It’s lucky that many pilots are able to, and do, maintain their fitness while evading Avmed’s damaging overreactions to the objective risks of “medical problems” that are not reported to DAMEs or CASA. The real safety problem arises when a person does not seek expert advice ‘when in doubt’ about something, for fear that it will get back to Avmed somehow. I have had numerous conversations with individuals in those circumstances, all of whom hold medical certificates. But CASA evidently believes or would prefer to pretend they don’t exist.
This was the point of my comment regarding weeding out individuals rather than dealing with the problems. Having been through the hoops for many years now and having a medical application that has more 'yes' than 'no's on it I can really add that the system is broken and does not achieve what it's meant to. Not one of my conditions has been caught by the medical system before it manifested and I self reported it. And I can say the same for a number of other pilots who have suffered heart/brain/disease related incapacitation. I know pilots that have suffered significant heart attacks weeks after a medical with ECG. By the time CASA/AvMed are aware a pilot has a problem the individual has probably been fixed by modern medicine and their specialist are most likely, "yep good to go in a month or two". But the now 'fixed' human is required to jump through massive flaming hoops to prove they are fixed while 50% of pilots flying around still have the same issue undiagnosed and with walk in/out medicals. Thankfully by luck, and really modern life, pilots really don't just drop dead or incapacitate at any frequent rate, even the unhealthy ones.
This is why I firmly believe your own specialists should be making the call on your ability to fly/drive/walk down the street. CASA and AvMed are simply an unnecessary impediment in the works.
One common thing I hear from specialists is 'why are they even asking that question, it's irrelevant to your condition...'
PS I still think DAMEs should be a thing with regular visits as is, just to ensure pilots are sticking to their plans and health requirements.