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.
Recent Comments
You write Formidable articles, keep up good work.
Took me time to read all the comments, but I really enjoyed the article. It proved to be Very helpful to me and I am sure to all the commenters here It’s always nice when you can not only be informed, but also entertained I’m sure you had fun writing this article.
Took me time to read the material, but I truly loved the article. It turned out to be very useful to me.
My coder is trying to convince me to move to .net from PHP. I have always disliked the idea because of the expenses. But he’s tryiong none the less. I’ve been using WordPress on numerous websites for about a year and am nervous about switching to another platform. I have heard great things about blogengine.net. Is there a way I can import all my wordpress posts into it? Any help would be really appreciated!
It is perfect time to make some plans for the future and it is time to be happy. I’ve read this post and if I could I want to suggest you some interesting things or suggestions. Perhaps you can write next articles referring to this article. I wish to read more things about it!
I do believe your audience could very well want a good deal more stories like this carry on the excellent hard work.
Woh I enjoy your content , saved to bookmarks!
Dude.. I am not much into reading, but somehow I got to read lots of articles on your blog. Its amazing how interesting it is for me to visit you very often. –
While this issue can vexed most people, my thought is that there has to be a middle or common ground that we all can find. I do value that you’ve added pertinent and sound commentary here though. Thank you!
Oh my goodness! an amazing article. Great work.
Good day! This is my first comment here so I just wanted to give a quick shout out and say I really enjoy reading through your articles. Can you recommend any other blogs/websites/forums that cover the same subjects? Thanks a lot!
Wish I’d thought of this. Am in the field, but I procrastinate alot and haven’t written as much as I’d like. Thanks.