Posted 08/09/2010 by Luke Buckmaster
Australia’s hung parliament has raised questions about the future of large-scale economic reforms such as emissions trading, the mining tax and national broadband. One significant potential reform in the social policy area over which there may also be uncertainty is national disability insurance.
In recent years, there have been increasing
calls from within the disability sector in Australia for the introduction of a new, national, long-term mechanism for funding support for people with disability—known as national disability insurance.
Those arguing for a new approach have suggested a number of significant problems with the current system, including the continuing failure of funded services to meet demand and projections of a significant increase in the number of people with a severe or profound disability—according to the
Australian Institute of Health and Welfare (AIHW), around 2.3 million Australians will have a high level of disability by 2030.
The Commonwealth currently provides income support primarily through the Disability Support Pension (DSP) for those affected by disability. Until recently, the provision and funding of disability services by the Commonwealth, State and Territory Governments was dealt with under the Commonwealth State Territory Disability Agreement (CSTDA). Under the Council of Australian Governments (COAG) reforms to Commonwealth-state financial relations, announced in March 2008, the CSTDA was replaced with the National Disability Agreement (NDA). In the new agreement the areas of responsibility remain essentially the same.
Under the NDA, open and supported employment services, as well as targeted employment support services, are administered by the Commonwealth Government. State and territory governments administer accommodation support, community support and community access services for people with disability, along with respite care services that provide relief and support to families or carers of people with disability.
Funding through the CSTDA/NDA has been an area of controversy in recent years, with the states and territories and many in the disability sector claiming that funding provided by the Commonwealth is inadequate.
The Commonwealth, in partnership with the States and Territories, is currently developing a National Disability Strategy (NDS). The purpose of the NDS will be to guide the development of disability policy across the jurisdictions.
A
report by the Disability Investment Group, commissioned as part of the development of the NDS, recommended that a feasibility study be carried out into a National Disability Insurance Scheme. In response, the Rudd-Gillard Government
requested that the Productivity Commission investigate ‘the feasibility of new approaches, including a social insurance model, for funding and delivering long-term disability care and support for people with severe or profound disabilities however they are acquired’. The Commission will report to the Government in July 2011.
Therefore, the Parliament is likely to be required to address one or more proposal(s) for the design of a new approach to funding support for the disabled.
Key features of the scheme proposed by advocates of national disability insurance include:
- eligibility to include all those born with a disability or who acquire a permanent disability through an accident, injury or as a result of a medical condition, including mental illness
- a ‘no fault’ model: provision of support and care for people with disabilities would be separated from legal action for negligence/culpable behaviour
- a lifetime approach to care, rather than simply at times of crisis
- active case management
- universal (non means tested) access
- funding drawn from, possibly, a special supplement to the Medicare levy, private health insurance, third party car insurance and/or workplace insurance
- national standards of assessment, care, support and case management.
The expected benefits of national disability insurance include improved health and employment outcomes as a result of an increased focus on early intervention and more private investment opportunities in an expanded disability services sector. Reduced expenditure on income support and medical care would be expected to offset some of the cost of the scheme.
If adopted, such a scheme would be about more than ensuring a funding base for disability services into the future. It could enable the development of a more long-term, integrated and planned approach to disability services than is possible under current arrangements.
The introduction of national disability insurance scheme would be a major reform. As with Australia’s most recent major social policy reform, Paid Parental Leave, there is likely to be significant, strongly contested debate about the design of any proposed scheme. Key questions are likely to include what will it cost, how will it be funded, who will be eligible (or, perhaps more importantly, ineligible), and how the scheme would interact with existing supports and services (including DSP, Medicare).
Reaching agreement on such questions would be likely to provide a substantial challenge for the new parliament.
(post co-authored with Michael Klapdor)
(Image sourced from: http://www.ndis.org.au/takeaction.html)