quebec to force optometrists to stay in ramq
the association des optométristes du québec plans to challenge the government's ministerial order.
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a day before the majority of quebec optometrists were to withdraw from the province’s public health plan, the government announced it will force them to stay. a ministerial decree will ensure that quebecers who benefit from ramq-covered optometry services — children, those above the age of 65 and low-income people — will not be affected by contract negotiations between the government and optometrists, health minister christian dubé said in a post on x on wednesday.
“while waiting for the discussions to end, children and the elderly should not bear the brunt of the negotiations,” he said. “services must be offered to vulnerable patients during negotiations. now, negotiations must take place at the tables. the priority is to offer quality services to the population.”
the decree will be in effect for six months and will be renewable twice for a period of up to 18 months, dubé’s office said.
stalled contract negotiations led nearly 90 per cent of the association des optométristes du québec’s 1,500-person membership to announce last month their intention to leave the plan as of thursday. at the time, dubé described the decision as a pressure tactic, stressing there was still time to reach an agreement. the aoq decried the fact that contract negotiations that first began in 2020 had arrived at an impasse.
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on wednesday, the association said it plans to challenge the decree, noting members are entitled to leave the public plan if they so choose.
“since every professional has the legal right not to participate in the public plan, we greatly deplore the government’s attitude,” aoq president guillaume fortin said in a statement. “negotiations have been at a standstill for nearly five years. we are dismayed by this authoritarian approach, as we have been waiting for a reasonable offer for years now.”
the contract involves the fees and conditions of optometrists’ participation in ramq.
“our operating costs have risen three times faster than the government’s fees for services, such that our compensation per ramq patient visit is now only $3.50,” fortin said, echoing a similar statement from last month. “the affected groups make up 55 per cent of optometrists’ patients, and that proportion is growing.”
the ordre des optométristes du québec, meanwhile, said on wednesday it’s following this latest development but so far has no comment. last month, it noted that according to quebec’s health insurance act, optometrists can use various means to “assert their positions within the framework” of a negotiation. the act also allows them to choose not to participate in ramq.
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“government authorities have different means of intervention in this regard,” the order said at the time.
patients’ rights advocate paul brunet of the conseil pour la protection des malade — who last month filed a complaint with the order over the aoq’s plans to withdraw from ramq — said on wednesday he supports the government decree.
“we support the optometrists with the kind of requests they make; i think that they deserve better,” brunet said. “but at the end of the day … we are going to fight for patients and for access to health care, which includes optometrists.”
brunet noted that the present case jeopardizes access to care for hundreds of thousands of patients, most of whom don’t have the means to pay for optometry services.
“so to us, it was a breach in access, even though we support the optometrists’ association,” he said.
brunet added that the complaint to the order didn’t meet the criteria to be studied on the grounds that the body typically handles complaints about individual optometrists rather than collective situations.
“we’ve made a complaint that was rejected, and now we will, of course, support the government with its decree,” he said.
the association admitted wednesday the decision to leave ramq is in protest of the “stalemate in negotiations” on fees between itself and the health ministry.
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“we are asking for reasonable and fair treatment so that we can continue to play our role throughout quebec and help to relieve congestion in the system, not least by treating some 180,000 eye emergencies every year,” fortin said.
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