Funding for disability - broadening the horizons

Fiona Tito WheatlandPhD Scholar ANU RSSS(Law)

Presentation to the Centre for Public Policy, University of Melbourne

Thursday 15 July 2004

People with disabilities

• Similar needs to other people without disabilities eg income, housing, health care, education, leisure

• Can include extra costs or services specifically associated with disability, depending upon level of disability

• Needs will vary over time, family circumstances and personal circumstances

Funding the extra costs

• Traditionally seen in terms of Government provision

• In reality, sources of funding are much broader eg compensation schemes, damages awards and settlements, private insurance, superannuation disability provision, family and personal resources.

Problems with current arrangements

• Often looks at cause rather than need• Policy focus has often been on cost-shifting

or double-dipping• Inflexible arrangements lead to over-servicing

based on crisis entry and fear of lack of provision

• Confusion for people with disability - many different rules - not consumer focussed

All this leads to …

• Inequitable provision

• Economic inefficiency

• Systemic complexity

• Bureaucratic fear of endless demand - “if we let them have leg-bags free, everyone will want one”

• Silo administrative and funding empires

Traditional Solutions

• Stop double-dipping

• Create broader “no-fault” compensation arrangements

• Argue about cost shifting and refuse to act because of fear of it

• Don’t do a serious policy analysis because of the fear of the flood-gates

Let’s dream differently …

• Start with need

• Audit what’s already there

• Look at all sorts of funding and ways needs are met

• Make the money and service provision flows transparent and comprehensive

• Create a person centred approach

Start with catastrophic disability …

• What everyone fears the most and is least able to cope with through private resources alone

• Have a “one shop stop” for person with disability, with funding sources coming in behind

• Decide what are the appropriate standards of “reasonable and necessary” assistance and ensure these are available through most effective means

Preliminary thoughts• Question basic assumption about who pays

and how• Recognise that the allocation of costs is a

public policy decision• Informed community discussion on what is

reasonable and necessary needs to be fostered

• Too often debate has not included the voices of those affected - models of service provision and assistance must also be shaped by these