Complementary Medicines Australia (CMA) welcomes initiatives announced in the 2019 Federal Health Budget, handed down on 2 April 2019. CMA says the 2019 Budget contains a number of health-related measures that are welcomed. But the opportunity to significantly invest in preventive health to build a more sustainable health system longer-term for Australia has been missed. 

The government is investing a record $104 billion in health in 2019-20 as part of a patient-focused investment of $435b over the next four years:

• $737m over seven years for mental health and suicide prevention including
  $461m to address youth mental health and suicide prevention.
• $448.5m investment over three years from 2020-21 for the primary care/chronic care funding model to support more flexible care models
• $386m to encourage more Australians to participate in sport, upgrade sporting infrastructure and support elite sport
• 1.1m of extended funding for the Health Star Rating (HSR) System food labelling scheme for an additional two years, with a review of the system to ensure it is meeting objectives. 
• $20m for a national anti-smoking campaign
• $6 billion over the forward estimates for medical research, including $160 million on the Indigenous Health Research Fund
• $17.2m for the development of activities and strategies to address a range of specific chronic conditions such as the Public Health and Chronic Disease Grant Program that will fund activities aimed at preventing and managing specific chronic conditions or disease groups that have been recommended in National Strategic Action Plans
• A further investment of $430m in genomics research.

CMA Board President, Paul Mannion said: “While the budget contained a number of welcome initiatives in primary healthcare, it has not significantly invested in prevention and a more deep-seated health reform that will ensure the system is sustainable in the longer term. With an ageing population and half of all Australians already having at least one chronic disease, the need to place a stronger focus upon preventive health has never been more critical.”

Paul Mannion added: “An older and unwell population can only foreshadow higher healthcare costs in the future unless there is a focus and shift towards early prevention, encouraging healthy and active ageing, and supporting individuals to take control of their health. While Australia has a good health system by international standards, rising health costs represent an obstacle to future reform.”

Preventive health
Globally, Australia has well-developed public health programs (such as immunisation) and good infrastructure (water supply, food quality). There are many positive attributes that contribute to the Australian system – world-class medical researchers, low smoking rates, a population that is generally accepting of health-promoting regulations, and the existence of political leadership and bipartisanship on major health issues. Our life expectancy at birth has increased greatly over the last century. This places us in the top third of member countries of the Organisation for Economic Co-operation and Development (OECD) for life expectancy with an age of 80.4 years for males and 84.6 for females. 

Still, it is recognised that the Australian health system has room to improve. One in two Australians suffers from chronic disease and these conditions are responsible for most deaths. Treating chronic disease costs the Australian community an estimated $27 billion annually, accounting for more than a third of our national health budget. Australia is ranked in the worst third among OECD countries for obesity among people aged 15 and over, and our alcohol consumption is slightly above the OECD average.

Yet Australia spends just 1.5% of health expenditure on preventative health.
The amount is considerably less than other OECD countries - Canada, New Zealand and the United Kingdom, indicating there are many missed opportunities. Opportunities such as evidence-based prevention measures for overweight and obesity, the growing cohort of older Australians, people with mental health issues and the needs of indigenous Australians.

When looking at Australia’s spend on health prevention, it must be remembered that one-third of all chronic diseases are preventable and can be traced to four lifestyle risk factors:

1. Alcohol use
2. Tobacco use
3. Physical inactivity
4. Poor nutrition

The key to determining the appropriate prevention spend is to compare the added value of an increase in spending on preventive health against the opportunity cost of doing so. A growing body of evidence indicates that selected complementary medicine preventive health initiatives are highly cost-effective, especially in the prevention and management of chronic conditions. This is not limited to, but certainly includes, the use of complementary medicines for primary and secondary prevention of illness and encouraging and empowering all Australians to take better care of their health.

Complementary medicines are an important and culturally acceptable part of healthcare around the world, representing for many people an accessible, affordable way to actively contribute to their health. All indicators reflect that there is a real and immediate role for smarter preventive health.