Thousands without provincially insured eye care in Ontario after optometrists withdrew services

Ontario optometrists withdrew OHIP-covered services after talks with the province over funding the procedures broke down.JOERG SARBACH/Associated Press

Ontario optometrists say they will continue to suspend services covered by provincial health insurance until the government agrees to nearly double the current level of funding to cover what they say is the true cost of service.

The Ontario Association of Optometrists estimates that approximately 15,000 people will be affected each weekday by the strike and that it will delay 2,000 cataract referrals to ophthalmologists each week.

“The longer this goes on, the more impact it will have on a lot of people,” said Dr. Sheldon Salaba, president of the Ontario Association of Optometrists.

The group withdrew OHIP-covered services on Wednesday after talks with the province over funding the proceedings broke down.

Ontario optometrists set to withdraw provincially covered services on Wednesday

Currently, OHIP pays for eye exams for people 19 and younger, people 65 and older, and people with specific medical conditions, such as diabetes, glaucoma, and macular degeneration, at about $45. by examination. But the true cost of an exam is $80, and government funding needs to reach that level, says Dr. Salaba.

The province offered to increase reimbursements by 8.48% and also offered the Ontario Association of Optometrists a one-time payment of $39 million to retroactively account for the increased cost of services. But the OAO says that’s not enough to make eye care sustainable for optometrists who cover the costs out of pocket.

The government’s offer is “fair and reasonable,” Christine Elliott, Ontario’s health minister, said in a statement released earlier this week.

“My goal remains to arrive at a solution that would help the province’s 2,500 optometrists provide high quality patient care now and in the future. Our government’s offer is extremely fair and reasonable, and I urge the OAO to stop denying patient care and commit to reaching an agreement today,” she said.

While physicians in Ontario regularly negotiate their fees with the government, optometrists do not have mechanisms included in their bylaws that require such routine negotiations.

The dispute has long matured. Last year, the OAO encouraged its members to refer patients to hospitals and emergency rooms in a lobbying action to address its claims of decades of underfunding. In March of this year, when the province announced no new funding for optometry in its budget, 96% of OAO members voted to withdraw OHIP services effective September 1, unless that the government does not agree to legally binding negotiations to fund all services. cost of providing OHIP-funded services.

Patients caught in the middle of the dispute hope for a quick resolution.

Stephanie Mann was planning to take her three children, aged 6, 16 and 17, for check-ups this month, as she does every year, but their appointments were canceled by the optometrist.

“It’s all part of back to school, haircuts, eye doctor and school errands,” said Ms. Mann, administrative assistant in Fort Frances, Ont. “It’s heartbreaking to know that my kids might have something wrong. What if their eyes are worse and I can’t get them tested? They’re playing sports. They’re at school. They’re watching the smart boards. What long-term effects do they have if they don’t have their vision corrected now?”

Ms Mann is also worried about her husband, who has eye exams every six months to test for any complications from his diabetes. One of these biannual meetings usually takes place in October.

“It’s a service that’s essential,” Ms. Mann said. “I think the government needs to look carefully at where its priorities lie.”

Patients who had appointments made on or after Sept. 1 are placed on a waiting list, and optometrists will help anyone in need of emergency care navigate the system, Dr. Salaba says.

“We don’t want anyone to be hurt by this,” he said.

Brooke Wilson, who usually takes her two children for their annual eye exams in September, worries about a backlog of appointments created by each passing day of professional action.

“Now it’s going to be on hold for how long?” said Wilson, a teacher in Sweaburg, Ont. “It’s frustrating too. When you have children who need this eye care. They are already struggling with what they have been through with COVID and going back to school. It would be nice to know that they can see well.

Although the Ontario Ministry of Health said its offer was fair and reasonable, particularly in what Ms Elliott called “today’s very constrained fiscal environment”, Dr Salaba says the Ontario optometrists receive the least funding of all provinces with funded optometry services.

For example, optometrists in Ontario are reimbursed $47 for an eye exam for seniors. In Manitoba, it’s $77. In Alberta, it’s $137.

“We are asking the government not to make us the lowest paid insured services in the country,” Dr Salaba said. “Eye care is broken in this province and we need to fix it.”

He said the withdrawal of services will continue until the government agrees to pay the amount it costs to provide OHIP-covered eye exam services.

“That’s what it will take. Otherwise, it will go on forever,” he said.

Our Morning Update and Evening Update newsletters are compiled by Globe editors, giving you a concise summary of the day’s most important headlines. register today.