A proposal for a National Disability Insurance Scheme (NDIS) is on
the table. But is it worth having in this form?
Some twenty percent of Australians have some kind of disability. You
may not have one today, then Bang, you too join the club. Accidents,
old age, illness, congenital impairment. It’s part of life and they
happen to you and me. Not just to someone else.
But you cannot really insure against disability, just against some of the financial costs of it. The reason you cannot is that the experience of disability is largely determined by social attitudes towards people who have impairments of some sort. Physical, mental, sensory or whatever.
Those social attitudes ensure social exclusion, isolation,
abuse, unemployment and poverty for many people who have
disabilities and their families. And these effects bother
disabled people far more than the fact that they cannot
walk, see or hear.
No insurance against disabling attitudes.
Significant disabling attitudes are those that see the
person as a tragedy, and a medical problem. Or as a
worthless deviant with no economic role to play. Or treat
them as a commodity in multi-billion dollar disability
services and “care” industries. As someone with long-time
personal experience of quadriplegia and involvement in the
disability area, I know that in a society like ours no
insurance premium can buy you the status of a valued person,
to be included in our society’s work, learning and playing
activities, alongside everyone else.
There is of course a case for a no-fault disability
insurance. I think of it as erasing the anomaly between
those who might become disabled in a car accident, and
receive a big compensation pay-out, or receive nothing if
you did the same thing by being dumped on your head by an
ocean wave, or acquired a disability at any time, whatever
the cause. Or the anomaly where a legally blind person
receives a means test-free disability support pension, but
no one else does – while many impairments involve higher
disability-related costs of living. At least a straight
no-fault disability insurance scheme might compensate
somewhat for the significant disability-related extra costs
of living, thereby relieving some disability-related
poverty.
There is now a proposal for a no-fault
National
Disability Insurance Scheme (NDIS) on the
table. It wants a public, tax payer levy like Medicare or
superannuation to pay for disability services and equipment
for people with disabilities, whether born with an
impairment or acquired one as a result of an accident. It
says the results will be “transformational” for people with
disabilities and their families but the scheme will not
provide income support. And it says nothing about
transforming disability services towards meeting fundamental
needs. Just the same disability services we’re getting now,
but more of them, along the same lines of existing
managerial service ideology. This, even as the NDIS proposal
says the disability services system is not good enough,
which is a notion I support.
Grounds for opposing NDIS
I oppose NDIS in its current form on several grounds. The
main one is that you cannot make mango juice out of a lemon.
We don’t need more of the same. We need something
fundamentally different. Something based on the meaning of
Care, not industry-based competition. Some approach that
genuinely meets individual needs. Secondly, in doing so we
need to honestly and transparently separate the budgetary
needs of the disability industry and government Treasuries
from the human needs of the people that this is all for:
people with disabilities - and not let the first two ride
over the third. Lastly, we need to pause and acknowledge
that a similar levy-based scheme, called Medicare, has not
so far led to an equitable, high quality, needs-based health
system. So why would NDIS?
Disabling barriers within disability services
The NDIS proposal states that the disability service system
was “not properly designed and structured, but has developed
in an ad hoc and deeply inequitable way over several
decades.” What it does not explore is where the causes for
the unresponsive system lie. They are found as much in the
disability industry’s values, fears and ignorance as those
that shut people with disabilities out from our society. And
often they are cemented in by the same managerialism and
application of market forces to human wellbeing that
Kevin Rudd says
he is concerned about. This goes beyond
tweaking or buying better quality service.
So what does NDIS propose? That its implementation will
create quality service through industry-wide competition
in a “a new competitive marketplace for service
provision” driving” efficiency and effectiveness” That
people can have more “case management”, a discredited
managerial tool. That we can have “training, development and
access to work to build self esteem...” Do you go to
work for that reason? It says this perpetuation of the
system, of which it also says does not work, will be
“transformational” for people with disabilities. Sadly,
making such calls about what people with disabilities need
may actually get NDIS over the political line as people with
disabilities and families grasp this straw in their
desperation. But the security and safety actually being
offered appears indeed as no stronger than that. Those are
not the fundamental needs we need met. NDIS seems deeply
incoherent and its real agenda apparently is simply more
money and reducing cost.
Money alone is not the answer, but it is a seductive one.
Truths about the devalued social position of people with
disabilities are expressed in numerous reports, including
the recent
“Shut Out”
report from the
National
Disability Strategy Review, and in the
feedback pages on the NDIS Plan website itself. These
reports show two noteworthy things:
1) The deepest felt needs, expressed by people with
disabilities, involve their social acceptance and inclusion
as a valued human being;
2) Such acceptance cannot be bought, yet there is a
pervasive feeling that if only enough money were available
to enable any services to be available to anyone who needed
it, that all would be well. A sense of relief, security and
safety would result.
But we also know, re-stated by 56% of submissions to the
current Strategy Review report, "that services and programs
act as a barrier to, rather than a facilitator of, their
participation." We don’t need an NDIS that would entrench
this.
Money cannot buy you love
We all know what happens when you try to buy love – it
becomes a commodity and is thereby perverted. Paid service
therefore always needs strong safeguards against its abuse:
the pornography of care. The disability industry has few
strong ones. One safeguard is to entrench service values,
structures and practices in fundamental, individual needs,
with care.
At heart, what people with disabilities need is full
acceptance into the social fabric of Australia, and true
service that enables them to be supported and celebrates the
aspiration of their full human potential. Doing this will
reduce many of the disabling effects of our impairments.
Yes, of course some of this needs money. But let’s not start
with that. At the core of it is priceless attitudinal
change. A society that attempts to buy it, with money or
with managerial tools, will find that is impossible. It
actually takes some hard yakka to create a welcoming
community.
And there are
also some examples of good service to build on.
A society that cannot do this with its most
vulnerable members is unsustainable because of the
underlying NDIS premise: We’re all in this together.
Let’s first look anew at the whole concept of insurance
against disability, where being of service is more important
than the disability services industry. Perhaps then,
together we can craft an NDIS that supports good lives for
people with disabilities.