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OPINION: A vision policy designed to blind

"Beginning today, cataract patients will receive foldable intraocular lenses free of charge. Foldable monofocal lenses - rather than rigid lenses - are now the standard of care for cataract surgeries and will be provided by the health authority.

"Beginning today, cataract patients will receive foldable intraocular lenses free of charge. Foldable monofocal lenses - rather than rigid lenses - are now the standard of care for cataract surgeries and will be provided by the health authority."

Vancouver Coastal Health, June 4, 2012

YOU have to hand it to the provincial government: It knows a good idea when it sees one.

What I'm referring to is the annexation by the province of a strategy used in the airline industry: "Fly to London for only $195!"

The price sounds like a great deal until you discover that taxes, fees and return fares quadruple the price of the trip - and on El Cheapo Airlines to boot.

And so it is with the province's "free-of-charge" lenses for cataract patients.

In a media release issued early last month, Vancouver Coastal Health proudly announced it would now be providing foldable, monofocal lenses without charge to replace the clouded natural lenses inside a cataract sufferer's eyes. "Specialty" lenses, however, would still come at a price - a steep price.

In its statement, VCH implied that the higher-end lenses were unnecessary, an optional upgrade for patients who prefer them to the basic model, perhaps because they don't want to wear glasses. In reality, the announcement was simply the province's way of masking a hidden fee.

Very few people choose specialty lenses for reasons other than to see clearly for the tasks they need to perform - and they pay up to $2,500 out of pocket for the privilege.

I know this firsthand, because I underwent cataract surgery on one of my eyes in May. When I wrote a column on the subject less than a week after the procedure, I was ecstatic about post-surgery results.

I remain so today - so much so I cannot wait for the second eye to be corrected.

Am I enthusiastic about the changes in government policy? Not so much.

Prior to my first procedure, eye-surgeon Dr. Aron Goldberg and his technicians took care to discuss my eye structure and my lifestyle, because those factors would influence the decision as to which of the six types of replacement lenses I should choose.

The irregular, more challenging shape of that area of my eyes into which the lenses must be seated, my need to do close-up work at the computer, to see at distance for driving and to correct astigmatism for improved focusing, all were important considerations.

Not once during those discussions did I sense I was being 'up-sold' to buy a more expensive lens than was appropriate for my short and long-term needs. I still will need to wear glasses.

To imply that specialty lenses were an unnecessary upgrade over and above a foldable lenses would be like saying that walking shoes are an unnecessary upgrade if the government were prepared to pay for slippers. The financial implications of this wrongheadedness are significant.

The media release declares: "Patients who choose specialty lenses will have to pay only the cost difference between the price of the lenses they choose and the foldable monofocal lens."

Hah! Even my unbalanced eyes can detect a bamboozle.

Check my math: When I had the left eye corrected on May 16 - prior to the change in policy - the total cost was $1,000.00.

That included $950 for the replacement lens, and a charge for pre-operative biometric tests not covered by MSP - $50 to photograph the cornea and record the topography of the eye, so the surgeon has precise information about the structure he is working on.

Compare that total with the charges I face for the second eye, after the change in policy:

Instead of the $1,000 paid directly to the surgeon's office, I now must pay Vancouver

Coastal Health $387.60 and the surgeon $600; a total of $987.60.

The difference between my May and July surgeries after I have factored the not-fully-covered $50 biometry tests into the equation is $12.40 - about two visits to a coffee house.

So what of the cost of that basic monofocal lens?

Are we to believe the government has negotiated a bulk-purchase lens price of around $25? If it has, what is the quality?

This sounds like the type of misleading, creative-accounting spin Premier Christy Clark put abroad when she claimed bonuses for executives of Community Living B.C. were "gone" and when BC Hydro claims its liabilities are "deferred assets".

Can't I even have a quiet

cataract surgery without tripping over political doo-doo?

There is much more to be learned about this story than I have discovered to date - including information about how decisions regarding your medical care are being directed, and by whom.

For now, if the hundreds of communications personnel employed by Vancouver Coastal Health, CLBC, and other government offices are not being allowed to produce straightforward, apolitical announcements, then they need to blow the whistle or quit.

Taxpayer-patients can name dozens of places where they could put the dollars to better use.

We can deliver the pink slips to prevaricating politicians ourselves - at the ballot box next May.

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