On Wednesday evening California’s Governor Gavin Newsom vetoed Assembly Bill 2236, which would have allowed California optometrists to join colleagues across the country to perform advanced in-office procedures. The bill would have allowed various anterior segment laser procedures including glaucoma treatments, eyelid “lumps and bumps” removal and cornea crosslinking. All such in-office procedures are well within the skill set and training of our current students and faculty. Sadly the big losers are the people of CA, especially those that rely on MediCal. So few ophthalmologists accept MediCal that they are essentially denied access to care. Certainly optometrists would not gain financially from performing these procedures, but patients will continue to struggle with access to care, and optometrists throughout the state will continue to be frustrated while advocating for their patients. It is indeed a sad week for health care.
The Governor espouses a California system whereby everyone will have state sponsored health care. His veto is a further nail in the coffin of those principles. It will be impossible to provide universal access to eye care and vision health without optometrists being allowed to practice as the primary eye care clinician to the full potential of our training, working with our ophthalmology colleagues to deliver a full scope of care and universal access. In a recent article in the LA Times, George Skelton states simply:
“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.” He concluded, “I’m hoping they (the Governor’s experts) tell him it’s safe and sensible to allow optometrists to expand their practice and provide more patient access — so the state can start to do what it claims to be doing about universal healthcare.”
It is easy to be bitter, especially following the toxic, unnecessary rhetoric that preceded AB2236. It is inevitable that we question the so-called “checks and balances” of our democratic process, and the power of lobbying and finance within our democracy. But now is not the time. We need to regroup and thank the enormous effort of our colleagues at the California Optometric Association and the support of the American Optometric Association. Executive Director Kristine Schultz and her team, COA President Amanda Dexter and her board (including Dr. Moy) and the COA Legislative Committee, worked tirelessly. Thank you!
Many within our school community, especially our students, worked hard to educate lawmakers about optometry and the healthcare inequities in our state. We are ready to fight for our patients again, knowing that we will succeed in the end. Demographics dictate it, our patients need better access, and common sense will prevail. And maybe, just maybe, a future Governor will consider the dignity and needs of the people they govern, rather than a short-term, personal, political endgame.
John G. Flanagan,
Dean and Professor