Canada

New research finds that access to the surgery has increased since an Ontario government funding change — “but only for one group”

A new study adds weight to such suspicions. Analyzing six years of patient data, it has found that a disproportionate number of surgeries performed by private clinics since the province’s new funding allocation have gone to the wealthiest Ontarians.

“You can’t actually charge patients for cataract surgery, because of OHIP,” says Campbell. “But [these clinics] would have OHIP pay for the cataract surgeries and charge patients for other services in a way that would cover their costs and left a profit.”

“What we did is divide people into five different strata by socioeconomic status and compare their rates of surgery before and after this policy change,” Campbell says. “To put it bluntly, access did go up, but only for one group — and that was the group that could afford to pay extra.” In fact, the team found that surgeries for those in the highest socioeconomic strata went up by nearly 25 per cent in private clinics. For those in the lowest, however, they fell by 8.5 per cent.

While it is difficult to say what precisely is driving this change, Campbell says it likely comes down to two major factors. “The first is the continued request for payment from patients who are seeking care in private centres … The second is these clinics keeping separate wait-lists for people who are willing to pay extra versus those who aren’t,” he says. “That allows them to sell, essentially, the ability to jump the line. Extra lenses and whatnot might have some value to them, but the real value is in jumping what is perceived as a really long queue.”

“The whole thing was equal parts unnerving and a miracle,” he says. “The most terrifying thing was seeing them interacting with 80-year-olds who were confused, worried, and just wanted their vision back so they could see their grandkids. These people were accepting those fees left and right.”