Thursday, 2 May 2013

An increase in the Medicare Levy has

been proposed as a way to pay for the National Disability Insurance Scheme. The Prime Minister announced this yesterday. It reverses yet another pronouncement she made earlier but even her most ardent supporters have come to expect such backflips.
On the surface paying for the NDIS through an increase in the Medicare Levy seems like a reasonable way of going about things - after all disability and health are closely related areas.
I am however opposed to doing it that way.
First of all, it does not cover the cost of the NDIS - estimates that have been bandied about in the press range from $8-15bn a year. That is at the current rate of need. The levy proposed would raise about $3.5bn a year. 
That means that the NDIS is only partially funded. Where the rest of the money is going to come from on an ongoing basis is a mystery. The government has remained strangely silent on this issue. The Opposition, which supports the idea of the NDIS in principle, has pointed out this difficulty but also not come up with a solution. 
No government is, in the current financial climate, going to commit billions of extra dollars each year to the care and support of people with disabilities when they know that families will take on the task - and take it on because they must. 
So, the NDIS is still not funded.
And then, it is being funded through a hike on the Medicare Levy. That seems perfectly fair as it is insurance for everyone - or is it? I can see at least two problems with this. 
The first is that, by raising the money through the Medicare Levy, there is no guarantee that what is raised will be spent on disability services and certainly not on the services people need and want. The money will be there in the general revenue. It is not a specific fund for a specific purpose. There is a danger that the money will be used to prop up other programs the government of the day sees as buying them votes. The amount available will be eroded or siphoned off and nobody will be able to quite account for it. To be at least partially transparent it needs to go into a separate fund. 
The second problem is that, if there are insufficient funds - and there will be - the money will go to those who make the most noise or will be "means tested".  
Those who make the most noise are not always those who need the most assistance. What do you fund - the family with the "autistic" child or the family with the child who has a medical condition which results in "a lack of bowel and bladder control" requiring a constant supply of nappies. I know families with both problems. 
The first family has a child with behaviour problems. Labelling the child "autistic" has allowed the family to come to terms with a child who is difficult to handle. His "condition" rules their lives and they have made a mission out of it. They are demanding and getting thousands of dollars a year in specialist services. I do not see it changing any time soon. Is he even "autistic"? I am not allowed to judge but I have come across children with much more serious adverse behaviours and I would have thought they needed much more help than he gets. 
The other family gets almost no assistance. The mother cannot go to work. She has to be available to help her son at school. There is no provision for someone else to change his nappy and, at five, he is too young to do this himself. He's a bright child and very conscious of his condition. If he could take himself off discreetly to a school nurse for help his life would be much pleasanter than it is. 
The cost of nappies each week is high. It is something for which there is very little help. 
I have a nasty feeling that nothing much will change under the NDIS. The first family, in which the mother chooses not to go to work, has a good income and they have worked the system. I suspect they could work the NDIS too. The second family has a similar sort of income but their actual expenses are much higher, especially as their son has been in and out of hospital many times. 
The NDIS should cover the expenses but it won't and they know it.
Other families think it is going to mean they will get all the support services they want. They think the introduction of the NDIS will mean they get showers seven days a week, new wheelchairs and other equipment, therapy, transport, expensive medications and just about anything else. They believe there will be money for professional carers - although nobody has said where they will find the trained staff.
As someone with a disability myself I would love to see all people with disabilities live on an equal basis with everyone else in the community. I also know that the cost of that means it is not going to happen. I also know that whatever people might say when it actually comes to paying for those services they will resent the cost when it becomes what they perceive as being "too high". It is no doubt another reason why the government has attempted to hide a new tax in an old one. 
What bothers me most though is the expectations which have been raised and will be dashed again through using people with disabilities as a political football. Our political leaders are to be condemned for that. 


Anonymous said...

Are we really going to get the NDIS - seems to me it is being hedged around with all sorts of ifs and buts on both sides. I mean really $15bn a year on top of what we already spend?
Not likely! They will take money from other places won't they? Ros

Philip C James said...

My sympathies but at least you don't have a Conservative government that is actively working to scapegoat disabled people and creating a climate in which hate crimes against them are allowed to take root and grow.

Anonymous said...

The devil is in the detail .... and I suspect there will be many volumes of fine printed details.