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Australian Optometry March 2005

KA puts case for higher contact lens rebates to Private Health funds

By Larry Kornhauser, P resident of Keratoconus Australia

Keratoconus Australia (KA) kicked off its campaign for higher rebates for gas permeable contact lenses at a meeting with the private health funds late last year. KA president Larry Kornhauser and secretary, Belinda Cerritelli, presented a submission in support of its case to the Ancillary Committee meeting of the major health funds held on December 8, 2004 in Sydney. The submission explained what keratoconus is, why gas permeable lenses are so important to keratoconus patients and how the current high cost and low rebates  on these lenses discriminate against people with keratoconus. It also contained results of a survey conducted by KA, which showed almost unanimous dissatisfaction with the current level of rebates on gas permeable lenses for keratoconus. The submission highlighted the perverse outcomes of this situation that can ultimately lead to higher economic and social costs for the patient, the public health system and the community at large when people are unable to pay for properly-fitted contact lenses. These were also explained in the articles published in the December 2004 issue of the Australian Optometry newsletter. The KA officers asked the health funds to consider reclassifying these lenses as a medical device and to raise benefits accordingly.

The health fundsí response to this submission was generally sympathetic and positive. However, the funds pointed out that by simply raising benefits, more inexperienced optometrists would be attracted to fitting these lenses  - increasing the risk to patients of being fitted with poorly-adapted lenses. They asked how a system could be devised for approving contact lens providers with the appropriate experience and qualifications to fit these specialized lenses. This is an issue that may need to be resolved by the Optometrist Association of Australia itself. Keratoconus Australia believes that such a system should be implemented and will now seek talks with the OAA to see how this can be progressed. The health funds also suggested KA seek greater financial support from the Federal government for disadvantaged people with keratoconus ≠ another avenue that will be pursued by the Association.

KA remains committed to achieving an outcome that gives people with keratoconus access to reasonably-priced gas permeable lenses fitted by optometrists experienced in fitting these specialized lenses. We hope to make further progress towards achieving this aim in 2005 ≠ preferably with the full support of the optometrists.

08 February 2005