Local optometrists say province has blinders on when it comes to funding eye care

Without changes, OAO says no OHIP patients will be seen as of Sept. 1

By William McGinn

Local optometrists say province has blinders on when it comes to funding eye care
Dr. Liana Cooper, an optometrist in Lindsay, says the province needs to update their agreement with eye care professionals. Photo: William McGinn.

Dr. Liana Cooper, optometrist at Lindsay’s Russell West Optometry, has been part of a three-decade old battle with the province that will soon see eye exams stop for thousands if the Ministry of Health doesn’t blink first.

That’ because optometrists feel they have been underfunded for years – and inflation has only made things worse.

Cooper’s professional association, the Ontario Association of Optometrists (OAO), is led by Dr. Sheldon Salaba. He notes that OHIP currently pays an average of $44.65 per patient exam. However, the actual exams cost more than that, and with a 30-year-old agreement the optometrists have to pay out of their own pockets to cover the remainder, which is more than half.

“We need to find other ways to cover these costs,” said Salaba. Right now, “children under the age of 20, seniors 65 and over, and adults with existing eye diseases or diabetes, are covered for eye exams under OHIP.”

On average, 70 per cent of a practice’s patients are covered by OHIP,” Salaba told the Advocate. Cooper said she suspects, locally, with Lindsay being a retirement community, that percentage could be even higher.

Ontario optometrists do about four million OHIP-insured eye exams a year.

A full 97 per cent of OAO members voted to stop giving eye exams to patients funded by OHIP as of Sept. 1 if the government doesn’t improve the agreement between optometrists and the province. It’s a choice they are making to save eye care, not undermine it, according to the OAO.

Cooper said there are two things the government must do.

“First, they have to agree we need a binding formal negotiation process, which every other health care person has, like doctors, nurses and teachers. Optometry has none, which means we have no way to get them to even sit down and talk to us as we try to explain that the funding system has just reached an archaic level.”

Cooper says OAO members spoke to the government in October and November, and “presented better alternatives,” showing the Ministry of Health how some other provinces have worked with optometrists.

“The government just said ‘no’ and then refused to have another meeting with us,” says Cooper.

The second condition, she said, is the funding arrangement must change.

Cooper and Salaba said the amount the government supplies them cannot cover the total cost of covering an eye exam, from extra factors such as rent, staff, utilities, equipment and technology, and because of this it is harder for optometrists to invest in modern technology that would improve the exam and therefore the eyes of the patients.

To complicate matters, Cooper says the Health Insurance Act that was signed into law in 1990 made it illegal for optometrists to accept direct payment or alternate health insurance from any patient that is covered by OHIP.

“I’ve got patients who told me they are willing to pay for eye care they need themselves if we can’t reach a deal,” but this agreement means that isn’t possible, says Cooper.

Salaba said over the last year he has had more than 40 meetings with MPPs and cabinet ministers to explain the issue. The date of September was confirmed in January to give a reasonable amount of time for discussion. Cooper said if August arrives with no change in the policy, OHIP-insured patients will not be able to see any optometrist for their issues and will have to find alternative care.

The OAO represents more than 1,800 optometrists across the province.

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