Reforms to NDIS Spending
The Australian government plans to reduce the National Disability Insurance Scheme (NDIS) costs by cracking down on prices and junk therapies. The scheme is expected to double in size, with more than one million recipients within the next decade, making the government’s decision to achieve an 8% spending growth target without cutting eligibility for Australians who need support, a controversial one. The new reforms will enable the NDIS to operate more like the Pharmaceutical Benefits Scheme (PBS) or Medicare Benefits Schedule (MBS), with clearly outlined services and set prices. NDIS Minister Bill Shorten has given assurance that the eligibility for the scheme will remain unchanged. The government plans to reduce costs by using its buying power to drive down prices from suppliers, such as negotiating bulk discounts on wheelchair purchases, which have in part contributed to the cost increase of the $35bn NDIS. Shorten did not specify which services he thinks are failing the scheme’s “reasonable and necessary” test, but he has previously questioned whether sex work or tarot readings were services taxpayers should fund. Shorten has also said that better support services in mainstream society, particularly in the mental health and education systems run by state governments, are also essential to bring down the costs.
The federal government is seeking to slow down the growth of NDIS costs from almost 14% to 8% per year to reduce the predicted $97bn annual costs in 2033. The government’s plans assume that the NDIS will grow from $29.9bn last financial year to $51.8bn in the 2026 financial year. While the original NDIS design said the scheme should provide “tier two” supports for an estimated four million people with a disability but without individual packages, it has not delivered on that promise. Children are the fastest-growing group of participants, with one in ten boys aged five to seven now on the scheme. The most common primary disabilities of NDIS participants are autism, intellectual disability, and psychosocial disability caused by mental illness.
The reforms have raised concerns among NDIS recipients, who fear they will miss out on support. However, Shorten has held conference calls with disability groups to assure them that he is not cutting the scheme. He has outlined his plans to better provision of services to make sure people are getting outcomes for the dollars that are spent. Shorten’s proposed reforms are aimed at ensuring that people are not referred to junk therapies, oversold services, or referred for purposes other than the ones for which they were intended.
One of Shorten’s examples is that the Commonwealth should negotiate cheaper bulk prices for wheelchairs rather than participants paying retail prices. Shorten said that the NDIS agency should administer the NDIS more like the pharmaceutical and Medicare schemes. He suggested that there are lessons in the PBS and MBS where, when you go to see a doctor, you don’t get anything you want. Self-prescribing drugs that are not on the list is not allowed. The use of the best evidence is important.
Shorten believes that better support services in mainstream society, especially in the mental health and education systems run by state governments, are essential to reduce costs. He stated that some people are stranded because states have folded a range of their services into the scheme as their form of contribution. Shorten believes that if the only option that psychologists or child pediatricians identify is a referral to the NDIS, referrals to the NDIS will increase.