Letter to Candidates to Include Acupuncture under Medicare

During a Federal election campaign, politicians are more likely to listen to what voters want, and many of our clients who have experienced the benefits of acupuncture believe that it should be included under Medicare. Below is a copy of a letter we sent to all of the local candidates for the 2022 Federal election, explaining why acupuncture should be included under the Chronic Disease Management scheme (and so covered by Medicare), and asking for their support on this.

Letter to candidates to include acupuncture under Medicare

Letters were also sent to Anthony Albanese and to Anne Ruston, who will be the new Health Minister if the Liberal National coalition wins.

Please feel free to write your own letters to Ms Ruston, Mr Albanese, and your local candidates as well. You can include details of your own experiences and benefits from acupuncture, and all or part of the contents of our letter.

Addresses

Senator the Hon Anne Ruston

PO Box 1671

Renmark, SA, 5341

Hon Anthony Albanese MP

PO Box 5100

Marrickville, NSW, 2204

(Letter wording supplied by the The Australian Acupuncture and Chinese Medicine Association.)

Letter

Dear ,

Health is a major issue for many Australians and affordable, accessible, evidenced based health care is a basic need for all Australian citizens.

The expenditure on health for 2021-2022 is estimated to be $98.3 billion which, according to the Budget Strategy and Outlook: Budget Paper No.12021-22 pp 161-162, represents 16.7% of the Australian Government’s total expenditure.

While it is understood that the provision of health care is under the jurisdiction of the State and Territory Governments, you will be aware that Medicare and the Chronic Disease Management (CDM) is a Federal Government responsibility.

It is the CDM and the inclusion of registered Acupuncturists that I wish to address.

Guaranteeing Medicare – Updating the Medicare Benefits Schedule Budget 2021-22

“The Australian Government acts on the best advice to continue to add and amend listings on the Medicare Benefits Schedule (MBS) to improve access to medical services for all Australians.”

“$14.2 million for new MBS items for allied health professionals who participate in case conferences which are organised by a patient’s GP. This will support increased allied health participation in multidisciplinary, coordinated care for patients with chronic and complex conditions.”

https://www.health.gov.au/sites/default/files/documents/2021/05/guaranteeing-medicare-updating-the-medicare-benefits-schedule_0.pdf

Chinese medicine became a registered allied health profession under the National Registration and Accreditation Scheme (NRAS) on 1st July 2012.

https://www.health.gov.au/initiatives-and-programs/national-registration-and-accreditation-scheme

https://www.health.gov.au/health-topics/allied-health/about

Despite registration and government recognition as an allied health profession, Chinese medicine Acupuncturists have been denied inclusion into the Medicare CDM.

Acupuncture is a recognised treatment under Medicare only if performed by a western medicine trained general practitioner. MBS Item code 173 for acupuncture will cease in November and will be replaced by four time-tiered acupuncture items (193, 195, 197 and 199), which are currently restricted to GPs who have done the training but will be opened up to all “qualified medical acupuncturists”, allowing non-GPs to claim them as well as long as they have done training overseen by the Australian Medical Acupuncture College.

These changes announced in the March 2022 federal budget coming into effect in November, announces Medicare rebates for acupuncture will be restricted to doctors who have done a one-year training course.

Recommended by the MBS Review Taskforce’s general practice committee, claiming “that it will promote high-quality acupuncture”, what it actually does is provide evidence of a gross anomaly.

This is further compounded by the fact that the Federal Department of Health did not have figures on the number of doctors who were providing Medicare-funded acupuncture without doing any formal training but still claimed acupuncture rebates under the outgoing item 173.

Dr Ian Relf President of Medical Acupuncture Association said it was unlikely to be many, which suggests that doctors were claiming Medicare rebates for a practise for which they were not trained nor endorsed to practise by the Medical Board of Australia. Such practise absolutely contravenes the Health Practitioner Regulation National Law (The Law 2009) that was passed by the Council of Australian Governments (COAG- now the National Federation Reform Council NFRC)) with the aim of protecting the public by standardising a high level of education and training for the 16 registered health professions that provide health care under the NRAS.

The decision to let more doctors claim the MBS items with higher rebates would likely benefit a small number of GPs who were not vocationally registered, Dr Relf added.

“There are GPs who have accreditation in acupuncture, but because they are not vocationally registered or missed grandfathering, they could not claim the 193 series. It is a great change for them because they will no longer be stuck in this no man’s land.”

Training for doctors to practise acupuncture is only 60 hours of online tutorials, 30 hours of hands-on clinical experience and both written and clinical exams. The training is overseen by the Australian Medical Acupuncture College.

In stark contrast, registered Chinese medicine acupuncturists must successfully complete a 4 year Bachelor’s degree that includes between 650-1000 hours of clinical practice to be registered with the Chinese Medicine Board of Australia to be able to practise acupuncture.

Chinese medicine practitioners were required and have shown proof of the effectiveness of acupuncture, even though it is already available on the MBS provided by practitioners who do not need the same standard of training.

Why is there this level of discrimination and double standards?

A great proportion of the health budgets in countries around the world are spent on pharmaceuticals. $43 billion has been committed over 4 years for the Pharmaceutical Benefits Scheme (PBS) to make medicines more affordable for Australians.

Pain medication ranks high on the list of medicines that Australians regularly need. According to Pain Australia, the total financial costs associated with chronic pain were estimated to be $73.2 billion in 2018 equating to $22,588 per person with chronic pain.

https://www.painaustralia.org.au/static/uploads/files/the-cost-of-pain-in-australia-final-report-12mar-wfxbrfyboams.pdf

Pain is universal and there are many studies that confirm the effectiveness of acupuncture for the relief of pain from a variety of conditions including knee osteo arthritis, migraine prevention, tension and chronic headaches, chronic low back pain and postoperative pain.

McDonald J, Janz S. The Acupuncture Evidence Project: A Comparative Literature Review (Revised Edition) Brisbane: Australian Acupuncture and Chinese Medicine Association Ltd; 2017. http://www.acupuncture.org.au

Acupuncture provides a drug free pain relief option which will not only help Australians living with pain to better manage their condition but also reduce the burden of cost for both the Government and the people who pay out of pocket expenses to manage their acute and/or chronic pain.

Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis

The Journal of Pain Volume 19, Issue 5 May 2018 pages 455-474

https://www.sciencedirect.com/science/article/abs/pii/S1526590017307800

In summary-

  • Acupuncture is available under Medicare and Chronic Disease Management only if delivered by General Practitioners who may or may not have completed acupuncture training
  • Chinese medicine became a registered allied health profession under the NRAS in 2012
  • Registered Chinese medicine acupuncturists have superior training but are denied Medicare provider status to be included in the CDM because the Medical Services Advisory Committee considers that there is not enough proof for acupuncture to be included in the CDM
  • Discrimination and double standards seem to apply for the inclusion of acupuncture in the CDM

We ask that if you are successful in winning your seat in the 2022 Federal election, you endorse the inclusion of Chinese medicine acupuncturists in Medicare’s Chronic Disease Management, thus providing an evidence based, drug free, cost effective, option for pain management for all Australian citizens.

Yours faithfully,

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