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Health funds spend millions on unproven treatments

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There is no evidence that any of the natural therapies typically covered by private health insurance deliver clinical benefit, increasing the focus on the value for money provided by health funds.

An exhaustive review of 17 natural therapies conducted by the Office of the National Health and Medical Research Council found that while a small number may provide some short-term pain relief, most lack any scientific evidence to back their health claims.

“Overall, there was not reliable, high-quality evidence available to allow assessment of the clinical effectiveness of any of the natural therapies for any health conditions,” the review, chaired by the Chief Medical Officer Professor Chris Baggoley, said.

The report, which has been with the Government for months, looked at therapies including massage, yoga, pilates, shiatsu, homeopathy, kinesiology, reflexology, naturopathy, aromatherapy, herbalism, iridology, Bowen therapy and Alexander technique – many of which are covered by insurers under their extras cover.

Medibank Private, for instance, will provide up to $200 a year toward consultations for reflexology, kinesiology, Chinese and Western herbalism, exercise physiology, shiatsu, aromatherapy, homeopathy, Bowen therapy, Alexander technique and Feldenkrais for singles with extras cover.

The Baggoley review found there was “moderate quality evidence” that massage therapy could provide immediate-term relief for people with chronic lower back pain, but said there was only very low-quality evidence that tai chi benefited health. For therapies like kinesiology, homeopathy, reflexology and rolfing it found scientific evidence was either lacking, insufficient or uncertain.

The funds argue that natural therapy cover encourages younger, healthier people to take out private health insurance, helping offset the financial drain from older and sicker members.

But critics argue it is a misuse of resources which should only be directed to therapies of proven clinical effectiveness.

The Baggoley review was commissioned by the former Labor Government, which wanted to stop paying the Private Health Insurance Rebate for therapies not backed by scientific evidence. It estimated the cut would save $32 million a year.

The report has been released in the midst of a Government review of private health insurance.

Health Minister Sussan Ley has launched a round of consultations, including a consumer survey, and has aired a range of ideas including allowing insurers to charge higher premiums for smokers or the obese, and to reduce industry regulation.

The Minister said cover for natural therapies would be considered as part of the review, but has so far stopped short of declaring the rebate for such claims would be axed.

She told The Australian that, in theory, she supported the rebate only going toward treatments backed by evidence, but said Labor’s decision to launch the Baggoley review had been “purely about desperate budget cuts…not evidence”.

Ms Ley claimed that around 500,000 dumped or downgraded their health cover in the past 12 months in a clear demonstration that something was wrong.

But AMA President Professor Brian Owler said that although there was clearly a problem, the Minister was misreading what was going on.

Professor Owler said most people were not choosing to downgrade their cover. Instead, insurers were shifting often-unsuspecting consumers onto policies with bigger excesses and more gaps and exclusions, leaving them liable for unexpected charges.

The AMA President warned that insurers, driven more by the search for profit rather than the health of their customers, were taking the health system down a path toward US-style managed care, which would see the poorest and sickest increasingly shunted into the already-stretched public health system.

Public concern about the quality of health insurance has been fuelled by relentless above-inflation premium increases and reducing coverage.

It has been reported that the funds, which are subsidised by the $6 billion a year Private Health Insurance Rebate, are seeking an average 7 per cent premium increase next year.

Adrian Rollins

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