The Australian: Time to see disability as a public, not a private, issue
02/03/11 EVERY now and again, a public policy issue emerges in which the social and economic arguments are so clear that it is hard to believe it is still being debated.
This is the case with the disability insurance scheme that the Productivity Commission is recommending to the federal government. That the disabled are now front-of-mind in Canberra after decades when they were easy to ignore is an encouraging development for the thousands of disabled people, their parents and other carers struggling year in, year out to cope. An insurance scheme for the severely disabled is overdue. The Australian supports such a scheme and welcomes the commission's draft report.
A modern, prosperous country such as ours can not only afford to improve its treatment of its disabled citizens and their families, but it can scarcely afford -- either financially or socially -- not to do so. The notion that disability is a private rather than a public issue is difficult to sustain in a civilised society. But, beyond the fact that an insurance scheme is the right thing to do for the 360,000 Australians with a "significant" disability, it also makes sense financially. The present fragmented federal and state funding is wasteful and uneven. Streamlining the delivery of the existing $6.2 billion a year will ensure it is better targeted. Adding another $7bn , as recommended by the commission in its report released on Monday, would give the disabled and their families a far better quality of life and more options about the way they organise their lives. It is particularly important for ageing parents faced with the trauma of how to care for disabled dependents. Advocates argue the transformation of disabled funding from a welfare model to no-fault insurance will also yield economic dividends. Family members will be freed up from caring responsibilities and have the chance to rejoin the workforce, and more jobs will be created in the disabled sector.
With bipartisan support for an insurance scheme, the big issue facing our politicians is no longer whether taxpayers should help pay for the disabled, but how to pay for the scheme.
The commission had been expected to argue for an extension of the Medicare levy from the existing 1.5 per cent to 2.3 per cent. Instead, it has suggested an alternative -- that the money come from consolidated revenue, with the agreed funding formula enshrined in legislation. This would encourage fiscal discipline rather than simply enlarging the tax take and would avoid a debilitating debate over a "big new tax". The politics of a levy are complex, with voters potentially resistant to a specific tax to help a minority. The commission also argues the Henry tax review had found problems with the efficiency and equity of Medicare. But there are dangers in not fixing a levy: look no further than the ease with which Labor raided, for short-term ends, the nation-building funds that had been set up by former treasurer Peter Costello and the Rudd government. The funding mechanism must be locked behind tamper-proof legislation.
In the end, the test will be the delivery of insurance, not the funding model. Here the commission has made sensible recommendations. It wants the commonwealth to take over all funding for the disabled and suggests the National Disability Insurance Scheme be phased in gradually by 2018. It would fund long-term, high-quality care and support, including specialist therapy, aids and appliances, home and vehicle modifications and respite for carers. A separate and far smaller National Injury Insurance Scheme would cover those who suffer a catastrophic injury such as a loss of a limb or spinal cord damage. The potential for recipients to exercise some choice in how they spend the money is welcome, given the wide range of needs and family circumstances.
Such care does not come cheaply, but the bipartisan support for this profound reform augurs well. Last September, after she had formed government, we suggested to Julia Gillard that, rather than labelling Opposition Leader Tony Abbott a "wrecker" she should develop policy "so patently in the national interest that it wins the support of the Coalition". She is already at first base with disability insurance, thanks in no small part to the commitment of her ministerial colleague Bill Shorten.
Just two years ago, the insurance scheme seemed a pipe dream, with the disabled a 10th order political issue ignored by most Australians. It took Mr Shorten, as the parliamentary secretary for disabilities, to embrace the concept and champion it to the stage where it was referred to the commission for review. Mr Shorten has moved on, but he is arguably even better positioned now as Assistant Treasurer to advance the scheme with the urgency it demands. Finding an extra $7bn a year for the disabled will require political courage, but this is a scheme that deserves to be pursued.
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