Mr Tan Siak Khian points out that policyholders must go to a doctor from an approved list laid out by the insurance company for the cap on insurance co-payment to kick in (List of insurer-approved doctors too restrictive, Feb 19).

He is concerned that the doctors he has already established a relationship with could drop off the list, and that he would have a difficult time looking for a new one. It makes matters worse that there is only one approved doctor in some specialities.

His concerns are valid. As an eye specialist in private practice for more than 20 years, I recently encountered the same problem.

Two longstanding patients who have been seeing me for well over 10 years have developed cataracts and require cataract surgery.

To their surprise, when they checked with their insurance companies about coverage for their cataract operations, they were told that the cost cannot be covered as I am not on either insurance company's panel of doctors.

My patients are left with no choice but to undergo the hassle of searching for a completely new eye doctor, whom they are not familiar with and who does not know the history of their medical condition - all because they are forced to choose an eye doctor who is on their insurers' lists of approved doctors.

In an attempt to resolve this, I contacted both of their insurance companies to request to be on the approved list. However, I was told that both companies' lists are full and that they will not be accepting any more doctors on the lists.

This is the predicament Mr Tan fears.

The inability of a patient to choose his own doctor based on set rules determined by insurers is not only inconvenient, but also goes against freedom of choice.

I foresee more of such predicaments emerging in our current healthcare system, and beseech parties involved to take proactive steps to address them.

Tony Ho (Dr)