An ongoing dispute between the Ontario government and Ontario optometrists has been causing a severe disruption in service for many patients.
The Ontario Association of Optometrists (OAO) says that the amount the Ontario Health Insurance Plan (OHIP) pays per insured patient does not come close to covering the optometrists’ costs. They say that the government has refused to negotiate and they have therefore stopped accepting OHIP-covered patients until the issue has been resolved.
People who are covered by OHIP for optometric care include children from newborns to 19 years old, seniors aged 65 years or older, and people who have diabetes or certain eye diseases. For these people, booking an appointment with an optometrist in Ontario is not possible at the moment.
Dr. Lorne Kay, an optometrist who has been serving the Elliot Lake community for many years and has recently relocated his practice to 30 Prince Edward Walk, explains the situation.
“I have practiced optometry in Ontario for almost 45 years and for half of that time, I received $39.15 for an eye exam. Every patient was covered,” he says. “The Ontario government then de-insured eye exams for adults 20-64 years old and changed the OHIP fee schedule to an average of $44.65 for an optometric eye exam. That was in 2008 and there has not been an increase since then.”
“The cost of running an optometric office has of course increased over the past 40 years and there has been no meaningful change in the OHIP coverage,” says Dr. Kay. “The amount paid by the Ontario government now covers just over half of the cost per patient. Optometrists, quite simply, lose money on every OHIP-insured patient that they see.”
The issue is definitely hitting home for many Elliot Lake residents.
According to Dr. Kay, the discrepancy between what the province covers and the actual costs to the optometrists is not sustainable. For communities like Elliot Lake with a large number of OHIP-covered patients including seniors and children, finding optometrists who can afford to operate under the current conditions will continue to be difficult.
“My practice in Elliot Lake is about 70 per cent seniors because this is a retirement community. I also see many young families with children and several middle-aged patients with diabetes,” says Dr. Kay. “Less than 20 per cent of my patients in Elliot Lake pay directly or through private insurance. The only reason I make a living practising optometry in Elliot Lake is that I keep my overhead costs far below the average. With my new office location, my overhead will be higher and that causes me some concern.”
“All Ontarians, whether currently covered for eye exams or not, should contact their MPP, the Minister of Health, and the Premier of Ontario to demand that the provincial government begin meaningful negotiations with the Ontario Association of Optometrists,” says Dr. Kay.
In the meantime, Dr. Kay says that OHIP-insured patients should contact their optometrists’ offices and ask to be placed on their waiting lists in order to reduce the wait time once the dispute has been resolved. Patients who are not covered by OHIP can still book appointments and see their optometrists as normal.
“Almost everyone in the province will benefit from the Ontario government properly funding eye care in the future, even if they are not covered now. That future is very much at risk,” says Dr. Kay.
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