“…based on the report, the Australian government has now removed coverage for all 17 therapies studied in the initial review. This move is part of an overall strategy to reduce the cost of private insurance for consumers, and boosting coverage for services like mental health.
What this means is that while people can still choose to access these therapies, they cannot be offered benefits under these private insurance programs. Notably, not on the list are chiropractic, acupuncture and reiki, none of which were included in the initial review – it’s not clear to me what their current status is under these programs.
The full list of the evaluated and evicted treatments:
Alexander technique, Aromatherapy, Bowen therapy, Buteyko (be careful to get the spelling right if you Google this one), Feldenkrais, Herbalism/western herbalism (but Chinese and Ayurvedic medicine were not reviewed), Homeopathy, Iridology, Kinesiology,
Massage*, Naturopathy, Pilates, Reflexology, Rolfing, Shiatsu, Tai chi, and Yoga.
The effect will come into place on 1 April 2019, from which point on it will become illegal for health funds to include the therapies in their coverage. It would seem that this decision will have important consequences for a number of therapy professions, physiotherapy most significantly, as many physios have built (quite literally with some of the magnificently renovated, natural-brick-exposed ‘studios’) their practices around Pilates as an intervention.
Interesting point made by the author at sciencebasedmedicine.org:
As I discussed earlier, the review didn’t consider plausibility in its review, which was a huge oversight. Practices like homeopathy and iridology are pure pseudoscience, while therapies like Pilates, yoga and tai chi are forms of exercise which have far more potential to offer some therapeutic benefits. The authors concluded, however, that the lack of evidence signaled that these treatments could not fairly be considered “evidence based”.
Magical movements and drinking your own Kool Aid?
Perhaps Pilates has become a victim of its own popularity, or, a casualty of the self-generated hyperbole surrounding it. While there seem to be some benefits, it’s not a magical movement with any more mystical benefits than other forms of exercise (of course yoga and tai chi also fall into this category). But… I’m sure the idea of doing Pilates (or yoga or tai chi) was a motivator for at least some to get off the couch and do something (anything seems to be better than nothing in terms of activity/exercise), and, notwithstanding some dubious explanations as to its underlying causal mechanism of benefit, that isn’t all bad. Is it?
Interested to hear the thoughts of anyone out there who this might impact.
– Tim Cocks
*EDIT: Over on Facebook, as part of a lively discussion, it has been pointed out that the document released from the Department of Health does not list massage in the list of interventions that will no longer be supported. Massage was on the list of therapies in the original review and in the Implications for practice section for massage therapy the review stated “There is a paucity of good – quality studies of sufficient size that examine the effectiveness of massage therapy for many clinical conditions.. The evidence is uncertain or unknown for 43 of the 46 clinical conditions assessed in this overview.”, but it seems that massage has survived the cut. Apologies for any confusion. TC