Health advocates say more patients in Waterloo region being charged out of pocket for cataract surgery

David Edwards of Cambridge, Ont., says he and his wife, Dorothy Schultz, felt pressure to pay thousands of dollars for cataract surgery at a for-profit clinic after they were told it would take a long time to get the same surgery at a hospital.

Edwards says their optometrist said it would take three years if they waited to have the surgery done at the hospital.

The private clinic in Brampton they went to also advised them that getting the surgery at a hospital could be anywhere between three and five years, he said during a news conference Tuesday.

But Edwards said they didn't feel they could wait that long.

"By 2018, her vision was impaired enough to raise concerns for both of us and our optometrists recommended a for-profit eye clinic that he considered the best in their field for cataract surgery," he said.

Edwards said the clinic's services were not covered by OHIP because they were getting "faster and a better surgery than at the hospital."

In the end, they paid $554 for eye measurements and $1,400 per eye for the surgery.

He said they found out afterwards the wait time for the surgery may not have been as long as they were told.

"After COVID, my wife got a hip replacement at Cambridge Memorial Hospital and we were talking with the nurses there and the doctors and we mentioned not getting cataracts surgery at the hospital because of the five year waiting period and they told us the longest waiting period they would have would have been six months and more likely three months for that surgery," he said.

Edwards's experience was among 18 in-depth case studies and 231 survey responses from patients across Ontario that were part of a report released by the Ontario Health Coalition on Tuesday.

The report showed more patients are being charged out of pocket for cataract services and surgeries at for-profit clinics.

The province wants to expand for-profit clinics and allow them to do surgeries like hips and knees in a effort to reduce wait times across the province. 

Many of the patient testimonies included in the report described similar stories to Edwards — people said they were referred to a private clinic by their physician or optometrists after being told they would have to wait years to get the surgery if they went to the hospital to get it done.

Others said they felt like they had information withheld by the clinics and charged for unnecessary add-ons, like upgraded lenses.

Will for-profit clinics help reduce wait times?

Jim Stewart, who's with the Waterloo region chapter of the Ontario Health Coalition, said cataract surgery is covered by OHIP and the report demonstrates there is two-tier medicine in the province and it's impacting patients.

"It's a real big problem because it really counters what public health care is all about. It's about compassionate care and about triaging people based on need, not their ability to pay," he said.

"Our publicly funded health-care system in Ontario is being transitioned from something we cherish into a U.S.-style for-profit health care system that will just expand as we move into knees and hips, up to obstetrics and other diagnostic tests."

He said expanding for-profit clinics in the province will not reduce wait time for patients. 

"We only have so many doctors, so many nurses and so many technicians and as those people are moved from public healthcare because they're overworked and underpaid ... and they moved into private care, they're not replaced," he said.

Stewart worries more patients will be impacted as the province moves to add hip and knee surgeries to private clinics. 

Ontario Health Minister Sylvia Jones responded to the coalition's concern about patients being up-sold for those services.

"We're talking about a group that's ideologically opposed to any innovation and any changes in the health-care system," she told CBC News.

Stewart said there needs to be accountability across the spectrum of health-care delivery, including doctors and optometrists.

"Our physicians should be aware of the actual wait times."