Today Prime Minister Julia Gillard introduced the legislation for the National Disability Insurance Scheme. This Medicare-like scheme is a very important reform, a long time coming for people with a disability, who have suffered under inadequate and differing support regimes from state-to-state. The NDIS will create a national framework under which the needs of those with a severe and permanent disability will be met.
The introduction of the legislation in the House of Representatives is just the first step. NDIS trial sites will be launched next year, but there is still a need to keep the pressure on, to ensure that the fully-fledged system will be realised.
Up until recently, most of the negative debate around the policy has been about the cost. It is significant, requiring approximately $15 billion a year from the first full year of implementation in financial year. That time comes at the end of this decade. But the scheme can and must be funded. There are numerous ways to ensure that it is fully funded.
This week, in an opinion piece in The Australian written by Doron Samuell from SR2 Healthy, relatively new arguments came to light.
In the first instance, Mr Samuell argued that, “lured by the promise of taxpayer dollars, it is inevitable that disability services will come to be dominated by large, corporate players in the post-NDIS world.”
Later in his op-ed, Doron Samuell provides an argument which says that this is already occurring. So really, what we will have is the status quo. It is hard to envisage that smaller providers could be crowded out even more than they already are.
For equipment, like wheelchairs and other mobility aids, disabled people will most likely choose to use bigger organisations that might have the capacity to carry a broader range of stock and therefore, more cost-competitive products.
For services, users will probably choose to use a mixture of smaller, community-based organisations and larger “corporatised” ones. This will, again, at least maintain the status quo. There is also a strong chance that smaller organisations able to adapt to client needs under the NDIS will be able to grow if they can prove they provide good services.
The idea of the insurance scheme, as it will apply to many applicants, is to give users, capable of decision-making, the choice to pursue services from providers that they perhaps already identify with.
Also on the question of choice, Samuell made what amount to some pretty offensive, not to mention inaccurate comments about the capacity of people to choose wisely under the disability scheme. He actually claimed that the disabled were “often unsophisticated” purchasers and asked “these consumers going to make the right decisions?”.
Well, of course those who have a capacity to make decisions for themselves are overwhelmingly going to make the right decisions according to their needs. People with a disability are no less rational than ‘able-bods’ and nobody else knows their personal requirements better than people with a disability themselves. No doctor, no healthcare professional, no bureaucrat understands disability better.
Mr Samuell also appears to have forgotten a provision in the bill, which allows for funds to be provided to a carer or directly to a service provider in the event that someone eligible for NDIS funds is unable to make or communicate decisions for themselves on their own care needs. The latter is a worry because, again, bureaucrats should not be making these kinds of decisions.
Samuell also states that “the NDIS will need to ensure that buying decisions are scrutinised, audited and reviewed”. The legislation actually provides for this.
Doron Samuell does go to the question of funding. He does this from the position that Medicare, the system that the National Disability Insurance Scheme is based on, is under-funded and has a bloated bureaucracy.
There is a danger that the NDIS will be under-funded. There is always that danger when government embark upon significant reforms, that costs might be under-estimated. But what is clear is that the claim about Medicare only coping “by progressively lowering the standard of care to maintain its universality”, will almost certainly not apply to the NDIS.
A bloated bureaucracy is of some concern. There will need to be a significant number of jobs created or filled across the states and territories to oversee the agency. However, the bigger concern should be too much centralisation of the increased bureaucracy.
Finally, Samuell’s contention about the NDIS not being based on insurance principles is neither here nor there. What is important is that this landmark reform provides adequate support for those it is targetted at.Getting bogged down in definitions is pointless.
The biggest concern should be making sure the introduction of the full scheme occurs in 2018-19.
The Minerals Resource Rent Tax has commenced and it’s causing problems for the Gillard Government, including in particular, the Treasurer. What most people would not have expected is the way in which it is causing trouble for Wayne Swan. Instead of having to defend a huge tax grab, the Treasurer today was forced to respond to reports in newspaper The Australian that the MRRT failed to raise any revenue in it’s first quarter of operation. This is a circumstance few would have seen coming, though tumbling commodity prices should have provided somewhat of a warning to the pundits.
You see, the Minerals Resource Rent Tax, the renegotiated version of Kevin Rudd’s Resource Super Profits Tax was designed in an interesting way. Even though the name was changed, the new iteration was still a tax on profits. Therefore, when profits were high, the tax would be paid and when they were low, it would not.
Budget papers, released earlier this week in the Mid-Year Economic and Fiscal Outlook showed that the government believed the tax would still raise $2 billion this financial year.
A failure to clearly sell the way the tax works is the main reason that the response today was as it was. Too little time was spent saying that the tax would not raise revenue in bad times, but would in good times.
It is also a failure of design. If the ALP wanted to be sure of revenue then pegging the new tax to profits as they did was not the way to achieve a certain stream of revenue, especially one so easily impacted by poor commodity prices. To make matters worse, the new mining tax is not to prop up revenues with proceeds put away for future benefits. No, the tax revenue raised was to pay for promises made by Labor.
Clearly the turn of events this week, including the broader revenue shortfalls announced as part of MYEFO, make the prospects of returning to surplus extremely unlikely. Commodity prices for one would have to not just get back to where they were, but likely higher to make up for the time when the price was below expectations. Those prices could yet stay low for some time.
But the tough week, more accurately the tough day today did not end there for Mr Swan.
Speaking to reporters in Brisbane today, Treasurer Wayne Swan twice made a mistake when saying how much revenue the Minerals Resource Rent Tax would provide to the budget bottom line. Twice the Treasurer said that the tax would make $9 billion this financial year.
Actually, the resource rent tax is set to make $9 billion, not over the first year, but over the forward estimates, the next four financial years. It was a case of third time lucky for Mr Swan.
Ordinarily a simple gaffe like that does not mean much. It happens to politicians from time to time. However,for a Treasurer battling for a surplus and not having the numbers add up, it adds to a perception of confusion and uncertainty on the part of Wayne Swan and the Gillard Government.
The Opposition of course were crowing, enjoying a day where again, the Treasurer has been squirming over economic issues. But the celebration should also have been a tad on the difficult side for them too. The tax raised no revenue, so it was not doing the damage to the economy and businesses that the Coalition had warned about.
Federal Labor are seeing any remaining hope they had of returning the budget to surplus, which was delusional in the first place, evaporating before their very eyes.
But it is not the surplus the ALP should be most worried about the most. It is a worry, but the least of them. What they should be worried about the most is how much they might have to borrow to pay for the spending promises associated with this new tax of theirs.