End dispute on eye care
Ontario’s Health Ministry pays about $5 more for an eye exam in 2021 than it did in 1989.
Five dollars covers a fancy coffee — not 32 years of increases in staff salaries, office rent and specialized equipment costs.
So it’s pretty clear that government payments to optometrists for patients who are covered by the Ontario Health Insurance Plan (OHIP) have fallen far behind the cost of actually providing those services.
But right now it’s the patients caught in the middle of a labour dispute who are suffering the most.
For weeks now, the vast majority of the province’s optometrists have been refusing to see children, seniors and others eligible for an OHIP-covered exam as part of their campaign to get the government to increase funding.
Roughly 250,000 appointments have been cancelled since Sept. 1, and that figure goes up about 15,000 eye exams a day.
As the Star’s Maria Sarrouh reported, a 10-year-old had to go back to school without the glasses she needs because of this job action. She has to rely on classmates to read for her. At the other end of the spectrum, it has delayed referrals for cataract surgery — about 2,000 a week.
This is not the first time the Ontario Association of Optometrists has resorted to a tactic that hurts their patients in order to get the government’s attention. A year ago, the association asked its members to send some patients to hospital emergency rooms for eye treatment — in the middle of the COVID pandemic, no less.
Patients whose eye exams are supposed to be covered by OHIP are stuck in the worst of all worlds. Most optometrists won’t accept their OHIP appointments and it’s against the rules for them to pay out of pocket, even if they’re willing and able. This can’t go on.
But the fix rests with the province agreeing to fair compensation. Ontario can’t expect optometrists to continue to subsidize eye care appointments that the government claims it pays for.
In August, Health Minister Christine Elliott wrote an open letter laying out the government’s offer. In it, she acknowledged that Ontario’s optometrists do not have “a fair and sustainable agreement.” Though, of course, she put the blame for that on the neglect of “previous governments.”
Elliott said the Ford government wants to reach a new agreement quickly and then will work to “build a long-term and sustainable funding relationship” with optometrists.
In other words: take the small increase we’re offering now and we’ll work toward something more later on.
It’s not hard to see why the optometrists’ association isn’t keen on that approach. They say they won’t end their job action until the government commits to covering the operating costs of eye exams.
Under the current system, the government reimburses optometrists 55 per cent of the cost of an exam. That works out to about $44 on an $80 exam. The government’s offer of an 8.48 per cent “catch up” increase moves the government payments to about $48, when the costs are typically in the $75-$80 range, according to the optometrists.
The optometrists’ figure, which has been supported by an independent study, also mirrors the Bank of Canada’s inflation calculator. Goods and services that cost $39 in 1989 — which is about what the government paid per exam then — cost nearly $74 in 2021.
If the health minister doesn’t agree with that figure she needs to explain why. Otherwise, the government should offer optometrists a fair deal. And she should do it without further delay because it’s patients who are suffering now.