Australia's Proposed National Disability Insurance Scheme
Australia's Proposed National Disability Insurance Scheme
The Australian Government is proposing the adoption of the Productivity Commission's Inquiry Report into Disability Care, along with its two recommendations: the National Disability Insurance Scheme (NDIS), a universal, no-fault, national social insurance scheme to fund basic services for any Australian born with, or acquiring, a severe disability, and the National Injury Insurance Scheme (NIIS), a state and territory-based scheme, which would provide lifetime support for people acquiring a catastrophic injury from an accident.
These systems will be significantly different from the existing system, in that they will be insurance-focused systems, founded on a similar modeling of the Australian public health care system, Medicare. The systems at hand propose a range of changes in the provision of services to the disabled, and the NDIS in particular is a scheme that would greatly benefit the Australian population as a whole in terms of its intended value to people with disabilities. In viewing the specifics of NDIS as well is its implications in Australian, history, government and society, one can see that its intended value to people with disabilities and the broader Australian population is one that will reap benefits long into the future.
While the general definition of disability is one that encapsulates a physical or mental condition that limits a person's movements, senses, or activities and is found to be a disadvantage or handicap, especially one imposed or recognized by the law, the intricacies of the concept vary in looking at the distinct definitions held by nations and organizations around the world.
The most commonly cited definition of disability is that of the World Health Organization which has been adapted by the United Nations and many other entities throughout the world. This definition draws a three-fold distinction between impairment, disability, and handicap. WHO notes that an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function, a disability is any restriction or lack -- resulting from an impairment -- of ability to perform an activity in the manner or within the range considered normal for a human being, and a handicap is a disadvantage for a given individual, resulting from an impairment or disability, that prevents the fulfillment of a role that is considered normal -- depending on age, sex and social and cultural factors -- for that individual (WHO 1976, pp. 1).
These social and cultural factors open the areas of intricacy the definitions of disability defined by other nations around the world. While countries around the world define disability in much the same manner, the acts and mandates enacted within these countries present the area for distinction in dealing with the issue. The United States, for example, has noted the barriers to employment, transportation, public accommodations, public services, and telecommunications that have imposed staggering economic and social costs on American citizens with disabilities as well as undermining well-intentioned efforts to educate, rehabilitate, and employ such disabled individuals. (ADA 2008, p.1). Through the mandating of the Americans with Disabilities Act (ADA), disabled individuals are ensured the opportunity to benefit society with all they have to offer with civil rights protections that guarantee equal protection in the aforementioned areas that have proved an issue in recent times.
Much of the same measures have been taken throughout Europe, specifically in member states of the European Union. EU states assert that disability covers both physical and mental impairments and mandates have been enacted that cover all employees who may be hampered in work performance, including people with long-term or progressive conditions as well as people with more stable disorders (OSHA 2010, p.1). The European Agency for Safety and Health at Work notes that policies have been implemented at a national level relating to people with disabilities that reflect the diversity of cultures and legislative frameworks found in the EU member states, with each member state adopting a range of measures to promote the integration and employment of people with disabilities (OSHA 2010, p. 1).
In assessing Australian views on disability, significant steps have been taken in years past to assess the need for greater consistency of concepts and definitions in the field of disability. Such consistency allows the Australian government to better assess the need for acts and mandates regarding disabled citizens and to ensure that these individuals receive the support they need both in the workforce, health field, and in society as a whole. As of 2008, 3.96 million Australians suffered from a disability, with the proportion continuing to increase (Kane 2011, p.37). In assessing this number, Australia has made significant moves in updating legislation to ensure that these individuals receive the equal opportunities that are presented to all Australian citizens, regardless of their disabilities.
Australian Health Care Initiatives
Australia has long established health care developments and functioning insurance models, such as Medicare, that are similar in ways to the proposed NDIS. Health care in Australia is provided by both private and government institutions. The Minister for Health and Aging, administers national health policy, while primary health remains the responsibility of the federal government, elements of which are overseen by individual states -- such as the operation of hospitals (Gallacher 2011, p.86). In Australia, the current insurance system, known as Medicare, remains the standard and has been in operation since 1984. It coexists with a private health system, and is funded partly by a 1.5% income tax levy (with exceptions for low-income earners), but mostly out of general revenue, with an additional 1% levy imposed on high-income earners without private health insurance (Shamsullah 2011, p.29). Medicare, a public health system, is universal and funds free access to hospital treatment and subsidized out-of-hospital medical treatment, while the private health system remains funded by a number of private health insurance organizations, the largest of which is Medibank Private, which is government-owned, but operates as a government business enterprise under the same regulatory regime as all other registered private health funds (ANJ 2011, p. 9).
Medicare can be viewed as an example of a functioning insurance company that will provide the structure and model similar to that proposed in NDIS. Medicare provides such a framework because the proposed NDIS functions like Medicare, specifically in terms of disability. The NDIS proposes a system that gives some 410,000 Australians with severe disabilities the personal care, accommodation modifications, therapy, equipment and supports they need to live a dignified life (Shorten 2011, p.1). In doing so, the NDIS allows people with disabilities the ability to work where possible and prevent difficulties that have been present in the past.
Past and Future Look at Australian Health Insurance
To begin looking toward the future of the proposed NDIS, one must first look into the past in terms of the discrimination that has been faced by people with disabilities. Australia first became directly involved with providing support for people with disabilities via the introduction of the Invalid Pension in 1908 (McIntosh and Phillips 2002, p.1). Such support did not continue to improve until WWII, when an influx of persons with disabilities began to surface due to injuries suffered in the combat zone. So began providing by the government of funding to organizations that provided accommodations, employment, and other support services to disabled individuals.
From the 1980s until today, Australia has further seen a succession of acts and mandates regarding the treatment and rights of the disabled, largely due to increased awareness and a steering away from the negative connotations associated with the disabled in previous decades. Without awareness and education brought to the forefront by the Australian government, citizens had a tendency to rely largely on the sociological theory referred to as the "labeling theory" when regarding the disabled. The labeling theory was developed by sociologists during the 1960s, and holds that deviance is not inherent to an act, but instead focuses on the tendency of majorities to negatively label minorities -- in this case the disabled -- or those seen as deviant from standard cultural norms (Becker 1997, p.13). The labeling theory is concerned with the manner in which the self-identity and behavior of individuals -- again, the disabled in this case -- may be determined or influenced by the terms used to stereotype them.
While opinions have certainly changed within Australian society, the NDIS proposition will ensure that government-commissioned care and support will measure up to public opinion. In February of 2010, the Productivity Commission found that the current disability support arrangements in Australia were "inequitable, underfunded fragmented and inefficient, and give people with disability little choice" (FaHCSIA, 2010, p.1). The NDIS seeks to remedy this infraction, through the providing to all Australians with insurance for the costs of support if they or a family member acquire a disability.
In looking at this aforementioned "inefficient" support for the disabled it must be noted that disabled individuals are often excluded and marginalized, especially in times of economic crisis, which has proven true in the past in dealing with Australia's…