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Negotiations Fail: Optometrists to Withdraw from Public Plan on March 10 2018-02-07

After almost 50 years of participation in the public health plan, the Association of Optometrists of Quebec (AOQ) will withdraw from the Régie de l’assurance maladie du Québec (RAMQ) on March 10. Ninety per cent of Quebec optometrists voted to withdraw from the plan after negotiations on a new five-year pricing agreement with the Ministry of Health and Social Services (MSSS) broke down. The agreement defines the conditions under which optometrists participate in the public plan, which covers people under 18, those 65 and over, and income security providers.

"We will continue to serve the population covered by the public plan, but not at a loss, as is currently the case," said Dr. Steven Carrier, optometrist and president of the AOQ. "For 15 years, we have repeatedly asked for fair and equitable compensation and the government is turning a deaf ear. There is a general gloominess in the profession regarding the insufficient fees paid by the RAMQ: for example $12 for an eye emergency or $42 on average for an eye examination, versus $95 in the private sector, according to the tariff guide of the AOQ. Our patience is exhausted and a catch-up is essential, considering, moreover, that the population covered by the RAMQ represents more than 50 per cent of our patients, and that this proportion is growing because of the aging of the population."

Operating costs incurred by optometrists have increased at a rate three times greater than fee-for-service over the past 30 years (150 per cent vs. 56 per cent). The increases granted by the MSSS during this period averaged only 1.6 per cent annually, which is lower than the Consumer Price Index (CPI).

On December 12, the government submitted another offer which was below the CPI, which the AOQ termed “derisory”. Since that time, the AOQ says the government has only wanted to discuss “secondary issues”, while refusing to review its compensation offer. The association notes that the total annual remuneration of optometrists by the RAMQ is $56.5 million, which is only 0.15 per cent of the total MSSS budget. At a time when the government is announcing budget surpluses and numerous financial commitments, including a vision screening program for children entering school, the AOQ believes that it has the means to make the necessary recovery. 

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