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
Assume you are doing good linking to position you on the first pages of search engines.
I dont think I’ve read anything like this before. So good to find somebody with some original thoughts on this subject. cheers for starting this up. This blog is something that is needed on the web, someone with a little originality.
Hi, I just hopped over to your web-site through StumbleUpon. Not somthing I might typically browse, but I liked your views none the less. Thanks for making something worthy of reading through.
I was referred to this web site by my cousin. I’m not sure who has written this post, but you’ve really identified my problem. You’re wonderful! Thanks!
You are good writer. Thank you.
Unquestionably believe that which you said. Your favorite reason seemed to be on the net the easiest thing to be aware of. I say to you, I certainly get annoyed while people consider worries that they plainly don’t know about. You managed to hit the nail on the head. Will probably be back to get more. Thanks
Advanced reading here!
This is something that will need all of our combined efforts to address.
We’re developing a conference, and it looks like you would be a great speaker.
I love your blog. It looks every informative.
You need to really control the comments listed here
Well, I don’t know if that’s going to work for me, but definitely worked for you! 🙂 Excellent post!
A thoughtful insight and ideas I will use on my blog. You’ve obviously spent some time on this. Congratulations
A friend of mine advised me to review this site. And yes. it has some useful pieces of info and I enjoyed reading it.
Like the way you’ve outlined things. Easy to follow. Not cluttered.
Woah this is just an insane amount of information, must of taken ages to compile so thanx so much for just sharing it with all of us. If your ever in any need of related information, just check out my own site!
How long does it take you to write an article like this?
Nice post.Very useful info specifically the last part 🙂 Thank you and good luck.
Thanks pertaining to discussing the following superb written content on your site. I ran into it on the search engines. I will check back again if you publish extra aricles.
I discovered your weblog site on google and verify just a few of your early posts. Proceed to maintain up the very good operate. I simply further up your RSS feed to my MSN News Reader.