Doug Ford’s fibs on cataract surgery

Premier Doug Ford claims that patients in Ontario will pay “with their OHIP card, never their credit card,” for the surgeries that he is moving from public hospitals to private clinics. Ford claims that will take pressure off the public system, and that private clinics work more efficiently. He says he will start by transferring surgeries for hips, knees, and cataracts to the private sector. I have some recent experience with cataracts which convinces me that once again, Doug Ford is misleading us.

Cataracts

I noticed for some time that I was having a more difficulty in reading. Eventually, I could make out the larger headlines in newspapers and magazines but not the print in the body of the stories. I was also having trouble seeing highway signs in time to make decisions while driving.

I was told by an optometrist that I had cataracts. With a cataract, the eye’s natural lens becomes cloudy and causes things to look blurry and fuzzy. During surgery, the cloudy natural lens is removed and replaced with a clear artificial intraocular lens. 

The clinic

The optometrist said he would refer me to a surgeon and not long after I found myself at an eye clinic in a newer office building in Ottawa for a consultation.  After undergoing some measurements and tests on my eyes, I was directed to a waiting room prior to seeing a surgeon.   

The room contained a large television screen displaying slick videos saying that the clinic could provide guided laser surgery. It was described as superior to cataract surgeries that doctors have performed manually over the years. The video and the pamphlets that I found also praised what were described as premium lenses.   

Candidate for surgery

When the young surgeon called me in, she reviewed the measurements and images that had been provided to her. I did have cataracts on both eyes, she said, and I was a candidate for surgery which could be done right at their clinic. She then ran through a variety of options. I could have laser surgery rather than the traditional surgery, where the surgeon removes the cataract using forceps or a sharp blade. She also said that the clinic could provide me with premium lenses.

Normally the intraocular lenses provided under the Ontario Health Insurance Plan (OHIP), provide a clear focus for distant vision, but you will need glasses for reading and probably for using your computer. The surgeon told me that the premium lenses would likely allow me to see well without eyeglasses.

Refractive consultant

The surgeon said that I should think about it and make a follow up appointment for more measurements. She then walked me down the hall to meet with someone called a refractive consultant. That person outlined the options provided by the clinic and their costs. Those ranged from $4,500 to $9,500 depending upon my choice for surgery (manual or laser), and upon what lenses I wanted to have.

The consultant gave me some literature and told me that I could inform the clinic of my preferred choices during my follow up appointment. I had not expected any of this when referred to a clinic by my optometrist. I thought I was going to see someone to arrange for surgery in a hospital with the costs covered by OHIP. Now I was being steered toward laser surgery and ridiculously expensive lenses.

Follow up research

In the following days I did some reading and research. I also talked to my wife and a variety of friends and acquaintances who had received cataract surgery. Without exception, everyone said their surgeries, performed in a public hospital and paid for under OHIP, had gone well and they were satisfied with the results. They continued to wear glasses for reading and close-up work, but I noticed in the clinic’s literature was careful not to guarantee that more expensive surgery and lenses would allow the client to do without glasses.

Follow up questions

When I next met the surgeon, I had a short list of questions. Did she perform cataract surgery in a hospital setting under OHIP if that was my preference? She did. Was she confident that she could perform the surgery successfully in the traditional manual way rather than its being laser guided? Yes, she was confident. Were the lenses paid for under OHIP good lenses? They were. But what about glasses, she asked? Did I want to continue wearing glasses? I said that was fine with me.

Surgery went well

That ended our brief, but pleasant conversation. She told me that they would set up a surgery date for one eye with a second to follow. When I did have surgery at the Eye Institute at an Ottawa hospital, it went well. My distance vision is fine and colours are deeper and more vivid than they had been in a long while. I have a new prescription for my glasses, and I can easily read the fine print in a newspaper or on my computer screen once again.

Ford’s fibs

But let’s get back to Premier Ford. What of his claim about never having to take out your credit card when undergoing surgery in a private clinic? Hardly. If I had not insisted on having my surgery in a public hospital, I would have racked up $10,000 on my credit card.  

The Toronto Star reports that 50 per cent of patients at one clinic surveyed opted for the more expensive lenses. Why? Perhaps they did not know about the OHIP option. In my first visit to the clinic, there was no mention of simply using the surgical option covered by OHIP. Or, it may be out of fear, induced in the private clinics, that the lenses available under OHIP are second best or even inadequate. You might call it upselling in what has become a medical marketplace.

The same story in the Star said that Ontario’s auditor general reported in 2021 about complaints from patients “being charged after receiving a publicly funded cataract surgery because they were misinformed of their right to receive standard surgery, free of charge through OHIP, without any add-ons.”

Fact checking Ford       

To those critics who said that moving surgeries to private clinics would mean beggaring the public system, the premier claimed surgeons would perform additional surgeries in their spare time. I did not get that impression. Surgeons are already busy people. There were about four other patients in the pre-op room when I had my surgery and there were more arriving as I had my orange juice and cookies before leaving. I doubt whether my surgeon would work in the hospital all day and in the private clinic only at night and on weekends.

The premier has said on various occasions that the private sector is more efficient than the public. The staff in the hospital that I visited appeared efficient to me. I also assume that the doctor who performed my surgery is equally efficient wherever she works.

Firing line

There is a sequel to this. I do not know why my optometrist referred me to a private clinic, but I have since dumped him. Who knows? Ontario voters may do the same to Premier Ford next time around.