The pre-election promise would see western herbal medicine and naturopathy re-included in private health insurance rebate-eligible extras cover.
Labor’s recent healthcare pledge could indirectly fund unproven treatments by allowing private health insurers to cover alternative treatments like naturopathy again.
In effect, the decision would allow government money in the form of the Private Health Insurance Rebate to subsidise the cost of private health insurance policies which cover select alternative therapies.
On Monday, health minister Mark Butler committed to following through on recommendations from the Natural Therapies Review 2024, which was led by incoming chief medical officer Professor Michael Kidd.
The final report from the review, which took six years to complete, recommended that private health insurers be allowed to offer extras cover for seven natural therapies on the basis of moderate-certainty evidence of clinical efficacy in at least one condition.
The therapies are yoga, Pilates, tai chi, shiatsu, naturopathy, Western herbal medicine and the Alexander Technique.
Crucially, the condition for which there was a moderate-certainty clinical effect could be somewhat niche and the clinical effect could be somewhat loose.
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Shiatsu, for instance, was green-lit based on moderate-certainty evidence from one randomised control trial of 160 participants that it improved bowel recovery in people who recently had minimally invasive surgery.
For Tai Chi, the evidence included reduced fear of falling in high-risk adults and improved psychosocial wellbeing for people with neurocognitive disorders.
If the next federal government does move ahead with allowing the seven natural therapies back into the definition of private health insurance general treatment, it will be up to individual health funds to choose which of those therapies to cover.
Once the private health fund covers a therapy as part of extras, though, it cannot dictate which members would receive care or the circumstances in which they would receive care.
Community rating principles mean that inclusion of services or modalities on a level of cover isn’t dependent on an individual person’s health condition; responsibility for the clinical appropriateness of a treatment falls to the treating practitioner.
While the moderate-certainty evidence for shiatsu was restricted to people recovering from minimally invasive surgery, insurers that cover shiatsu would not have the power to restrict that coverage only to people recovering from minimally invasive surgery.
Epidemiologist and University of Wollongong senior research fellow Dr Gideon Meyerowitz-Katz told The Medical Republic that the inclusion of naturopathy and Western herbal medicine was particularly concerning.
“Naturopathy in particular claims to be able to treat pretty much any disease, and most naturopaths use homeopathy,” he said.
“This means that Aussie taxpayers [through the Private Health Insurance Rebate] will be paying for quite a lot of disproven medical care.”
Private Healthcare Australia CEO Dr Rachel David told TMR that many health funds would likely welcome the opportunity to provide benefits for the credentialed providers of the seven therapies.
“It will take time for insurers to make sure practitioners and programs are properly accredited, but many health funds are looking forward to supporting their members’ health with these therapies,” she said.
For his part, Mr Butler said Labor would ensure “timely” re-inclusion of benefits for natural therapies and that the coverage would be available “as soon as possible”.
The therapies that Professor Kidd’s review did not recommend for re-inclusion were aromatherapy, Bowen therapy, Buteyko, Feldenkrais, homeopathy, iridology, kinesiology, reflexology and Rolfing.
Professor Kidd, a former RACGP president, will begin his term as Australia’s chief medical officer in June.
