Aged Care - complex, bureaucratic and heavily controlled. NDIS not so much...
The community generally has little interface with the aged care process - and typically experience a significant shock in terms of its complexity, bureaucracy and cost when it comes to arranging for family members to enter residential aged care or receive home care. It often comes entangled with profound decisions about what to do with ageing parents and the potential sale of the family home.
Entry to any aged care process involves detailed scrutiny and means testing - there is now very heavy emphasis on everyone paying their way, in light of a very rapidly ageing population and one in which there will be relatively fewer and fewer taxpayers to maintain services.
Paying your way seems fair and proper, and our only concern is that the process is fair - and that individuals who have managed their finances properly over time, often saving rather than spending, are not disadvantaged in terms of those who have been more dependent on social services. If that doesn't occur, then you have a “moral risk” and the risk of the wrong behaviour being rewarded.
Compared to aged care, NDIS represents the other end of the spectrum - it is a program that may one day be considered amongst the worst ever introduced into Australia in terms of preparation, supporting legislation and controls. There was a significant underestimation of the demand for the service and the uncapped financing seems to have been premised upon a world where resources were unlimited. At least some of us know that’s never been the case and choices need to be made.
Currently, the NDIS with 650,000 participants is budgeted to cost $39 billion a year, increasing to $60 billion in 2027/2028 - but it has never run to budget. Undeniably well-intentioned, it is nevertheless unsupportable in its current format, and more worryingly it may be having adverse consequences – it is difficult to believe that 12% of all boys between ages 5 to 7 are on the NDIS and that this anything other than an awful outcome.
While the NDIS may on balance be doing more good than harm, it is doing it at a cost that is unacceptable and cannot continue in its current form. The media is continually deluged with stories of how some NDIS providers have milked the system. And the fact that they may be charities doesn't provide any solace - many of the charities seem to be run more for the benefit of the management more than their clients.
The point of this article is to say that we are in a world where there are competing demands for services, and that we should all pay our own way where possible. That means in fairness that NDIS participants should be subject to the same means testing and controls as aged care participants and the services should also be capped and managed efficiently.
This should happen as soon as possible, and politicians should (again) begin to develop habits that can be characterised as leadership – and that means saying “no” or at least “not now” to pressure groups with vested interests.