Life Wellbeing Yoga, naturopathy and Pilates hit as natural remedy rebates disappear

Yoga, naturopathy and Pilates hit as natural remedy rebates disappear

Yoga instructor Jess Fenech (right) with students during a yoga class in Sydney. Photo: ABC News: Brendan Espocito
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If you are among the 80 per cent of Australians using natural medicines and treatments such as naturopathy, yoga and Pilates to improve your health, prepare for a shock.

From Monday, Australians claiming a rebate from their private health insurance for those services will no longer be able to — and there are warnings its wider implications will affect many Australians.

The Federal Government has drawn up a list of natural therapies private health insurers are now “banned” or “prohibited” from funding because the treatments are deemed to be lacking in scientific evidence.

The National Health and Medical Research Council (NHMRC) investigated the decision, overseen by the country’s chief medical officer.

There are questions around the relevance of the review because it only included studies done up to 2014.

At the time the Government said the changes would “remove costs from the system and contribute to reducing the costs of private health insurance premiums”, which a recent survey showed was a concern for 82 per cent of all households.

But Private Healthcare Australia has admitted the decision would have a “very minimal” impact on premium costs.

Pilates Alliance Australasia’s Sharan Simmons in her Sydney studio. Photo: ABC

Which natural therapies and treatments are affected?

If you currently claim a rebate from your insurer on some of the following popular treatments, that’s about to end:

  • Pilates (exercise inspired by calisthenics, yoga and ballet to improve flexibility and strength)
  • Yoga (discipline including breath control, meditation and specific body postures)
  • Naturopathy (approach focussing on diet, exercise and stress management)
  • Homeopathy (medical system based on belief the body can cure itself using natural substances)
  • Reflexology (massage of the feet)
  • Tai chi (series of slow movements and deep breathing)
  • Aromatherapy (use of plant extracts and essential oils for healing)

There are some loopholes

There are still some ways to make a claim on some of these treatments.

For example, if you see a physiotherapist who incorporates some Pilates techniques into treatment, that is OK — as long as it is not advertised as Pilates.

Photo: ABC
Ibis World estimates the Australian “alternative health therapies” industry generates $4 billion in revenue each year. Photo: ABC

What will Australians miss out on?

It depends on who you talk to.

There is an ongoing debate in the medical profession over the value of natural therapies. Some say they are viable complements to traditional treatments, others disagree.

Independent Wentworth MP and general practitioner Kerryn Phelps said the ban would have a “devastating impact” on providers and the huge numbers of consumers using them.

Dr Phelps has written to Health Minister Greg Hunt asking for yoga, tai chi, western herbalism medicine and naturopathy to be removed from the banned list.

Kerryn Phelps said complementary medicines could actually produce savings in public expenditure Photo: ABC

Yet, groups such as Friends of Science and Medicine (FSM) are less convinced of the benefits of natural therapies.

Headed by John Dwyer, FSM has lobbied the Federal Government for the past seven years to stop subsidising treatments the NHMRC had deemed ineffective.

“The move is important in our efforts to use precious health dollars wisely,” Professor Dwyer said.

“But even more important is the clear message to Australians that these modalities will not benefit their health.”

At the heart of the discussion is exactly what the review deemed to be ineffective and how the NHMRC arrived at its banned list.

UTS Associate Professor Jon Wardle, who works for the Australian Research Centre in Complementary and Integrative Medicine, said the list included some therapies which had good scientific evidence.

Professor John Dwyer is a critic of the subsidies for natural therapies. ABC News: Josh Robertson

However, some did not.

“You have therapies which perhaps aren’t warranted like iridology, which is quite fringe, to yoga, tai chi and herbal medicines, which are often included into international treatment guidelines,” he said.

Department of Health chief medical officer Professor Brendan Murphy told the ABC the NHMRC review used the same scrutiny of scientific evidence used for all publicly funded health therapies, including those that were reimbursed by Medicare.

“We had to have an objective criteria for people who did the review,” he said. “The fact is that the evidence base wasn’t there.”

But many of those in the complementary medicine sector said they believed the review was flawed and more recent studies had shown benefits for treatments such as yoga, Pilates and naturopathy.

Professor Murphy said the Department of Health would review the impact of the changes next year and urged people to come forward with any recent “high-quality” scientific evidence.

What if I don’t have private health insurance?

Experts say the decision has already had some serious unintended consequences, including potentially stifling legitimate medical research into how natural therapies could treat a wide range of conditions.

Western Sydney residents taking part in tai chi, which has been linked to lowering blood pressure Photo: AAP: Dean Lewins

Professor Wardle said his centre at UTS had already felt the impact.
“We lost a few projects as a direct result of these changes,” he said.

“And it really comes down to how the legislation was written.
“The prohibition is very extensive.”

Professor Murphy said he had heard of isolated cases where local funding bodies had decided not to give research grants to natural therapy studies.

“Through the Medical Research Future Fund and the National Health and Medical Research Council, I would encourage research into these areas where there is a contested position about whether they’re beneficial,” he said.

“In fact the Medical Research Future Fund has a $20 million specific grant program to look at these sort of areas.”

What happens to your extras cover?

Private health insurers admit some people will be disappointed with the changes.

The companies began offering natural therapies as part of extras cover to encourage young people to take out policies.

Some of the therapies have been described as “wacky” by medical experts. ABC News: Mary Lloyd

Private Healthcare Australia chief executive Rachel David said the decision to stop paying rebates was done in consultation with stakeholders such as doctors groups, the Federal Government and the insurance industry.

“In hindsight, it would have been more useful to take a more detailed approach to what went on the list and have a more detailed review of evidence, particularly for yoga, Pilates and tai chi,” Dr David said.

“Those things should have been left on … and we would have supported some of the wackier ones like homeopathy being excluded.”

“Those things should have been left on … and we would have supported some of the wackier ones like homeopathy being excluded.”

She said there were no plans to reduce private health insurance premiums, despite the changes.

Many yoga instructors have criticised the decision to cut the therapy from rebates. ABC News: Brendan Esposito

“In terms of the financial impact on health funds, it’s very minimal. These [natural treatments] were not a big source of health plan claims,” she said.

Some of the other therapies impacted include:

  • Alexander technique (system designed to retrain posture)
  •  Bowen therapy (sequences of small moves working on soft connective tissue)
  • Buteyko (technique of controlled breathing)
  • Feldenkrais (type of exercise therapy)
  • Western herbalism (herbal traditions of Europe and the Americas)
  • Iridology (practice of diagnosing disease by examining the iris of the eye)
  • Rolfing (intensive massage to realign body posture)
  • Shiatsu (pressure applied to body using the hands)
  • Kinesiology (therapy using muscle monitoring to identify “imbalances” in the body)

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