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.
316 Responses to “The disproportionate fees for cataract surgery”
« Older Comments | Newer Comments »
Recent Comments
My brother suggested I might like this web site. He was entirely right. This post actually made my day. You can not imagine simply how much time I had spent for this info! Thanks!
Hi my family member! I want to say that this article is amazing, great written and include approximately all important infos. I’d like to see more posts like this .
This is really interesting, You’re a very skilled blogger. I have joined your feed and look forward to seeking more of your fantastic post. Also, I have shared your website in my social networks!
Some genuinely choice content on this site, bookmarked .
However, it is virtually all done with tongues rooted solidly in cheeks, and everyone has absolutely nothing but absolutely love for his or her friendly neighborhood scapegoat. The truth is, he is not just a pushover. He is basically that special variety of person strong enough to take all of that good natured ribbing for exactly what it is.
Awesome post. It’s so good to see someone taking the time to share this information
I really believe you will do well in the future I appreciate everything you have added to my knowledge base.
This overview was very well written, presenting the topic in a logical and well-organised manner. Highly recommend reading this to anyone with even a passing interest in the subject.
The sketch is tasteful, your authored material stylish.
What a great article.. i subscribed btw!
This blog post was truly outstanding, presenting the topic in a logical and well-organised manner. A well-deserved bookmark; I will be referring back to this more than once.
Buenas. jetx es real. 22Bet
I am very happy to look your post. Thanks a lot and i am taking a look ahead to touch you.
The sketch is tasteful, your authored material stylish.
Truly one of the most useful articles on this topic available online right now, the combination of expertise and clear communication makes it an invaluable resource for anyone interested.
Have you always been concerned about these issues?
Hello there! I really enjoy reading your blog! If you keep making amazing posts like this I will come back every day to keep reading.
Our community leaders need to read this, and look at developing some of your recommendations.
A thoughtful insight and ideas I will use on my blog. You’ve obviously spent some time on this. Congratulations
A well-researched and thoughtfully presented piece that earns the reader’s trust through its honesty, depth, and the obvious care that has gone into every aspect of its creation.