The disproportionate fees for cataract surgery
Posted on July 17, 2011 in Health Delivery System
Source: Globe & Mail — Authors: Editorial
TheGlobeandMail.com – news/commentary/editorials
Published Friday, Jul. 15, 2011.
Cataract surgery and implanting a new lens used to take one hour to perform, almost a decade ago when British Columbia ophthalmologists were paid $533. Technological improvements mean the surgery can now be done in a fraction of that time – 15 minutes – yet the fee is unchanged.
When a surgery becomes quicker, less intense and safer, it’s fair to consider a fee reduction, especially in a publicly funded health-care system where value for money and sustainability are inextricably linked.
Should B.C. ophthalmologists be paid $28.17 a minute for cataract surgery, when orthopedic surgeons receive $4.89 for a hip replacement and a surgeon bills $5.49 per minute to remove an appendix?
This disparity is a familiar story across Canada. A Freedom of Information request revealed that eight of the 20 Ontario doctors who billed medicare more than $2-million each in the fiscal 2009-10 were ophthalmologists. In B.C., 13 ophthalmologists billed more than $1.5-million that year. (These numbers are not take-home pay, but billings to provincial health plans.)
The high billings are a side effect of the federal government’s $41-billion health accord, which expires in 2014 – the supposed fix for a generation. It sought to whittle down wait times in five areas, including cataract surgery.
B.C. and Ontario say they will seek fee reductions during negotiations with their medical associations. Ontario has obtained one fee decrease; a second (the ophthalmologists suggested it themselves) is to take effect in September. Though still too high – $491.05 for a cataract removal and lens implantation – the change is at least in the right direction.
Overpriced cataract surgery highlights why the fee-for-service system, where doctors are paid for each procedure they do, should be replaced with a mixed payment system. Since 1999, such a system has been in effect for some surgical groups in Quebec and has resulted in reductions in billable services, more time spent with patients and increased time for doctors to do administrative work and teaching.
At a time when Ontario’s Excellent Care for All Act is tying hospital chief executive salaries to quality of care, all provinces need to be rethinking how they pay for their medical services and how much is too much. They need to negotiate hard with their medical associations.
Though some fees will go up, others down and procedures may be dropped or added, what’s really needed is a new way to compensate doctors that is fair and equitable, and helps sustain the public health-care system for decades to come.
< http://www.theglobeandmail.com/news/opinions/editorials/the-disproportionate-fees-for-cataract-surgery/article2099212/ >
Tags: budget, Health, ideology
This entry was posted on Sunday, July 17th, 2011 at 6:49 pm and is filed under Health Delivery System. You can follow any responses to this entry through the RSS 2.0 feed. You can skip to the end and leave a response. Pinging is currently not allowed.
315 Responses to “The disproportionate fees for cataract surgery”
« Older Comments | Newer Comments »
Recent Comments
I would really like to appreciate the endeavors you cash in on written this article. I’m going for the similar best product from you finding out in the foreseeable future as well. Actually your creative writing abilities has urged me to begin my very own blog now. Genuinely the blogging is distributing its wings rapidly. Your write down is often a fine illustration showing it.
Surprisingly good post. I really found your primary webpage and additionally wanted to suggest that have essentially enjoyed searching your website blog posts. Whatever the case I’ll always be subscribing to your entire supply and I hope you jot down ever again soon!
Simply want to say your article is as amazing. The clarity in your post is just great and i can assume you’re an expert on this subject. Fine with your permission allow me to grab your feed to keep up to date with forthcoming post. Thanks a million and please keep up the gratifying work.
This is something that will need all of our combined efforts to address.
fantastic internet site, I could definitely go to your web page once more…acquired some really nice info.
It sounds like you’re creating problems yourself by defining this as such a comprehensive, almost unknowable problem. Isn’t that self-defeating?
I loved your idea there, I tell you blogs are so exciting sometimes like looking into people’s private life’s and work. Every new remark wonderful in its own right.
Hi there! I just wanted to ask if you ever have any trouble with hackers? My last blog (wordpress) was hacked and I ended up losing several weeks of hard work due to no back up. Do you have any solutions to protect against hackers?
Nevertheless, it’s all carried out with tongues rooted solidly in cheeks, and everybody has got nothing but absolutely love for their friendly neighborhood scapegoat. In reality, he is not merely a pushover. He is simply that extraordinary breed of person solid enough to take all that good natured ribbing for what it really is.
I found your blog through google and I must say, this is probably one of the best well prepared articles I have come across in a long time. I have bookmarked your site for more posts.
Thanks For This Blog, was added to my bookmarks.
Surprisingly good post. I really found your primary webpage and additionally wanted to suggest that have essentially enjoyed searching your website blog posts. Whatever the case I’ll always be subscribing to your entire supply and I hope you jot down ever again soon!
bonjour I love Your Blog can not say I come here often but im liking what i c so far….
I think that may be an interesting element, it made me assume a bit. Thanks for sparking my considering cap. On occasion I get so much in a rut that I simply really feel like a record.
Surprisingly good post. I really found your primary webpage and additionally wanted to suggest that have essentially enjoyed searching your website blog posts. Whatever the case I’ll always be subscribing to your entire supply and I hope you jot down ever again soon!
It’s time for communities to rally.
I would really like to appreciate the endeavors you cash in on written this article. I’m going for the similar best product from you finding out in the foreseeable future as well. Actually your creative writing abilities has urged me to begin my very own blog now. Genuinely the blogging is distributing its wings rapidly. Your write down is often a fine illustration showing it.
A colleague in the field told me to check out your website.
Aw, this was a very nice post. In idea I wish to put in writing like this moreover taking time and precise effort to make an excellent article! I procrastinate alot and by no means seem to get something done.
Assume you are doing good linking to position you on the first pages of search engines.