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Budget good news: no taxpayer dollars for a ‘bunch of hooey’

It’s good news indeed that the Federal Budget is providing the chief medical officer with a million dollars to review what works and what doesn’t in the world of “natural” medicine. Professor Chris Baggoley…

Treasurer Wayne Swan delivering the Budget on Tuesday. AAP

It’s good news indeed that the Federal Budget is providing the chief medical officer with a million dollars to review what works and what doesn’t in the world of “natural” medicine. Professor Chris Baggoley will have one year to report his conclusions.

At the end of that time, says Health Minister Tanya Plibersek, “The Private Health Insurance Rebate will be paid for insurance products that cover natural therapy services only where the Chief Medical Officer finds there is clear evidence they are clinically effective."

Truth be told, this could be the easiest million dollars the CMO will ever earn for the government. He could have a report ready next month, as there are very few “natural” therapies that have any chance of meeting a requirement of evidence. The government predicts it will save $30 million a year after the review.

So what therapies does the government have in mind? This recent article tells readers that the government is referring to modalities such as “homeopathy, Reiki, aromatherapy, iridology, ear candling, crystal therapy, flower essences, kinesiology and Rolfing."

Never heard of Rolfing? Well, according to Wikipedia it’s “ a therapy created by The Rolf Institute of Structural Integration (also referred to as ‘RISI’) whereby the alleged manipulation of the fasciae by specific methods is believed to yield therapeutic benefit! Rolfing lacks a solid scientific evidence base.”

Ear candling may no longer be coverd by a private health insurance rebate. Bjørn Bulthuis

As the founder of the Skeptics, Michael Shermer, noted, Rolfing represents “a bunch of hooey”. Those looking for quality evidence on for natural medicines will find the Cochrane Library invaluable.

The article suggests chiropractic and acupuncture will continue to be funded, as they are “mainstream” practices. But these modalities are used in ways for which there is certainly no clear evidence of clinical effectiveness.

While there’s weak evidence for conservative chiropractic being effective for helping patients with minor musculoskeletal problems, there’s none to support the more extreme use of chiropractic spinal “adjustments” to treat a wide range of diseases in adults and children.

Using acupuncture to control pain for a very limited number of musculoskeletal problems has been established in clinical trials. But despite many studies, there are no data suggesting it can treat any disease process and the breadth of conditions it’s used for today will not meet the government’s requirement for support.

The initiative announced with the budget papers may well represent the beginning of a more critical assessment of government-funded health programs, with an emphasis on proven effectiveness. This approach would provide a much larger dividend than the anticipated $30 million dollars to be saved after the proposed review.

Australians are, at last, being told by their government that a large number of diagnostic and therapeutic claims made for many so-called “complementary and alternative medicines” are without merit and often lead to a delay in correct diagnosis and the start of beneficial treatment.

The process of debunking health services and health-related education involving pseudoscience has surged in recent months in multiple guises. A growing number of articles addressing this issue have appeared in the national press and the matter has been prominent in radio interviews. The teaching of pseudosciences in university health courses has also been questioned.

The evidence base for acupuncture will not be reviewed by the chief medical officer. NYCTCM/Flickr

The disadvantages of national registration of traditional medical practices has been debated, as has the therapeutic benefits from homeopathic preparations and other “alternative” therapies.

All this coincides with active campaigning for the primacy of science-based medicine by a group of scientists, clinicians, lawyers and consumer advocates, (of which we are founding members) now numbering more than 700.

It’s no longer tenable to accuse those concerned with the growing influence of “sciences” not supported by credible evidence of effectiveness to be on a “witch hunt”. Irrefutable worldwide research on homeopathy and many other “natural” therapies shows that they have no more effect than a placebo.

The Government’s commitment to science-based medicine raises a number of interesting questions. Will the private health industry wait for the results of the review before it stops paying for ineffective modalities or at least makes coverage for such treatments an optional extra? If it did, customers could have broad coverage without having to pay for modern pseudosciences.

With international agreement that homeopathy and many other natural therapies are no better than placebo, will Australian pharmacists rid their shelves of homeopathic and other useless preparations? And will the few universities that still prepare people for a career based around these nonsensical therapies stop and recommit to teaching good science? Let’s hope so.

