The troubled birth of the NDIS
Published in The Australian, October 1, 2013
IF you are confined to a wheelchair at the age of 29, it should not take a year to get the lock on the front door moved to a height where you can reach it.
A child of 4 1/2 with chronic cerebral palsy should be entitled to a powered wheelchair and if there is a rule that says she does not get one until she turns five, anyone with an ounce of common sense would be prepared to bend it.
Advocates of the National Disability Insurance Scheme invite us to believe that these and countless other lived experiences of official intransigence will be solved once the NDIS is introduced at a cost of $14.5 billion a year.
It is a figure that trips off the tongue rather too easily these days. For the record, it is somewhat more than we spend on the Pharmaceutical Benefits Scheme, though marginally less than it costs to fund Medicare.
There is little dispute that assistance for the disabled should be better funded and better administered. Putting the burden on parents, as we now do, is a random form of taxation that is both inequitable and inefficient.
It is important to ensure we are getting value for money, however, since the hopes of hundreds of thousands of disabled Australians rest on the scheme working as advertised.
There is a catch, and it is rather a large one. The bureaucracy-busting National Disability Insurance Agency, the body set up to help cut through the red tape, will itself be run by bureaucrats.
We can only hope that these bureaucrats will be unlike any others we know and that they will be dedicated to reducing suffering, not increasing it.
We trust they will be able to work seamlessly with their state colleagues, local administrators and community organisations to maximise the number of cents in every dollar that will ease the friction of everyday life for people who have suffered chronic misfortune and minimise those spent on administration.
Parliamentarians, anxious to be seen to be on the side of virtue, passed the National Disability Insurance Scheme Act virtually on the nod.
Let us hope the paucity of parliamentary scrutiny does not mean it has not been properly thought through.
It has been a busy year all round, and some readers may not yet have had time to acquaint themselves with this particular piece of legislation. The fact that it runs to 168 pages is the first clue to how complex the NDIS is likely to be.
Beneficiaries, known as “participants”, will first have to demonstrate that they have “substantially reduced functional capacity” and that it is likely to be permanent in nature.
The gap between “substantially reduced” and “partially reduced” allows considerable bureaucratic wriggle room.
Rejected candidates will have the right of appeal, but there are only two likely outcomes: either there will be a long queue of aggrieved partially disabled applicants, or the number of participants and the cost will blow out considerably.
The good news is that whether you are 4 1/2 or 64 1/2, the NDIS will pay for a powered wheelchair.
A 65 1/2-year-old, however, is out of luck, since the scheme does not apply beyond pensionable age.
Architects of the scheme have worked hard to persuade us that this is not another top-down, centralised behemoth in which the welfare of the administrators takes precedence over the welfare of the participants.
Personalised plans allow the disabled to decide how funds can best be spent to overcome their disadvantages. They will choose which approved provider can best perform the task at hand and they can judge if they are getting value for money.
Yet none of this disguises the big-government nature of the NDIS. Where once families, friends, communities, friendly societies and churches might have stepped in to assist those visited by misfortune, the first recourse these days is to place further demands on the state.
Altruism has been nationalised. The anguish-relief business has been requisitioned by the commonwealth. Compassion has become the currency of modern politics, and both sides are anxious to spend it.
It falls upon Tony Abbott’s government to make this thing work. Mitch Fifield, as Assistant Minister for Social Services with responsibility for disabilities, has his work cut out, for the design of the scheme is crucial if it is to deliver for taxpayers and beneficiaries.
The Coalition has pledged to provide the promised funds, but believes the scheme is unnecessarily complex, duplicating responsibilities and blurring lines of accountability.
The involvement of the Productivity Commission notwithstanding, this is a very Labor kind of scheme, one in which the worthiness of the goals excuses a lack of attention to the detail of how it will be administered and funded.
Labor went so far as to remove the word “insurance” from the scheme, a mistake the Coalition says it will correct.
The distinction is more than semantic. Operating the NDIS on insurance grounds from revenue generated by a hypothecated levy would force its administrators to live within their means and place an effective cap on benefits.
The Coalition now has the chance to reshape the scheme to fulfill its original intention of removing, where possible, the barriers to a productive and contented life.
Framed that way, it is a challenge that sits comfortably within the Liberal Party’s core beliefs, as articulated by its leader in his election launch speech.
“Our country will best flourish when all of our citizens, individually and collectively, have the best chance to be their best selves,” the Prime Minister said.
“Government’s job is rarely to tell people what to do; mostly, it’s to make it easier for people to make their own choices.”
Rest assured, in the implementation of the NDIS, the bureaucracy will be trying its level best to make sure that does not happen.