Thanks to several visionary leaders in Congress and the AOA's relentless lobbying efforts, the 2010 health care law is making healthy vision for America's children a new national health care priority. The legislation specifically recognizes pediatric vision care as essential and requires that health plans cover it starting in 2014.
This means that millions more children who now lack health insurance or whose families struggle with plans with insufficient or segmented benefits will soon be closer than ever to having a range of vision problems diagnosed and treated by their local optometrist.
Throughout the Washington, D.C., battles over health care, the AOA's mission has been to expand patient access to optometric care. We have fought to gain and to hold our profession's seat at the table whenever and wherever health care policy issues are decided. From my trips to the nation's capital for meetings at the White House, the Capitol and the Department of Health and Human Services, I've seen our hard work make the difference.
In fact, the bill that became law two years ago not only makes pediatric vision care essential in health plans, but also includes AOA-backed provisions telling insurers that they can no longer discriminate against us or confuse our patients by covering vision but not all of the medical services we provide.
The battles rage on though, and it will take a Supreme Court decision later this year to begin to cut through some of the uncertainties. No matter what happens, we will need to be vigilant and prepared to do whatever it takes to again defeat organized medicine and insurers who continue their scheming to undo every one of our gains.
As AOA president, I'm committed to ensuring that neither medicine nor insurers gain the ability to define optometry. Medicine continues to try to tell us and our patients what we are not, while insurers seek to use reimbursement to tell us how and when to provide care. The former is overt and the latter more covert, but both are equally dangerous to our profession.
That is why we must take a stand when health plans try to impose artificial and anti-patient restrictions on our services. This includes the stand-alone plans whose outdated business models result in the isolation of the profession of optometry from the rest of health care, as if somehow vision care must always "stand alone" from primary health care.
Under the new pediatric vision essential benefit, which should be based on a comprehensive eye exam and all necessary follow-up care, the law is aimed at allowing O.D.s to provide our full range of eye health care services while stopping insurers from limiting us to only vision care. This is an important new recognition in Federal law of full-scope optometric eye health care, included to assure the seamless delivery of care for millions of our newest patients as well as to deliver opportunities for optometrists to become providers on the medical plans' health panel.
I still do hear from insurance executives who, while claiming to have our best interests in mind, want a special loophole that would allow them to go back to segregating optometry from the mainstream of health care, requiring us to refer patients when medical eye care is needed. I've let them know that preserving forever a very broken status quo may be very good for their corporate bottom line, but it won't be good for our patients or our practices.
Although there are many uncertainties in the era of health care reform, the integration of vision and eye health care coverage for currently uninsured and under-insured children is a certain step toward expanded access to the full range of care that we provide. It's an advancement that builds on decades of our access and scope of practice gains, and the hard work and visionary thinking of optometric leaders from every state that have made them a reality.
Let's continue looking ahead and continue doing everything necessary to ensure that only optometrists define optometry. For more information on what you can do to help advance our profession, please don't hesitate to contact me or the AOA's Washington, D.C., office.
--Dori M. Carlson, O.D.
President, American Optometric Association
Carlson, Dori M.
Source Citation
Carlson, Dori M. "AOA: optometry should be defined by optometrists." Review of Optometry 15 Feb. 2012: 22+. Health Reference Center Academic. Web. 26 Mar. 2012.
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