Those who rely on provincially covered eye care could soon find themselves left out in the cold the next time they need an eye exam.
A problem 30 years in the making is coming to a head on September 1, 2021, when optometrists across the province will stop administering any eye exams covered by the Ontario Health Insurance Plan (OHIP). Currently, OHIP covers exams for those 19 and younger, 65 and older and any adults in the province with specific medical problems.
According to the Ontario Association of Optometrists (OAO), after years of the government failing to increase OHIP payments for insurance-covered eye exams – the OAO currently lists the OHIP covered portion at 55 per cent, leaving the other 45 per cent to be covered by the individual optometrist – the majority of optometrists in the province voted to withdraw OHIP covered services in an attempt to bring the government to the bargaining table to increase the OHIP covered portion to at least cover the cost of delivery of those services.
In a press release from the OAO, the association noted that in 1989 OHIP covered $39.15 for an coverable eye exam. In 2021 that amount had increased to $44.65, which has led to an increasing amount of money coming out of optometrical practices to make up for what OHIP does not cover year over year. OAO president Dr. Sheldon Salaba said that the association has given the government plenty of notice to come to the table to prevent the Sept. 1 deadline coming to pass.
“Government neglect has jeopardized access to eye care for those who need it most, undervaluing the eye health of Ontarians,” Dr. Salaba said.
“Optometrists are being fair and reasonable: we ask only that government commit to cover at least the cost of service delivery, and we’re giving them lots of notice to avoid any impact on patients.”
The OAO also state that optometrists in Ontario have never been given a formal negotiation process with the government.
Dr. Bruce Lidkea is one of several optometrists working in Fort Frances. He said the decision to withdraw OHIP-covered services isn’t one that was made lightly, as that is access to “critical” eye-care that is being removed, but the government itself hasn’t kept up the investment in eye care to match pace with inflation.
“[The OHIP coverage] doesn’t come close to covering office expenses, such as staff, rent, utilities, equipment and supplies required to provide an eye exam,” Lidkea explained.
“With over four million services performed annually under OHIP this level of funding is just not sustainable. All we’re asking for is the government commit to a binding formal negotiation process, the same way that they do with other health care sectors like the Ontario Medical Association, to ensure quality eye care for everyone in Ontario today and in the future.”
There’s an inherent risk in stopping OHIP covered eye exams, as these are ways to catch serious eye-related conditions early, providing treatment or referrals to an opthamologist. Lidkea explained that for those outside the OHIP-covered age ranges, the program will cover conditions like glaucoma, cataracts or diabetes related conditions.
An additional wrinkle presents itself in the fact that it is currently illegal for optometrists to accept private insurance or direct payments for OHIP-covered exams, meaning there is no other way for those eye exams to get done should the withdrawal take place as planned.
“There is an enormous fine levied by the Ontario government to practitioners who do that,” Lidkea said.
“There will be no exams available for children, seniors or adults with vision-threatening conditions. In our region that will be especially devastating because of the fact that we do not have any ophthalmology in the region to help with emergency work that local optometrists do here.”
Lidkea went on to explain that one thing he’s noticed in the responses from the government so far relating to the issue, they provide information that the budget has gone up based on utilization. According to Lidkea, an aging population is driving those utilization numbers up naturally, which means that the budget isn’t keeping pace with what they’re asking for.
“Ontario’s aging population has placed an even bigger strain on the system that has failed to adapt,” he said.
“The shift in demographic reality is only going to persist for the foreseeable future, so more people are using optometry because more people are becoming seniors, that’s a larger group of the demographic.”
The OAO and Lidkea both encourage the public to email local MPPs and the Ford government as part of an online petition to let them know where they stand on the issue. A link to more information and a form letter for government officials can be found at www.saveeyecare.ca.
“Vision is our most important sense, and our political leaders must help us protect it,” Dr. Salaba said in a press release.
“After almost three years in office, it’s time for action from Premier Ford and Minister Elliott. They must ensure Ontarians continue to receive the quality eye care they depend on and deserve.”