On Shaman's Rock

We live in a world of negotiations. When you need a new auto, house or a better TV service you negotiate an agreement.

The purpose of negotiations is to reach an agreement that benefits both parties. In the case of an auto, the buyer wants the best product at the best price. The dealer seeks a sale that will sustain his or her business.

Then there are negotiations in which two parties negotiate for agreements that can help or hurt third parties who are not even part of the negotiations.

That’s what’s happening in Ontario between the Ford government and the province’s optometrists. Except there are no negotiations and thousands of third parties are hurting.

Optometrists withdrew services Sept. 1 for patients covered under the Ontario Hospital Insurance Plan (OHIP). OHIP funds eye exams of people 65 and older, children and teens and people with special conditions such as glaucoma and macular degeneration.

The Ontario government has underfunded eye exams for OHIP patients for decades. In 1989 it paid $39.15 for an OHIP eye exam. Today, 32 years later, it pays $44, an increase of less than $5 over three decades.

The Ontario Association of Optometrists (OAO) says that an independent accounting study found that the average cost of providing an eye exam now is $75.51 because of increases in rent, real estate, support staff salaries and more advanced and expensive diagnostic equipment.

The Ford government readily admits there has been underfunding and has offered a one-time $39-million payment to help alleviate the underfunding. It also has proposed a funding increase of 8.49 per cent, which according to my math would provide just under $48 for an eye exam.

As is the case in many difficult negotiations, each side is accusing the other of not wanting to negotiate in good faith.

I don’t know who is doing what or not doing what in this fight. I do know that the health of thousands of seniors, children, teens and people with special conditions is at risk because they cannot see an optometrist. (They can’t even pay out of pocket because optometrists are not allowed to take money from OHIP patients).

Eye exams are important because they detect serious diseases. They are especially important for children and seniors.

A child might be struggling in school without realizing she cannot read the blackboard, computer screen or paperwork because she needs glasses. A senior notices vision is not as sharp as it once was and attributes it to old age. The lack of sharpness might be caused by eye disease such as glaucoma or macular degeneration, which can lead to blindness.

More than one million Canadians now live with vision loss, according to new research commissioned by optometrist, ophthalmological and vision care groups. That number is expected to double within the next 10 years.

Also, eight million Canadians are living with an eye disease that could make them blind. These are diseases in which regular eye examinations provide early diagnoses and treatments. 

Gila Martow, Progressive Conservative MPP for Thornhill riding, criticizes her own government’s proposed fee increase as “heavy-handed” and delivered with a “take it or leave it” attitude. 

She says she is uncomfortable breaking ranks because she is an optometrist, but did so to draw attention to the dispute that has left tens of thousands without eye care. 

Bravo to her for declaring her conflict of interest. Because I am reporting on this subject, I should declare my own.

I have sight in only one eye and three months ago was diagnosed with macular degeneration and glaucoma in the good eye. I haven’t been able to see an optometrist since then because of the funding dispute.

My personal situation and Ms. Martow’s conflict are of little consequence to anyone. The main focus in all this must be the children who need eye care to ensure they have all the advantages needed for a solid education.

This eye care funding dispute has gone on far too long without the public attention needed to push the parties into negotiating an agreement. We all need to start talking about this – among ourselves, to our politicians and to the media.

Only public pressure will get this resolved.