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Talks fail; optometrists withdraw OHIP services

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As of Sept. 1, optometrists in Ontario no longer provide OHIP-covered services to patients.
The job action came as a result of failed discussions between the Ontario Association of Optometrists and the provincial Ministry of Health. The OAO seeks an increase in funding for OHIP-covered services. Sault optometrist Dr. Krista Bruni said insured eye exams in Ontario are funded at the lowest level of all Canadian provinces.
“Eye exams for seniors are funded at $47,” Bruni told Sault This Week. “The same service in the next lowest province is Manitoba which funds at $77; Quebec is next at $107. In order to reach the next lowest province, the government needs to commit to increase funding in Ontario by 70 per cent.”
The OAO has stated that under the current funding model, reimbursement runs about $35 short of covering an average eye exam, and the optometrists themselves pay for that difference.
The government offered the optometrists a $39-million one-time payment, amounting to approximately $16,000 for each of the province’s 2,500 optometrists. They also offered to increase the $45 provincial reimbursement to $49. The OAO declined the offer.
“The one-time payment amounts to about $1 for each of the 34 million eye exams done during the last decade,” said Bruni. “It leaves optometry services in this province funded at the lowest in the country and has the provider paying for people to access those services, and that impacts the quality of care that’s delivered.”
Bruni added, the OAO does not feel the one-time payment addresses the problems in eye care.
“We have been clear, the OAO is committed to finding a long-term sustainable solution that will ensure Ontario’s families have access to optometry services,” she said.
Ministry of Health only reached out to the optometrists to discuss the matter eight months after the OAO gave notice of its intentions, Bruni said.
“They have silently ignored our calls and proposals through the entire mandate until public pressure has forced them to consider addressing the issue at the eleventh hour,” she said. 
Health Minister Christine Elliott maintains the government is committed to ensuring Ontarians continue to have access to services.
“Our government has made every effort possible to lay the foundation for a long-term relationship with the Ontario Association of Optometrists,” Elliott said in a statement released by the Ministry on Sept. 1.
“This includes engaging a third-party mediator to assist us in reaching an agreement and offering a one-time lump sum payment as well as an immediate OHIP fee increase. This represents a significant and sustainable increase in today’s highly-constrained fiscal environment.”
The province is willing to return to mediation, but the OAO declined the mediator’s conditions, Elliot indicated. The OAO, meanwhile, says it is willing to return to discussions.
“The OAO remains ready and willing to engage in intensive mediation with the Ministry of Health once they are prepared to commit to the principle that Ontario’s optometrists should be compensated in line with optometrists who practice in other provinces with comparable publicly funded optometry systems, and, in any event, should receive compensation for providing OHIP insured services that is, at minimum, sufficient to cover the overhead and operating costs of delivering those services to the public,” said Bruni.
With the withdrawal of services, patients who are covered under OHIP will not be able to receive routine care.
“If a patient has an ocular emergency, the optometrist will ensure that the patient is referred to the appropriate provider for care,” said Bruni.
“I can say that all local optometrists in Sault Ste. Marie would much rather be taking care of patients than be involved in job action. However, in its current state, how the government funds eye care is not sustainable. We want to be able to continue to offer the same level of care that our patients expect and deserve.”

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