Join the conversation

17 Comments sorted by

  1. Michael Brown

    Professional, academic, company director

    Historically society demanded registration of doctors and pharmaceuticals to protect them from quacks and charlatans. The use of completely ineffective therapies takes us backwards and should be stopped by the Minister for Health. Now.

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    1. Ian Donald Lowe

      Seeker of Truth

      In reply to Michael Brown

      Historically, herbs and other natural therapies were the only medications available and many were proved to be effective. Many modern day medicines synthesise the chemical properties of these traditional medicinal plants. I am not saying all alternative therapies (including some herbal medicines) are effective but I noticed the author included aromatherapy in their list and I would suggest that this is one type of alternative therapy that has potential benefits, especially when compared to the ridiculous…

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    2. Marcello Costa

      Professor of Neurophysiology, Department of Physiology at Flinders University

      In reply to Ian Donald Lowe

      Ian, all prescientific (traditional) medicines did very little for serious diseases. Scientific medicine, really born out of the European herbal remedies and primitive surgery, is relative a recent process that although has already made a tremendous impact on human health, is still an ongoing human endeavour. There is no point simply to take a better-than-saints position and by a blanked blind criticism of doctors and the industries that develop drugs. To state that there is no meaningful research at all on how good or otherwise, pharmaceutical products are is simply naive and ignores the complex process behind every drug development. The need to keep a rigorous attitude on the process of approvals of new and old drugs should not be confused with the need to develop therapies based on scientific knowledge and clinical evidence for effectiveness and efficacy.

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    3. Sue Ieraci

      Public hospital clinician

      In reply to Ian Donald Lowe

      The amount and quality of research in just one class of pharmaceuticals - say the clot-busting drugs, for example (thrombolytics) far exceeds the entire body of alleged evidence for all "remedies" in homeopathy. Not to mention Bach flowers (not even containing the flower - but a dew drop), iridology, or any other non-science-based remedy.

      The problems we experience with antibiotics are FAR, FAR outweighed by the benefits of not having to die from pneumonia, urinary infections, septic arthritis, mastoiditis and meningitis, to name but a few.

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    4. Sue Ieraci

      Public hospital clinician

      In reply to Michael Brown

      You are right - Michael Brown. While mainstream medicine separates the prescriber from the dispenser and retailer of medications, most CAMs do nothing of the sort. Homeopaths in particular will virtually always sell you a "remedy." Doesn;t work? Try another. Pay for the consultation, pay for the "remedy", come back next week, and the week after that.

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    5. Catherine Wilkinson

      Medical practitioner

      In reply to Sue Ieraci

      Overheard conversation:
      Lady A "I've been seeing my <insert alternative medicine practioner here> for my vertigo. She's amazing! I've seen her 6 times in the last four weeks. You should see her too!"
      Lady B "So she's fixed your vertigo?"
      Lady A "Not yet, but she thinks she definately can, in the next 10 visits. Oh, she's just so good!"

      Yes, I really overheard this.

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  2. Brian Glassenbury

    Primary Care Physician

    The problem reverts to many peoples' inability or reluctance to weigh evidence, plausibility and risk. Many appear swayed by breathless recommendations from mainstream media. Perhaps we should expect the reporting of claims of health benefits to be more responsible. More cost to society resulting from the race-to-the-bottom.

    May also be interesting for the public to be made aware of the contribution to the rise of "Ancient Chinese Medicine" & acupuncture of Mao's horrific purges of intellectual dissent.
    - No more doctors
    - Gotta offer the people something
    - Might as well be woo.

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    1. steve jenkin

      logged in via LinkedIn

      In reply to Brian Glassenbury

      The FedGov is interested because of the money, not patient safety, not effectiveness.

      Aus spending on Health went over $100,000M 3-4 years ago, this saving is $30M or 0.03%.
      Translated back to human scale, the average wage of $50-55k, $15, or 3 cups of coffee. Something I'd normally describe as 'a rounding error'.

      Are the authors claiming this is an effective use of FedGov resources?

      Are they claiming that they can't improve hospital performance? (My guess is $45,000M/yr by Govt).
      Even…

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    2. Mike Hansen

      Mr.

