MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

I was alerted to this recent and most interesting announcement by the Australian Government:

From 1 April 2019 the following natural therapies will be excluded from the definition of private health insurance general treatment and will no longer receive the private health insurance rebate as part of a general treatment policy: Alexander technique, aromatherapy, Bowen therapy, Buteyko, Feldenkrais, Western herbalism, homeopathy, iridology, kinesiology, naturopathy, Pilates, reflexology, Rolfing, shiatsu, tai chi, and yoga.

Rules have been made to exclude these natural therapies from the definition of general treatment under section 121-10 of the Private Health Insurance Act 2007. Insurers will then not be able to offer benefits for these therapies as part of a complying health insurance policy.

Insurers can offer incentives to purchasers of private health insurance as long as the incentives meet the requirements of the Private Health Insurance (Complying Product) Rules. These incentives could include services provided by a natural therapist. It will be up to each insurer to decide whether to offer this type of incentive.

Consumers will still be able to choose to access these natural therapies outside the private health insurance system.

Why is this important?

A review chaired by the former Commonwealth Chief Medical Officer found there is no clear evidence demonstrating the efficacy of the excluded natural therapies.

This review was informed by an evaluation of the evidence undertaken by the National Health and Medical Research Council (NHMRC). NHMRC was tasked with reviewing scientific literature examining the effectiveness and, where available, the safety and cost effectiveness of 17 natural therapies. This was conducted in line with NHMRC’s approach to assessing evidence, and was undertaken for the specific purpose of informing the Australian Government’s Natural Therapies Review.

Changing coverage for the excluded natural therapies will ensure taxpayer funds are spent appropriately and are not directed to therapies that do not demonstrate evidence of clinical efficacy.

Who will benefit?

Around 54 per cent of the Australian population is covered by general treatment (extras) insurance. Changing coverage for the excluded natural therapies will remove costs from the system and contribute to reducing private health insurance premium growth.

What impact will this change have on private health insurance?

This change will contribute to reducing private health insurance premium price increases.

_____________________________________________________________________

The attempt to make health insurance more evidence based is no doubt laudable. I therefore commend this decision and hope other countries are following suit. Despite my general agreement, I feel compelled to make a few critical comments:

  1. Some of the banned treatments are not entirely devoid of good evidence. I am thinking of herbalism and tai chi, for instance.
  2. Iridology is a diagnostic technique and not a ‘natural therapy’.
  3. The term ‘natural therapy’ is of debatable value: not all of the listed modalities are natural (nothing natural about homeopathy, for instance). Personally, I much prefer ‘so-called alternative medicine (SCAM).
  4. I can think of many more SCAMs that should be on this list.

It will be fascinating to see whether the stated prediction that the ban will reduce health insurance premiums will be borne out by data. Many SCAM enthusiasts have in the past argued that it will have the opposite effect. Therefore, it would seem very important that the economic effects of this decision are being accurately monitored and that, in time, the results are analysed and published.

20 Responses to Another ban of homeopathy (and several other SCAMs)

  • This will of course be seen by many as the the medical profession “running scared” and banning the competition. What they won’t do, of course, is start maintaining proper records, recording and reporting failures, conducting proper trials, and cracking down on the obvious frauds and scammers within their system — who they should see as their real enemy, oif they genuinely feel they have something to offer.

  • Not including homeopathy in its social security hardly means “ban” … Merely that the anti homeopathy lobby representing pharma interests got to them… Not even triple blinded studies supporting homeopathy is considered by that camp… As was sent to you guys twice… Would be of interest to know who sponsors this site…

  • My private health insurer still offers extras cover under “Natural Therapies” for Acupuncture, Chinese herbal medicine, Myotherapy & Remedial massage. Not sure what’s “natural” about acupuncture.

    Under “Mind & Body Therapies” covered services it lists Chiropractic & Osteopathy. Physiotherapy is also listed in this section.

    I’m not sure who would deliver rebatable remedial massage if not a physiotherapist, but I’ve never made any claims for anything in their “natural therapies” list, nor any chiropractic or osteopathy. I have claimed for physiotherapy.

    Though I think everything in their natural therapies list should go, along with chiropractic and osteopathy, things have improved. The insurer’s standard information sheet (the formal declaration of their cover) for 2017 includes chiropractic, acupuncture, naturopathy (which is explicitly mentioned as covering homeopathy) and remedial massage, though it doesn’t include Chinese herbal medicine or myotherapy.

    While I applaud what’s been done (even if IMO it’s insufficient), I doubt that these changes to “natural therapies” rebates will cause anything more than the tiniest downward blip (if even that) in the steadily rising cost of private health insurance in Australia.

    • I hope all insurance companies make clear whether or not their policies reimburse for camistry/SCAM – modalities not having plausible evidence of benefit.

      I hope insurance companies offer entirely comparable policies which exclude camistry/SCAM, so that patients can choose for themselves.

      Most patients would prefer not to be obliged to subside camistry/SCAM.

      Patients enthusing for camistry/SCAM and needing counselling should get counselling.
      Some insurance companies might wish to offer policies to cover that – but they should demonstrate integrity and be honest about what they cover. A perrenial problem for the insurance industry.

      • In a word, no.

        Neither my (smallish, not-for-profit) insurer nor Medibank Private (the largest, for-profit, ASX listed Australian provider) make any statement on their web pages listing their extras cover about whether the treatments are effective. Generally only the benefit limits are listed. Medibank has similar “natural therapy” cover to my provider.

        However, Medibank has “Members’ Choice providers” (“Member’s Choice” meaning “insurer’s choice” 😉 ) for chiropractic and acupuncture, which I think gives undue implied approval to them. Members’ Choice gives preferential rebate treatment if you use those providers.

  • Insurance should not pay for SCAM but believe individual people should be able to pay out of pocket. The SCAM is big profit and keeps many folks in business and people employed from vulnerable people, that is their right to pay for it. It is your right to expose them, almost certain you will not reach these vulnerable people.

  • In the long run this is probably for the best. The insurance industry is ruining CONventional MEdiciNe (CONMEN) industry around the world, particularly now in the USA. Insurance agents decide how doctors will practice not doctors. In addition the 20-30% overhead that insurance companies charge is helping to destroy the affordability of CONMEN. Good riddance!

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