pushed by one of the schools in the UNC system.

The University of North Carolina at Pembroke (UNC-P) has advanced a plan to build a new school of optometry at the geographically remote campus. The budget contains $10 million for the initial planning and development of the project, but no funds can be expended until the UNC president’s office gives approval. A meeting to decide on the plan is scheduled for later this month.

There are no schools of optometry in North Carolina, but it isn’t unusual for a state to have no optometry school. There are only 16 in the country (plus one in Puerto Rico), so most states don’t have schools within their borders. That doesn’t prevent people who receive training in optometry from going wherever the demand is.

In its press release announcing the project, UNC-P observes that there is no school of optometry between Philadelphia and Birmingham, Alabama. Quite true, but how does that lead to the conclusion that North Carolina taxpayers should pay to build an optometry school in Pembroke? If citizens of Raleigh, for example, need optometric services, we don’t have to drive to Philly or Birmingham. We have plenty of competing optometrists right here.

UNC-P officials – eager to spend other people’s money – insist that the rural southeast is “underserved” with optometrists. Rural areas are “underserved” with lots of things that one finds in greater profusion in cities, but that doesn’t mean that people who live there are unable to get what they want or need.

Furthermore, even if there were an optometry school at UNC-P, why should anyone believe that students who studied there wouldn’t go wherever the best-paying jobs were? There is an optometry school at the rural Ferris State University in northwestern Michigan, but there’s no evidence that people who got optometry degrees at Ferris head out into the hinterlands looking for some little hamlet that doesn’t have an optometrist.

If there were a looming shortage of optometrists, it would make sense for the existing schools of optometry to expand. That’s how businesses behave when they find demand for their product rising. Building a new school certainly isn’t a very cost-effective means of increasing the number of trained optometrists.

But the more likely scenario, according to a study done for the American Optometric Association (AOA), is that there will be a surplus of optometrists without adding a school at UNC-P. According to a 2000 analysis commissioned by the AOA, by 2010, there may be more than 3,500 more optometrists than there is work for in the U.S.

Commenting on that study, the president of the Pennsylvania College of Optometry, Dr. Thomas Lewis, said, “I don’t think anyone in the colleges is thinking about increasing enrollment, but we should be concerned about a decline.”

Further underscoring the lack of any pressing need to build an optometry school at UNC-P is the fact that North Carolinians aren’t taking full advantage of the good deal the state has for them if they want to study at several of the existing schools of optometry.

Under contracts UNC has with the Southern Regional Education Board and the Pennsylvania College of Optometry, up to 84 North Carolinians can take spaces in four schools. They get the benefit of low in-state tuition at two public universities, and substantial tuition assistance at two private schools.

If optometry were anticipated to be a growth industry, you’d expect those spaces to be filled. They aren’t, though. During the 2003-04 school year, only 65 of the spaces were used. Why go to the expense of building a new optometry school if North Carolinians currently aren’t using all the subsidized places UNC has negotiated?

Answer: Other people’s money.

The UNC-P officials and supportive politicians who want to see the project continue won’t be spending their own money on it. They wouldn’t blow their own money on, say, costly diagnostic equipment for their cars when they can have a garage or dealership do whatever work is necessary with its equipment.

Citizens of the state who have vision problems will be no better off with an optometry school located at UNC-P. They will, however, be somewhat poorer, with tax dollars diverted to another needless UNC expansion.

George Leef ( is the executive director of the John W. Pope Center for Higher Education Policy in Raleigh.