      In reply to steve jenkin

      But Rolfing and many other modalities aren't trying to treat *disease*, they are trying to promote wellness.

      Crap

      They are trying to promote "richness" - the richness of the practitioner at the expense of the gullible.

      Here is some more woo being promoted on the Gold Coast and in the USA
      http://scienceblogs.com/insolence/2012/05/heal_your_genome.php

      "Genome Healing represents an inspired approach to the restoration of health and wellbeing for the new millennium.

      "DNA/Stem Cell Healing based on the principles of quantum physics

      Yeah good one - they have a bank account where you can send your hard earned Steve and get your "wellness"

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    3. Grendelus Malleolus

      Senior Nerd

      In reply to steve jenkin

      Fine, those who want "wellness" can buy it. I'm happy for my taxes to support evidence based health. I don't care if it's a small fraction of the overall total, I want my tax dollars to help people be healthier. CAM modalities that have no reasonable evidence base should not be supported.

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  3. Luke Weston

    Physicist / electronic engineer

    It is absurd that chiropractic and acupuncture are somehow getting a free pass from this review.

    How are the absurd pseudosciences of chiropractic and (to a slightly lesser extent) acupuncture any fundamentally different from, say, homoeopathy?

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    1. Grendelus Malleolus

      Senior Nerd

      In reply to Luke Weston

      While I agree, I suggest that those two nuts, being somewhat harder to crack will have to be left for now. Itis encouraging to see at least that the government has recognized in principle that health care practices must be evidence based. I would accept your point that there is no substantive difference in evidence bases for the modalities you noted - at least in their most common form, however their popularity and broad practitioner base protects them politically to a certain extent. Not a valid evidence-based reason for leaving the out of the review but the government I guess is wary of alienating too many people at one time.

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  4. Stephen Lehocz
    Stephen Lehocz is a Friend of The Conversation.

    Interested public.

    I have never seen so much hate in one article and it’s comments and so little respect for the general population of Australia.

    The success of alternative treatments does show that people are interested in their health and doing something about it.

    The Australian people are not as stupid as you seem to be implying. They only keep going back for something from which they have attained some success and they also exercise their judgment and they do stop doing something that does not work for them…

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    1. Grendelus Malleolus

      Senior Nerd

      In reply to Stephen Lehocz

      "I have never seen so much hate in one article and it’s comments and so little respect for the general population of Australia."

      Really? You need to go read the bigotry over in the articles about same-sex marriage then. I don't think there is any "hate" at all in the comments above. There is disdain and scorn in plenty.

      As far as popularity is concerned - astrology is popular, and pointless. McDonald's is popular - and terribly unhealthy. Vitamins are popular, and for the most part unnecessary…

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    2. Stephen Lehocz
      Stephen Lehocz is a Friend of The Conversation.

      Interested public.

      In reply to Grendelus Malleolus

      Hate or hatred is an emotion of intense revulsion, distaste, enmity, or antipathy for a person, thing, or phenomenon; a desire to avoid, restrict, remove, or destroy its object. http://psychology.wikia.com/wiki/Hate

      I invite you to reread the article and the comments and compare them to that definition. My last opinion still stands.

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    3. Grendelus Malleolus

      Senior Nerd

      In reply to Stephen Lehocz

      I did - but still considering the opinions proffered above and those over on other article comment threads I still think you opening statement is hyperbole.

      Your definition requires an element of intensity in combination with any of "revulsion, distaste, enmity, or antipathy'. I'm really finding it hard to see where the opinions above can be characterised as hatred. However, I think it unlikely that you will agree with me on that point so I ask you go compare comments on one of the same-sex, or even climate change threads.

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  5. Roderick Martin

    Sports Clinic Owner

    I look at this with some sadness. It is interesting that at a time of 10% Iatrogenic disease and 1/300 medical interventions going so wrong they are fatal, there is so much thrashing around about therapies that individuals enjoy and benefit from.
    Money spent on treating the side effects of 'proven' drugs far surpasses the amount spent on these natural therapies. The argument of science and proof is a difficult one as we see the lack of evidence for anti psychotics, anti depressants (2 of the top…

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