The National Disability Insurance Scheme (NDIS, or the scheme) aims to boost the economic engagement of its participants. According to the 2015 Survey of Disability, Ageing and Carers, 53% of people between 15 and 64 years of age living with a disability participate in the workforce, compared to 83% of those without a disability.
Departing from traditional approaches to policy making, the scheme personalises welfare by putting choice and control at the hands of participants. With the help of a National Disability Insurance Agency (NDIA) representative, participants identify their goals and aspirations, which serves as the basis for budget allocation. Once approved, participants can choose their preferred services, supports, therapies and interventions.
In this sense, the NDIS is grounded on a means-ends perspective. For example, individuals aspiring to “get a job or keep current employment” receive funding for Supports towards getting and keeping a job. (Figure 1).
But what if the scheme’s objectives are at odds with each other? Does it make sense to expect the one program to achieve both outcomes, considering that boosting employment (a top-down policy outcome) may be in conflict with participants’ aspirations to find and keep a job (a bottom-up choice)? What does it mean for the scheme if participants prioritise goals other than an employment-related goal?
Do disability-related choices translate to a boost in employment and, if not, how can the scheme be improved to promote this personal goal?
What do people choose, and why do they choose it
For decades, mainstream economics has embraced the contribution of psychological insights in developing policies more attuned to the “real world”. Partnering with the Capital Markets Cooperative Research Centre and National Disability Services, the Institute for Choice conducted a pilot large-scale study to understand the goals of eligible NDIS participants, and how they go about fulfilling them.
Our research strategy was designed to uncover the choices of current and potential NDIS consumers (or their nominated carers) within the parameters of the scheme. Through an online survey, we collected information about the goals of individual plan managers, the required supports and the choices for NDIS providers. A qualitative pre-study was used to inform and adapt the language used to describe the goals and support services covered by the scheme’s capacity building funding. The data collection wave of the study totalled 286 valid responses.
Our findings revealed that neither consumers nor carers prioritised the goal to “find and get employment”. In total, 37% of subjects disagreed when asked whether this was an important goal.
When it comes to Supports towards getting and keeping a job, 34% of respondents reported them as required. These individuals revealed a higher willingness to pay for this type of service — AU$ 31.88 on average against their NDIS package for an hour of service. This higher willingness to pay is perhaps reflective of their aspirations for more individualised and/or better-quality services for these eligible participants who require this service type.
Further, research in social psychology indicates that multiple means can be used to achieve one end (“all roads lead to Rome”), as well as one mean to achieve multiple ends (“killing two birds with one stone”).
We propose that a consumer-centric NDIS would incorporate the benefits these services afford to consumers in its pricing structure.
In our study, eligible NDIS participants who required supports towards getting and keeping a job associated these services to a number of goals, in addition to “get a job or keep current employment” (69%). These were “learn a new skill/try something new” (54%), “have a good, happy or fulfilled life” (52%), “avoid poor mental health”(42%) and “be more independent and mobile” (40%)(see Figure 2).
This is not to say that this type of support should be favoured in lieu of other means more instrumental to achieving other personal goals. Instead, we argue for a pricing structure that incorporates the various benefits of this support in participants’ lives.
We additionally asked individuals which types of supports they associated to the goal “get a job or keep current employment”. In addition to Supports towards getting and keeping a job (69%), other supports were associated to this goal. When required, Supports towards prosthetics customisation (35.3%), Therapy to help physical, mental or social needs (27.3%), Supports towards developing day-to-day skills (27%) and Supports towards exercise and physical wellbeing (26.4%) where all deemed instrumental (Figure 3).
Creating a scheme from the bottom-up
We propose the alignment of incentives to promote employment on an individual level. By mapping which supports help individuals get or keep a job, the scheme facilitates the pursuit of this goal.
Our insights promote the improvement of the NDIS by incorporating participants’ voices in its pricing structure towards the achievement of specific policy outcomes.
Such insights can potentially define the success of the NDIS — helping shape its financial sustainability. Understanding goals and disability-related supports in a network-like fashion can influence how plans are designed and funded.
More generally, our insights raise questions about the objectives of the NDIS. If the employment-related goal is not incentivised on an individual-level, does it make sense to expect it as a policy outcome?
Perhaps the scheme should restrict itself to putting choice at the hands of consumers, leaving an independent, complementary program (such as Disability Employment Services) to focus on promoting a boost in disability employment.
Flavio Souza is a consultant at BIS Oxford Economics and an adjunct research fellow at the University of South Australia School of Commerce.