As a trained optometrist, sister of a practicing optometrist, wife of a practicing ophthalmologist, and niece of a retired optometry professor, I am in the uncomfortable position of also representing constituents as the Member of Provincial Parliament during the Ontario Government’s contract negotiations with the Ontario Association of Optometrists (“OAO”).
Year after year, optometrists have delivered quality eyecare services. Unfortunately, governments of all political stripes have chosen to ignore efforts to ensure that eyecare services remain sustainable.
Over the past three decades, optometrists have seen only a 4 per cent fee increase - even though the profession has expanded to include far more medical diagnoses and treatments. The cost of equipment is also significantly higher than other medical specialties.
If we factor in the increased time, liability, staffing costs, and inflation, optometry practices have actually seen their operating fees decrease substantially. Optometrists across Ontario have been delivering OHIP-funded eye exams at a loss - but they can’t do so indefinitely!
That’s why in 2020 the OAO hired an independent accounting firm to determine what a reasonable exam fee should be. Many optometry offices were analyzed, and the actual cost of delivering an eye exam was determined to be approximately $80 - in line with other provinces across the country.
The Ontario government was asked to participate in this independent study as part of the negotiation process - but the government declined.
Rather than collaborate with the OAO to negotiate a reasonable deal, the Ministry of Health opted to ignore this important file. So when the OAO was forced to take the dramatic step of announcing a withdrawal of government-funded services effective September 1st, government negotiators decided it was finally time to act. They proudly announced that they were “ready to negotiate in good faith”.
The OAO took them at their word and readied teams of paid lawyers and negotiators - but were dismayed when discussions began and the government was working with outdated data. When they finally thought proper negotiations were underway, the OAO was met with a blank screen for hour after hour. A few minutes before the end of the final day of negotiations, the optometrists were presented with a ‘take-it or leave-it offer, which the government presented publicly, breaking the confidentiality agreement they implemented as part of the negotiation process.
Clearly, the government was unprepared for the negotiations, even though two members of the government’s caucus are optometrists. Instead, the Ministry of Health tried to force the OAO into accepting an unsustainable offer - and the heavy-handed tactics haven’t stopped there.
Optometrists have been told they can face thousands of dollars in fines if they decide to bill a patient directly for eye exams at full price - instead of billing the government for less than half of what the service costs to deliver. The optometrists feel as though they are backed into a corner: they cannot charge their patients, nor can they continue providing services under the government's fee structure.
Optometrists have repeatedly offered assurances that they are willing to come back to the negotiating table - but not without assurances that the process will address their costs.
I have repeatedly suggested the Ontario government implement an incremental yearly increase until Ontario’s eye exam payments are in-line with the rest of Canada. I have also recommended implementing a fixed negotiating process to prevent similar problems from occurring in the future.
I will continue advocating for a sustainable eyecare model where optometrists, ophthalmologists and all other healthcare providers are appropriately funded and respected!
MPP Gila Martow
