The Commission argues, refreshingly, that
The current disability support system is underfunded, unfair, fragmented, and inefficient, and gives people with a disability little choice and no certainty of access to appropriate supports.It responds by calling for a new national scheme (the National Disability Insurance Scheme or NDIS, administered by the National Disability Insurance Agency - "a federal agency created by, and reporting to, all Australian governments") that would provide insurance cover for all Australians in the event of significant disability and fund long-term high quality care and support (but not income replacement) for around 360 000 people.
While Australians would pay more taxes (or governments would cut other spending), people would know that if they or their family acquired a significant disability, they would have a properly financed and cohesive system to support them.The Commission envisages the NDIS as having -
several other important roles, including mustering community resources, providing information to people, quality assurance, diffusion of best practice among providers, and breaking down stereotypes.The fine print is more traditional, with the Commission commenting that -
the needs of people with a disability and their carers would be assessed rigorously by NDIS-appointed local assessors, with careful management to avoid assessment 'softness' or 'hardness'. Assessment would lead to individualised support packages. Strong governance would be necessary to contain costs and ensure efficiency.The National Disability Insurance Agency -
would have strong governance arrangements, with an independent board, an advisory council of key stakeholders, clear guidelines to ensure a sustainable scheme and with legislation that protected the scheme from political influences.The Commission emphasises choice -
People would have much more choice in the NDIS. Based on their needs assessment and their individualised support package, they would be able to choose their own service providers, ask a disability support organisation (an intermediary) to assemble the best package on their behalf, cash out their funding allocation and direct the funding to areas of need they think are most important. There would have to be some controls over the latter to ensure probity and good outcomes. People would need support to adopt this option and, given overseas experience, it would take some time for many to use it.How much will the glittering future cost? The Commission estimates that in 2009-10 the national, state and territory governments provided around $6.2bn funding to the disability sector.
The NDIS would cover the same range of supports currently provided by specialist providers, but would give people more opportunities to choose mainstream services and would encourage the development of innovative approaches to support.
The Commission's preliminary estimates suggest that the amount needed to provide people with the necessary supports would be an additional $6.3 billion, roughly equal to current funding. Accordingly, the real cost of the NDIS would be around $6.3 billion per annum. That could be funded through a combination of cuts in existing lower-priority expenditure and tax increases. ... The Commission is proposing that the Australian Government take responsibility for funding the entire needs of the NDIS. This is because the Australian Government can raise taxes more sustainably and with fewer efficiency losses than state and territory governments.The fiscal magic pudding can be resliced through reduction of state and territory taxes (unsurprisingly the Commission's preferred option) or by transferring revenue to the Australian Government.
The Australian Government would fund the NDIS through payments from consolidated revenue into a 'National Disability Insurance Premium Fund', using an agreed formula entrenched in legislation. The scheme would commence in early 2014 ("with a full scale rollout in a particular region in Australia") and extend to all Australia in 2015, progressively expanding to "cover all relevant people with a disability, commencing with all new cases of significant disability and some of the groups most disadvantaged by current arrangements".
In the oh it is scary basket the Commission flicks responsibility for funding of lifetime support to the state/territory governments -
A separate scheme is needed for people requiring lifetime care and support for catastrophic injuries - such as major brain or spinal cord injuries. Currently, many Australians get poor care and support when they experience such injuries because they cannot find an at-fault party to sue. A no-fault national injury insurance scheme (NIIS), comprising a federation of individual state and territory schemes, would provide fully-funded care and support for all cases of catastrophic injury. It would draw on the best schemes currently operating around Australia. State and territory governments would be the major driver of this national reform.
