Public health

Pilates, yoga rebates axed in private health reforms

The federal government will axe private health subsidies for Pilates, yoga and tai chi classes, after concluding there is ‘no clear evidence’ for the exercise therapies.

The decision has been questioned by a leading back pain expert who says it flies in the face of evidence suggesting all three exercise therapies can help with a range of musculoskeletal conditions.

From April 2019, the government will no longer subsidise insurance packages that offer cover for 16 natural therapies including homeopathy, iridology and rolfing.

“A review undertaken by the former Commonwealth Chief Medical Officer found there is no clear evidence demonstrating the efficacy of the listed natural therapies,” the reform summary document states.

The government will continue to subsidise remedial massage and chiropractic, under the reforms designed to make private health care simpler and more affordable for consumers.

Professor Chris Maher, director of Musculoskeletal Health Sydney at the Sydney School of Public Health at the University of Sydney, said yoga, tai chi and Pilates each have a rationale evidence base and should not be lumped in with “implausible” modalities like homeopathy and iridology.

“I think it is a mistake to equate them with homeopathy and make access more difficult. I think this decision would benefit from a reconsideration.”

The Australian Physiotherapy Association says it’s concerned to find pilates, offered by some physiotherapists to help patients manage MSK conditions, on the chopping board.

President Phil Calvert said that while the association agrees with the reform’s intent to focus funding on evidence-based treatments, it is concerned that discerning, evidence-based application by physiotherapists “has been caught up in the reform recommendations”.

“(We) will work to ensure that physiotherapy clients can continue to claim rebates for modalities where the evidence supports their use in the circumstances,” he told the limbic. 

Private Healthcare Australia (PHA) CEO Dr Rachel David said the PHA did not support the decision to remove pilates but was pleased that remedial massage would still be subsidised.

“This is essentially the compromise position. We do pay out the majority of claims for massage under natural therapies, and we felt we could possibly do without some of the wackier things on the list.”

She  said individual health insurers may choose to keep offering packages that give rebates for yoga, Pilates and tai chi but would need to charge more.

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