Optometrists, ophthalmologists square off over bill to expand role of primary care eye doctors

There’s a nonsensical disconnect in California’s efforts to provide universal healthcare. There aren’t enough doctors willing to accept the state’s small fees for treating

low-income patients. So it’s universal healthcare in name only — despite Gov. Gavin Newsom’s repeated boasting about it — because millions of people are denied access to

preventative medicine or treatment of their ailments. Medi-Cal — California’s version of Medicaid for the poor — is an unfulfilled promise in too many cases. A third of

Californians, including 40% of the state’s children, are enrolled in Medi-Cal. But the reimbursement fees paid by the state to doctors are so low that most of them lose

money on each patient, they say. Those who do accept Medi-Cal patients make up for the loss by pulling in much higher fees from folks with private insurance. The Newsom

administration has started to negotiate provider contracts that require more patient access. But neither the governor nor the Legislature has been willing to spend the money

needed to raise provider fees to an acceptable level, despite a nearly $100-billion budget surplus this year. OK, that’s the overall big picture. There’s a

little-picture partial solution to the access dilemma on the governor’s desk — one of 680 legislative bills as of Wednesday that Newsom must sign or veto by Sept. 30. This

measure, AB 2236, concerns only vision care — but would affect millions of patients. It pits two quarreling families against each other: primary care eye doctors and eye

surgeons. The former are optometrists, the doctors you go to for an annual exam. The latter are ophthalmologists, the surgeons who remove cataracts, for example.