Update - Government Private Health Insurance Rebate Review

At the end of 2012 ANTA National Council was invited to nominate a representative to participate in a review of private health rebates for natural therapies chaired by the Chief Medical Officer (CMO) Prof Chris Baggoley who was commissioned by the then Labour Government to conduct a review of research outcomes in regard to 31 unregistered Natural Therapies through the Federal Government’s Department of Health and Ageing.

The Natural Therapies Review Assessment Committee (NTRAC) consisted of representatives from public and private health funds, the Department of Health and Aging, Veteran’s Affairs, consumer groups, technical experts, and three natural therapies professional association representatives:

• Jim Olds: Australian Natural Therapists Association
• Eta Brand: Australian Naturopathic Association of Australia
• Raymond Khoury: Australian Traditional Medicine Society

The four criteria that were applied to the therapies under review were that research outcomes be reviewed to demonstrate Cost Effectiveness, Clinical Efficacy, Safety and Quality over such “therapies” as:

Reflexology, Massage Therapy, Iridology, Alexander Technique, Kinesiology, Bowen Technique, Myotherapy, Herbal Medicine, Nutrition and Naturopathy, to name a few.

The rationale for this review was based squarely on the question of whether private health fund providers should continue to receive the Australian Government rebate of 30% to private health providers based on evidence of cost effectiveness, clinical efficacy, safety and quality if it could not be shown to exist in relation to goods and services associated with the 31 therapies in question.

The National Health and Medical Research Council contracted a number of known researchers and companies to perform a review of the literature and evidence that might demonstrate level one evidence existed over the 31 items on the list for review. The result would inform an overview of the outcomes in regard to these items under review and this was scheduled for handing up to the Minister for Health by the end of 2013.

Over the Christmas vacation period of 2012/2013, ANTA directors pursued a worldwide search for research articles that satisfied the required standards and criteria for research evidence relevant to the therapies under review.

The change of government in 2013 militated against the schedule being reached and the administration review process continued into 2014, concluding in July of this year. The CMO’s report has been completed and forwarded to the minister. To date we have no word of the minister’s decision regarding the retention or otherwise of the 30% rebate as a result of the review.

In regard to the CMO’s office oversight of the meetings attended by the natural therapy professional association representatives, the level of fairness and inclusion of submissions and presentations was above reproach. In regard to the standard, criteria for acceptance of evidence imposed by the NHMRC, these posed a barrier to progression for any submission due in no small part to the absence of funding leading to a paucity of Level 1 research related to any of the 31 items on the list.

This paucity of Level 1 evidence is clear to all representatives who participated in the NTRAC process. What is also clear to the ANTA National Council is that the provision of funding for research, the paucity of suitable and relevant research must be addressed to produce results that meet the standards and criteria of the NHMRC and demonstrate Level 1 evidence does exist to clarify the question around cost effectiveness, clinical efficacy, safety and quality for consumers of natural therapies’ goods and services in Australia.

We will keep members updated on any developments or announcements on this matter.