Honest Universe

Superstition, pseudoscience, and scepticism

ACC and Alternative Medicine

with 3 comments

The Accident Compensation Corporation (ACC) is part of the healthcare system in New Zealand. To quote themselves on their purpose, they provide “comprehensive, no-fault personal injury cover for all New Zealand residents and visitors to New Zealand”. To put it simply, if you hurt yourself in an accident in New Zealand, ACC will likely pay for all treatment you require to recover from that injury.

They are not strictly part of the government, but they are a Crown organisation set up via the Accident Compensation Act 2001, and they are controlled directly by the government through an ACC minister. At the time of writing, the current ACC minister is Judith Collins. The ACC is funded publicly through various avenues, including levies on people’s earnings.

Recently, the current chair of the New Zealand Skeptics, Gold, submitted an Official Information Act (OIA) request (using the great service FYI, which makes these requests public) to the ACC asking:

Please can you tell me, for each of the last 10 years, how much the
ACC has paid out for each of the following services:

Acupuncture
Chiropactic
Osteopathy
Naturopathy

On the 20th of May 2014, the ACC responded to Gold’s OIA request with this information:

The following table shows the total amount (in dollars, excl GST) ACC has paid under Regulations for Osteopathic, Acupuncture and Chiropractic services for the last 10 years.

Financial Year $ cost
Osteopathy Acupuncture Chiropractic Total
2003/04 6,210,642 4,424,458 8,056,875 18,691,975
2004/05 6,767,849 5,452,119 8,007,011 20,226,979
2005/06 7,237,766 5,954,239 7,947,342 21,139,347
2006/07 8,038,676 7,616,042 8,734,453 24,389,171
2007/08 10,082,351 12,392,494 12,007,580 34,482,415
2008/09 10,945,880 15,761,415 13,173,902 39,881,197
2009/10 10,470,269 15,605,042 11,804,095 37,879,406
2010/11 9,802,401 16,225,902 10,832,912 36,861,215
2011/12 10,029,446 16,958,808 11,654,292 38,642,546
2012/13 10,964,806 19,961,329 12,312,832 43,238,967

Naturopath is not an ACC funded service; therefore your request for this information is declined under section 18(e) of the Act, as the document alleged to contain the information requested does not exist or cannot be found.

Here’s that information on a chart, excluding the totals. As you can see, spending on acupuncture in particular has increased dramatically over the last decade:

ACC spending on alternative therapies per financial year from 2003/04 to 2012/13

ACC spending on alternative therapies per financial year from 2003/04 to 2012/13

This OIA request was a follow-up to an earlier request from Mark Honeychurch regarding essentially the same information. The response to Gold’s request included a new column for 2012/13, as well as the “Total” column although that isn’t strictly new information. Also, the information from Gold’s request seems to have been a catalyst for an article published on the 24th of May 2014 on stuff.co.nz: Big Bill for Alternative Health.

This article did a little more digging, asking questions of doctors, acupuncturists, and the ACC. I highly recommend you read it. The most interesting part to me was this:

In 2009, then-ACC Minister Nick Smith questioned the ballooning ACC bill for complementary treatments and said their effectiveness would be reviewed.

Since then, the cost has risen another $5m but ACC said no review ever took place.

ACC Minister Judith Collins did not answer questions about the review.

It is not mentioned in this article, but I have known for some time that the ACC has a document published on their website entitled Acupuncture Treatment Profiles. The document describes itself as:

a valuable guide in the application of protocols that are included within a Traditional Chinese Medical (TCM) diagnosis, providing important information that assists an acupuncturist’s treatment strategy.

This appears to be an official ACC document, to be used by ACC-registered acupuncturists to determine appropriate methods of diagnosis and treatment that are approved for ACC funding. However, having a look through it one can’t help but notice egregiously wrong and pseudoscientific statements such as the following:

  • Acupuncture… Relieves pain by treating stagnation of Qi and Blood in the affected areas and channels
  • Qi is the vital force of life which… Is the material substrate of the Universe
  • Brain… Is considered to be the same in substance as marrow
  • the Kidney produces marrow

I shudder at the thought that the ACC levies I pay are partly used to fund this. It seems to me that it’s high time the ACC carried out a review of the evidence behind these therapies that it funds, so problems like this can be rooted out and dealt with. Publicly funded healthcare should be based on science, after all.

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Written by Mark Hanna

2014/05/25 at 1:33 am

3 Responses

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  1. For the record, the request for the total was misinterpreted. I was after the total spend for the year so as to determine the percentage each of these had contributed. What we got was the total of the 3 columns. I can see how it could be misinterpreted, but really? Anyone could add the 3 numbers.

    I have asked for the actual total spend for each of the years also. Hopefully this will come through soon.

    Gold (@unifex)

    2014/05/25 at 5:58 pm

    • Yeah, it would be good to add those data, particularly to see how overall changes in ACC spending have (or haven’t) been reflected in these particular rates of spending. I’d had a couple of people suggest on Facebook that in some years ACC spending on claims has gone down significantly, at least in some areas, but these ones have kept rising, although time will tell if the data support this.

      In the meantime, the ACC website has a page on Frequently requested facts and stats that says over the 2012/13 financial year, ACC spent $2.6 billion on claims.

      Mark Hanna

      2014/05/25 at 9:35 pm

  2. Shockingly, that Treatment Profiles document seems to be the closest thing the ACC has to a measure of acupuncture’s effectiveness. Last year, an Official Information Act request from James Sullivan asked “a summary of what processes and requirements the ACC uses to measure the effectiveness of every alternative medicine that is funded.”

    The ACC responded to that question by saying:
    “With respect to processes and requirements for measuring effectiveness, Treatment Profiles have been developed for 150 common injury types. Treatment Profiles are guides to the treatment and rehabilitation services ACC expects a practitioner to provide to a client for a particular injury. They describe current ‘good practice’ and what outcomes should be achieved.”

    Mark Hanna

    2014/06/09 at 2:13 pm


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