Carl Gibson, CMA CEO
Australia has one of the highest performing health systems in the world. But, in common with other developed countries, we are also experiencing an ageing population and increasing rates of chronic and complex health conditions. Spending on health has grown from $5,000 per person in 2006-07 to $7,100 per person in 2015-16. Half of all Australians have at least one chronic disease, and the need to place a stronger focus upon preventive health is becoming increasingly important.
Complementary medicines and therapies are valuable ways to help manage chronic disease, prevent the exacerbation of illness, and to optimise nutrition and wellbeing
An older and sicker population can only foreshadow higher healthcare costs in the future. That is unless there is a shift towards early prevention, encouraging healthy and active ageing, and supporting individuals in taking control over their health.
Natural therapies are recognised by the World Health Organization and by governments around the world as effective, appropriate and cost-effective solutions to helping people manage their healthcare. Complementary medicine practitioners emphasise nutrition, lifestyle modifications, and the importance of taking personal responsibility for health as fundamental principles for improving quality of life. Research conducted in Australia has demonstrated that the total number of client consultations is estimated at 16 million annually, contributing over AUD$1.8 billion to the economy each year.
Rising out-of-pocket costs across the health sector; the ongoing debate
From 1 April 2019, private health insurers were no longer permitted to provide cover for a wide range of natural therapies, including naturopathy, herbal medicine, yoga and tai chi. All of these have a strong evidence base supporting their use in good health promotion.
An analysis carried out by PwC found that private health insurance members across all levels of hospital cover who also choose ancillary (extras) benefits for natural therapies claimed $200 per person less every year in hospital and medical costs; for members with top hospital cover it was $430 per person less claimed if they chose ancillary benefits for natural therapies.
CMA has, strongly recommended, and continues stress to Government, that ceasing the private health rebate for natural therapies, such as herbal medicine and naturopathy, be reconsidered. This is in light of the evidence supporting the use of these natural therapies for cost-effectively contributing to good health.
Complementary Medicines’ Role in Preventive Heath
Individuals use complementary medicines as adjunctive therapy to conventional medicine, to help manage chronic disease, prevent the exacerbation of illness, and to optimise nutrition and wellbeing. There is robust evidence that complementary medicines are a cost-effective way to improve health outcomes.
The 2017 McKell Institute report: Picking the low hanging fruit: Achieving a more equitable and sustainable healthcare system found that targeted, evidence-based uptake of certain complementary medicines results in notable cost savings in Australia, whilst delivering better health outcomes and greater equity. Through addressing some of the social determinants of health, which a poor diet, complementary medicines can play a role in addressing long-term health budget pressures.
Increased uptake of vitamin D and calcium
In Australia, between 31% and 58% of the population have vitamin D deficiency, despite the fortification of many foods with vitamin D. D deficiency has been linked to an increased prevalence of a number of chronic diseases, including osteoporosis, diabetes and heart disease. The McKell Institute estimates that up to 8,895 fractures annually could be avoided in Australia with increased uptake of vitamin D and calcium, saving the Government up to $142 million in direct health costs.
Folate, iodine and vitamin B3 are known to prevent neural tube defects. Current Australian guidelines recommend routine supplementation of folate and iodine, with vitamin D and iron supplementation for pregnant women with identified deficiencies. Maternal malnutrition leads to adverse pregnancy outcomes and can lead to a long-term negative impact on growth and development during childhood and increases in the risk of developing chronic diseases later in life.
CMA supports the recommendation of increasing the uptake of pregnancy vitamins by low-income mothers to help address health inequalities, estimated by the McKell Institute to cost between $26 million and $46 million per year, a small cost given the potential benefits to health equity and long-term savings from stemming the rise in prevalence of chronic diseases.
National Preventive Health Body
CMA supports the call to re-establish a National Preventive Health Body to evaluate evidence-based interventions at a population level, which is an important step towards placing good health at the centre of policymaking in Australia. A fundamental aim of any health system should be to prevent disease and reduce ill health so that people remain as healthy as possible for as long as possible.
Preventive health is also an essential move towards improving the cost-effectiveness of the health care system, by enhancing Australians’ health and quality of life and reducing preventable illness. In the case of complementary medicines, a thoughtful and rigorous strategy, coordinated by the preventive health body, would further demonstrate the cost-effectiveness and health benefits of complementary medicines for contributing to improved public health. How will we do this? In three ways:
1. Reinstate the private health rebate for natural therapies, in light of the evidence supporting the use of these natural therapies.
2. Development of a strategy, in consultation with physician groups, to increase the uptake of vitamin D supplementation amongst at-risk groups, and the introduction of a scheme to provide free vitamins during pregnancy through medical practitioners for women that hold concession cards.
3. Re-establish a national preventive health body to implement and evaluate population-wide prevention initiatives, improving the health and wellbeing of the community and providing long- term savings for the health budget.