Finding a focus for disability policy reform efforts
Over the past 12 months the Gillard government has attempted to improve its opinion poll ratings, in part by advocating policies to appeal to core Labor values. The proposal to establish a National Disability Insurance Scheme is a case in point.
The government is not only hoping that the NDIS would satisfy Labor's true believers by selling it, as Prime Minister Julia Gillard has, as ''a great Labor reform in the tradition of Medicare''. The NDIS might also prove attractive to people not firmly wedded to any political party, but whose votes could be won by promises of future benefits for themselves, their relatives or somebody else they know with a disability.
The Gillard government is also running hard on the NDIS to pressure the Coalition into a political position of agreement on the need to extend federal involvement in disability support.
The NDIS would subsidise packages of care, including aids and appliances, personal care and community access support, needed by those people with a significant disability to enhance their social and economic participation and, through it, their sense of self-worth and dignity.
The proposed system either pays for care packages from approved providers selected on behalf of disabled people, or directly provides funds for those willing and able to choose their own care. The idea is to empower people with disabilities with an increasing choice of service providers, and harnessing such choices by allowing funding entitlements to follow the person.
This disabilities voucher model was advocated by the Institute of Public Affairs in 2006, and is in line with similar proposals in other policy areas such as education, health care and welfare services.
Critics of the NDIS have focused attention on the significant price tag, of up to $14 billion in gross terms by 2018-19, including for the establishment of a government agency to administer the scheme. This funding ask is more than double the amount currently allocated by commonwealth and state governments towards specialist support services.
Coughing up the funds to implement the NDIS proposal is problematic in an Australian welfare state that already overreaches in its attempts to increasingly cater to the whims of middle and upper-income earners from cradle to grave. In its July 2011 report advocating the NDIS the Productivity Commission suggested one way to fix the affordability problem is for the Commonwealth to fund the scheme and the states reduce their taxes to the amount of disability funding they surrender to the Commonwealth. With the states having already resisted this idea, expect the Commonwealth to make a future play at clawing back some of the states' GST revenues to fund the disability scheme.
In making the case for a Commonwealth-managed NDIS, the commission has advocated a centralist solution that could be disadvantageous to the ultimate interests of people with disabilities. And this is not only due to the less than flattering record of successive Commonwealth governments in managing big bang reforms in service delivery, an area in which they lack expertise compared with the states.
While the commission joined with disability advocates in deriding interstate policy differences as a form of ''fragmentation'', disability support reforms enacted by individual states are already providing important lessons in policy experimentation for other jurisdictions to observe and act upon.
By most accounts Western Australia and Victoria are the most advanced on the path to self-directed funding, whereby people with disabilities are allocated a budget to then expend on care packages relevant to their needs.
Although progress by other states in promoting greater consumer autonomy over the use of public funds has varied, the NSW government has responded to longstanding criticisms of bureaucratically-driven block funding in that state by promising individualised funding packages for people with disabilities.
Competitive federalism is doing its work in spreading the benefits of good policies across the country, and confining the consequences of bad policies in fewer jurisdictions over time, without recourse to a national NDIS. This is not to say that existing state-based systems are perfect; far from it. One criticism which drenched the pages of the commission's NDIS report concerned unmet demands, and the insidious effects of politicised resource allocation, leaving the disabled on supported accommodation and other waiting lists.
Apart from urging state government stragglers to voucherise their own funding arrangements, in effect creating state versions of the NDIS, a policy conversation needs to be had about even greater non-government sector involvement, including by the private sector, in service delivery.
More non-governmental involvement will be important in the future, as it can help transcend the states' budget limitations and provide a far more responsive system meeting unfulfilled needs.
The participation of more private and-not-for-profit service deliverers can best be facilitated through a process of crowding in, including through a substantial downsizing of regulatory obligations imposed on providers. A smaller, better-focused welfare state will also assist by providing room for non-government providers to provide extra disability support services, and encourage more philanthropic contributions to the sector. It is the twin pillars of state funding reform and additional non-government service provision that should be the focus of disability policy reform efforts, rather than the unquestioning acceptance of a social policy power grab by the federal government in the name of some of our most vulnerable community members.