David Beard: A visit to an exercise physiologist is an unnecessarily expensive exercise

Why would a Government want to discourage people from exercise?

We know that exercise is essential in fighting the chronic health epidemic that is costing lives and will bankrupt governments if not reversed, so surely politicians would want to remove any roadblocks to getting us active and healthier.

Apparently not, because Canberra continues to make visiting an exercise physiologist an unnecessarily expensive exercise.

There are 500 exercise physiologists in WA and 10,000 in Australia.

I am one of them.

Through our professional body, Exercise and Sports Science Australia, I represent over 500 allied health professionals in WA (there are 10,000 in Australia) who have spent three to six years getting university-qualified to help people with chronic health conditions, mental health challenges or recovering from injury and surgery.

Exercise physiology is a relatively young profession. It wasn’t until 2005 when the Federal government acknowledged the value of our profession and included it in the Medicare system.

This meant GPs could refer their patients and Medicare would subsidise the cost, as they do with other allied health professions. This was a major milestone and in the two decades since, its positive impact on Australian’s health has seen the profession grow rapidly.

On entering the Medicare system, exercise physiologists anticipated that they would be treated the same as other allied health professions with respect to tax rules.

Unfortunately, tax legislation has not kept pace with Medicare recognition and exercise physiology continues to have GST applied in most situations.

In 1998, the white paper on tax reform: not a new tax, a new tax system, outlined the government’s rationale for making most medical and hospital services GST-free: “Applying taxes on health care would place the private health sector, with its heavier reliance on direct fees, at a competitive disadvantage with the public health system.”

The white paper also stated: “Medical services will be GST-free if they attract a Medicare benefit or are commonly used health services, listed by the Government.”

Since exercise physiology wasn’t part of the Medicare system when GST started back in 1999, it wasn’t included in the schedule of health services with GST free status.

However, from 2005 it meets all the criteria to be a GST exempt health service. Our patients expected exercise physiology would automatically be afforded GST exempt status making our services more affordable and accessible to Australians managing a wide range of illnesses.

Every politician we contacted has agreed this is an anomaly that should be fixed to make access to our services more affordable and reduce the burden on the public health system.

They understand exercise physiology should have the same GST free status as 21 other allied health services. They quickly comprehend exercise physiology helps the keep the health system sustainable by keeping people out of acute care.

For the GST legislation to change, all state treasurers must agree, and the Federal Treasurer must act.

In 2021, all State treasurers endorsed a proposal from Treasury to adopt a principle-based approach to deciding what professions should be GST exempt. All that was needed was the Federal Treasurer to put it on the agenda of the Council of Federal Financial Relations to be formally endorsed.

Sadly Jim Chalmers, does not seem interested and recent communication with his office would indicate he just doesn’t think it is important.

Given it is the States who get the funds from GST, it is hard to see why Treasurer Chalmers and the Albanese Government is blocking this simple proposal to make health care more affordable for thousands of Australians who need professional help to manage their physical and mental conditions.

The frustration of having all the State treasurers agree to change and the Federal Government failing to act is unconscionable. I see first-hand how our current health system is struggling under the weight of an ageing population and a chronic disease epidemic. On all counts, exercise is one of the most potent tools for helping people, especially older adults, to maintain their health.

Professionally prescribed exercise for older Australians keeps them independent for longer, reducing the demand for aged care services, which we know are not keeping up with demand. Independent research has shown that for every dollar invested in the services of exercise physiologists it saves the government $6.

Exercise is also a major determinant of immune system function. When we are being warned that another virus could be just around the corner, surely Australians should be supported to maximise their immune system as much as possible.

I’m calling on Treasurer Chalmers to act on this issue in this term of Parliament to make health care affordable and keep our public health system sustainable.

David Beard is WA Chair of Exercise and Sports Science Australia and works as an exercise physiologist at HFRC in Nedlands