Market-Models Like the NDIS Are Failing People With Disabilities

The National Disability Insurance Scheme (NDIS) has been one of the most significant social reforms of our time, transforming the way people with disabilities access services and funding. We generally accept that the NDIS has improved the support and quality of life for people with disabilities, but the underlying inequality within the scheme is rarely talked about. So, let’s talk about it! If we take a closer look at the NDIS’s criteria, application process, and ongoing rollout, we can examine just how much is going wrong, and why market-based models of disability support are further entrenching oppression.

The NDIS, introduced as federal legislation by Julia Gillard in 2013, is an individualised, social insurance approach to providing disability support. This means that government funding is directed to individual ‘clients’ of the scheme, who can then choose the disability providers they want to ‘purchase’ from. This policy shift has been heavily based on neoliberal ideology, in which individual responsibility is fetishised and agency, control and choice over consumption is seen as ‘empowering’. This market model, like all others under capitalism, ultimately disadvantages those who face multiple oppressions and doesn’t account for heterogeneity in the population of people with disabilities.

To access the NDIS, people with disabilities need only apply – sounds easy enough right? But this application process is arduous, often excluding marginalised groups and those who deviate from the conventional subject seen in disability discourses: a white, middle-class man.

As the NDIS assumes a basic level of English and education, requiring people to request support, understand the application process and make informed decisions based on this information, those who are already marginalised in different ways are disadvantaged by the scheme. Those with poor education – most likely to be people of colour, migrants, Aboriginal and Torres Strait Islanders or working class people – may all struggle to overcome the bureaucracy of the scheme, and be unable to apply for the support they need. For migrants, Aboriginal and Torres Strait Islanders and those with intellectual disabilities, cultural and language barriers further impact this ability to access the NDIS.

For those with the means to apply for the scheme, roadblocks present themselves in a strict set of criteria. The citizenship requirements of the scheme exclude those who aren’t permanent residents or don’t hold a Protected Special Category Visa, as is now the case for many NZ citizens living in Australia. While I am sure many of us would like to hope that the needs of people with disabilities transcend borders and nationality, ABC News has reported that severely disabled children born in Australia are being denied access to the NDIS because their parents are NZ citizens. You read that right: severely disabled children are being denied disability care because of arbitrary citizenship requirements.

Criteria surrounding psychosocial disability produce similar horror stories, with many people with mental illnesses being denied disability care. Psychosocial disability benchmarks are hard to interpret, especially given the NDIS requires an impairment to likely be permanent. This means that people with mental illnesses are at risk of missing out on NDIS support due to their fluctuating support needs; most people with periodic mental illness struggle to qualify for NDIS support packages. The NDIS’s psychosocial criteria disproportionately affects some of the most vulnerable people in our communities, who we know are most likely to be disadvantaged by these restrictions. For Aboriginal and Torres Strait Islander people, who suffer some of the highest rates of psychosocial disability because of unresolved social injustice like the removal of children, mass incarceration, and institutionalised structural violence, NDIS support becomes almost unattainable.

It’s important to understand that inequality within the NDIS extends far beyond this criteria and application process, having been just as evident in the scheme’s rollout. What often goes unacknowledged when discussing different states’ and regions’ gradual transition to the NDIS is that many areas in remote and rural Australia are left waiting; government support has been withdrawn in some places leaving people with disabilities without specialist allied health services altogether.

We know that people living in rural and remote Australia are those most likely to be living in poverty, with lower median gross household incomes, widespread unemployment and highly-priced goods and services. We also know that rural Australians already face challenges when accessing healthcare; these challenges associated with higher rates of chronic conditions and disabilities. Although there is no difference in the prevalence of disability for women living in rural and remote Australia compared to those in cities, for men rates of disability are 20 per cent higher.

It is impossible to deny that this spatial inequality is racialised, with colonialism rearing its ugly head in a disability scheme that fails to meet the needs of Aboriginal and Torres Strait Islander people living in remote communities across Australia. Because providing adequate services in remote locations may not be ‘economically viable’ for organisations, many remote communities continue to be unable to access disability providers. This is despite the fact that there is a significantly higher rate of disability in the Indigenous population, with up to 45 per cent of Indigenous Australians over the age of 15 saying they experience a disability! As one of the starkest examples of neoliberalism’s perversion of disability care, this demonstrates exactly why market-models fail people with disabilities – they will disregard those who are in most need of support if there is no economic incentive.

This is only a snapshot of the ways in which the NDIS continues to leave many people with disabilities behind. It is undeniable that race, class, gender, and one’s overall material conditions determine access to the scheme. It’s easy enough to blame the Gillard government, or the subsequent Liberal governments as responsible for poor planning and ongoing healthcare cuts, resulting in this mess. While these people are all responsible, this misses the point – it is neoliberalism and blind faith in the market that has failed disability care in this country. Market-based models that fetishise the individual in the name of ‘empowerment’ only further entrench oppression, with profit and marketing, rather than the welfare of people with disabilities, driving the provision of services.

Sociologists, policymakers and governments alike should turn to the words of Peter McLaren, who reminds us that bodies are the primary means by which capitalism does its job. As such, disabled bodies, often incapable of contributing to capitalism, are fundamentally at odds with this system. A neoliberal approach to providing disability support then, like the NDIS, will never achieve liberation for people with disabilities.