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PACFA CEO lobbying Private Health Funds

The PACFA CEO, Maria Brett, has been engaging with a range of private health insurers (PHIs) to identify opportunities to increase private health rebates for services provided by counsellors and psychotherapists.

During July, the CEO met with representatives of nine Private Health Funds:

  • Australian Regional Health Group
  • Australian Unity 
  • Bupa
  • HBF
  • HCF
  • Medibank
  • NIB
  • St Lukes
  • Teachers Health

A key message presented to the PHIs is the fact that counsellors and psychotherapists are a highly-skilled but under-utilised part of the mental health workforce. We are, in fact, the practitioners of choice for many people who do not wish to see a psychologist and who wish to access other interventions besides CBT. There is strong evidence that providing services according to client preference improves outcomes (Lindhiem et al. 2014; McLeod, 2012).

We know there is significant demand for mental health services amongst all age groups with up to one in five people aged between 16 and 85 experiencing a common mental illness. An estimated 45 per cent of all Australians experience a mental illness in their lifetime, but less than half will access treatment (Black Dog Institute, 2019).

There are long term savings to be made by avoiding worsening mental health conditions and potentially preventable hospitalisations through prevention and early intervention. Early intervention counselling and psychotherapy can have a significant longer term impact on mental and physical health, with associated savings in health costs. However, not all PHIs offer products that provide adequate access to a full range of mental health services, including counselling and psychotherapy.

A strong link has been found between mental and physical health (Nabi et al., 2008; Surtees et al., 2008). Poor physical health can lead to an increased risk of developing mental health problems. Conversely, poor mental health can negatively impact on physical health, leading to increased risk of some conditions. Mental disorders also delay the return to physical wellness.

Counselling has a growing role as an adjunct to medical interventions involving chronic conditions. Research from Australia Institute of Health and Welfare (2010) found that the 1.8 million people experiencing back pain were 2.5 times more likely to experience mood disorders, 1.8 times more likely to have anxiety and 1.3 times more likely to have a substance use disorder, compared to people without back pain. Short-term counselling is a sound, evidence-based response to concurrent physical and mental conditions.

We know from recent media reports that participation in the PHI market is going backwards. Customers are concerned about the cost of premiums and some customers, especially younger customers, are cancelling their private health insurance or downgrading their cover, including dropping Extras cover. The removal of natural therapies from Extras since 1 April 2019 may be one factor that has led to increased dissatisfaction with private health insurance.

In this climate, there is the potential for counselling and psychotherapy to be an attractive new Extras option for customers by increasing rebates for counselling and psychotherapy through Extras. Longer-term psychotherapy in hospitals and for outpatients to prevent re-hospitalisation is another option that could be explored further.

Cost-effectiveness could be a key factor for the PHIs. PHIs are run as businesses – even those that operate on a not-for-profit basis – so they are to a large extent driven by financial factors. Counselling and psychotherapy are cost effective prevention and early intervention strategies that could have a significant impact on the both the mental and physical health of the community.

PACFA will continue to engage with PHI around all of these issues and we advocate for recognition for all PACFA Registrants to be private health providers.

References

Australian Institute of Health and Welfare. (2010). When musculoskeletal conditions and mental disorders occur together. Bulletin 80. Cat. no. AUS 129. Canberra: AIHW.

Black dog Institute, 2019. Retrieved from https://www.blackdoginstitute.org.au/docs/default-source/factsheets/facts_figures.pdf?sfvrsn=8.

Lindhiem, O., Bennett, C. B., Trentacosta, C. J., & McLear, C., (2014). Client preferences affect treatment satisfaction, completion, and clinical outcome: A meta-analysis. Clinical Psychology Review, 34, 506-517.

McLeod, J., (2012). What do clients want from therapy? A practice-friendly review of research into client preferences. European Journal of Psychotherapy, Counselling and Health, 14, 19-32.

Nabi, H., Kivimaki, M., De Vogli, R., Marmot, M. G., & Singh-Manoux, A. (2008). Positive and negative affect and risk of coronary heart disease: Whitehall II prospective cohort study. Bmj, 337, a118.

Surtees, P. G., Wainwright, N. W. J., Luben, R. N., Wareham, N. J., Bingham, S. A., & Khaw, K. T. (2008). Psychological distress, major depressive disorder, and risk of stroke. Neurology, 70(10), 788-794.