OHIP-funded eye exams stopped until government blinks on financial support

OAO wants to build sustainable system says group's president

By William McGinn

OHIP-funded eye exams stopped until government blinks on financial support
About 70 per cent of all optometry patients are covered under OHIP.

Ontario optometrists will no longer be providing OHIP insured eye exams until further notice, making good on a warning their professional association made in January.

Dr. Sheldon Salaba, president of Ontario Association of Optometrists (OAO) said the last minute offer from the Ontario government of $39 million and a couple of other concessions was too little and does not address requirements to move forward.

Across Ontario, Salaba said about 70 per cent of all optometry patients are covered under OHIP, and Dr. Liana Cooper, a Lindsay optometrist, estimated previously to the Advocate that this number is likely larger, here, due to the higher concentration of seniors.

Ontario optometrists do about four million OHIP-insured eye exams a year, and OHIP currently pays an average of $44.65 per 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. The Health Insurance Act, signed into law in 1990, prevents optometrists from accepting outside payment or alternate health insurance for any patient covered by OHIP, therefore making it illegal not to pay out of their own pockets. There is also no formal negotiation process allowing optometrists to sit down and speak about their issues, despite the fact other health care professionals have this.

On Aug. 23, Health Minister Christine Elliott sent out and tweeted a letter to optometrists, which included an offer of an immediate compensation increase of 8.48 per cent at the fee code level for expenses retroactive to April 1, 2021, and a one-time retroactive payment of $39-million to cover periods over the past decade. She also committed to establish a working group with the OAO and ensure ongoing monthly discussions. The letter also said the one-time payment will be distributed regardless of OAO’s response.

Salaba told the Advocate there were two things wrong with this letter. One is her publicly tweeting it. “We’re concerned that Christine Elliott tweeted all of the details of what they proposed during a confidential closed mediation process. That wasn’t following the rules of engagement,” he said. “I think doing so was a posturing to get some information into the media to try and defend themselves.”

The second problem, says Salaba, was the actual deal offered. “The offer is void of any formal detail, mechanism or commitment to making long-lasting change. It shows that the government is not listening and is simply trying to make this issue go away.” Not only that, he said the one-time payment of $39-million sounds like a lot of money at first glance, but “we provided about 40 million eye exams over the last decade, so it amounts to less than a dollar per eye exam that we’ve performed over that time” and the proposed 8.48 per cent funding increase does not come close to reaching the current cost of delivery.

Salaba said optometrists don’t want to worry about what’s happened in the past. “We’re not interested in a retroactive payment, because we want to make sure these services are adequately funded so we can build a sustainable eye care system in this province for the future.” He hopes the government will return to the table. In the meantime, OHIP insured eye exams have stopped until further notice across the province.

Leave a Reply

Your email address will not be published.