Optometrists say they will withdraw OHIP-covered services starting Wednesday after talks break down with province

The Ontario Association of Optometrists (OAO) says it plans to move forward with a withdrawal of OHIP-covered eye exams on Wednesday after talks between the province's optometrists and the government broke down.

"One of the things that we want the government to commit to is to at minimum cover the operating costs for us to provide insured optometric eye exams in the province and the government staunchly refuses to do so," said Dr. Sheldon Salaba, president of the OAO, on Tuesday morning.

"And because of their refusal to do so, we remain at the bargaining table ready to sit down with them, but at this point in time, talks have broken down and it looks like tomorrow there is an impending service withdrawal," Salaba said. "You will see a withdrawal of routine eye exams for OHIP patients in all categories across the province."

"We're absolutely prepared to suspend the service withdrawal date as long as the government commits to pay the operating costs for the services," he added.

OHIP covers the cost of a yearly eye exam for Ontarians 19 or younger and 65 or older. It also covers an eye exam and follow-ups each year for Ontarians 20–64 if they have a medical condition like diabetes that affects their eyes.

Salaba said optometrists get around $45 for OHIP-covered eye exams, but that operating costs to deliver these services sit at around $80. This is where the OAO and the province don't see eye-t0-eye.

The government says it has offered the OAO an 8.48 per cent OHIP fee increase, retroactive to April 1, and a one-time payment of $39 million.

"Combined, this reflects a 'catch up' of fee increases similar to what Ontario’s doctors received over the past decade while the association was without an agreement. It also represents a significant and sustainable increase in today’s highly-constrained fiscal environment," wrote Health Minister Christine Elliott in an op-ed in the Toronto Sun on Aug. 30.

But Salaba said an increase of more than 70 per cent would be needed to cover operating costs and that the lump-sum payment would amount to about $1 for each of the 40 million or so eye exams done during the last decade.

"So there's still a massive shortfall," he said.

Salaba said while minor discussions took place in 2020, when the association didn't see any commitment to cover operating costs in this year's provincial budget, it put the government on notice with a Sept. 1 negotiating deadline.

Meanwhile, Salaba confirmed that the OAO is taking legal action against the government for "breach of confidentiality" after Elliott publicly released a letter last week that included details of the government's offer.

Our gov't has put forward a fair and reasonable offer that includes immediate funding increases and a third-party process to determine future fee increases.

Despite the disappointing OAO response, we intend to distribute $39M regardless to optometrists directly, as a start.

— Christine Elliott (@celliottability) August 23, 2021

"The government provided an offer, that offer was provided in confidential mediation process, so we were shocked the government broke confidentiality and tweeted it last Monday," Salaba said.

Asked about any plans to update its offer, the Ministry of Health pointed to Elliott's op-ed.

"We have put forward a fair and reasonable proposal that is designed to take immediate action to address years of neglect and represents a 'good start' proposal for continued discussions," Elliott wrote, noting that she's aware the association would like to "immediately see further increases."

"But consideration of these complex issues and expensive demands, especially when taxpayers foot the bill, requires homework," she said. "That is why as part of our offer we have proposed to immediately set up a joint working group, to understand these and other issues as quickly as possible."

But Salaba blamed the government for waiting "till the eleventh hour."

"Why didn't they pick up the phone earlier on in the year and initiate the discussion so we didn't have to be sitting here today on the service withdrawal that's going to impact our most vulnerable patients?"

Elliott added that she was "disappointed to learn this past Saturday that the association declined the opportunity to proceed with further mediation." She also raised concerns about optometrists redirecting patients to emergency departments, especially as COVID-19 cases and hospitalizations climb.

Salaba said the association was prepared to continue with mediation if the government "recogniz(ed) that they need to cover these operating costs."

"We stand ready to get back to the table with them in the next hour if they will commit to those terms, and we can avert this crisis, absolutely," he said.

Asked about his message to patients who are concerned about the withdrawal, Salaba said he understands why people might be feeling anxious.

"We're regretful that it has come to this," he said. "I think people should expect to experience delays in routine care. If somebody is having a problem that is an emergency, we obviously want them to contact us and we are going to listen to what their problem is and help them navigate the system in the most appropriate manner depending on what's happening to them."

Photo credits: Andrew Francis Wallace/Toronto Star; Ontario Association of Optometrists