Tag Archives: disability

NDIS and how many disabled people are there anyway?

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Regular guest writer, James Glover, returns to the Mule today to look at the figures behind the proposed NDIS.

The National Disability Insurance Scheme (NDIS) is in the news again. A welcome development for people with disability and their carers and families…and friends and pretty much anyone else who cares about their fellow humans. It is not a platitude to say that disability can strike anyone at any time in their life and the stories of these people are truly moving and shaming, especially as we live in one of the richest countries in the world. Adults who are only provided with two assisted showers a week and parents providing 24/7 care to profoundly disabled children but who cannot afford a new specialised wheelchair because there is limited funding for such things (wheelchairs cost from $500 for the basic models, of which I have two, and range up to $20,000 or more). In August 2011 The Productivity Commission reported on and recommended the NDIS and since then pretty much everyone agrees it is a good idea if we could only agree how to fund it.

So what does it replace? Currently most people with serious disabilities that prevent them from, inter alia, working, can receive the disability support pension (DSP). A small number will have insurance payouts if they were “lucky” enough to to have someone else to blame for their disability. In addition, anyone can receive a rebate on medications in excess of about $1,200 a year and, of course, access to (not quite free) public health care. On top of that, there are concession cards for public transport and a taxi card system which provides half-price taxi fares to partially make up for many disabled peoples inability to use public transport. The DSP does not depend on a specific disability and for a single adult over 21 with no children it is about $19,000 a year. For child under 18 who is living at home it is about $9,000 a year. While this would appear enough to live on (forgetting overseas holidays or a mortgage) most such people rely on additional support services for everything from basic medical equipment to respite for carers. There are currently 820,000 people, about 4% of the population, on the DSP. The Productivity Commission estimates 440,000 people on the NDIS so most of these will not be eligible for the NDIS but may still receive the DSP. People 65 and over of pensionable age are not eligible for the DSP and will not be eligible for the NDIS.

The purpose of the NDIS is to provide funding for care in line with the specific requirements of the recipients, and will mean additional support to the DSP for some. You can read more about it at ndis.gov.au. Unlike the DSP, it isn’t a fortnightly stipend or, like standard disability or employment insurance, a lump sum. The government is planning to roll out pilot programs in many regions in the next few years, aiming for a complete national program by 2018-19. I won’t go into the politics but it seems even politicians can feel shame and  bipartisan support for the NDIS is emerging with a good chance of a bill through this parliament in the next few weeks. The total cost of the NDIS is often quoted as $18bn a year. Some funding is proposed from an additional 0.5% to the Medicare levy. Other funding wil come jointly from the federal government and the states. The proposed levy will raise about $3.8bn a year, so nowhere near enough for the full cost. If you subsume the half the DSP cost of $11bn a year that (only) leaves an outstanding amount of $8-10bn a year to be funded even with the Medicare Levy. Hopefully with bipartisan support the full NDIS will be implemented sooner rather than later.

So that’s the background on the NDIS. The real purpose of this article though is to consider the question “How many disabled people are there in Australia anyway?”.

Well that’s easy, just read any article on disability–for instance this one by disability advocate and media personality Stella Young–and you’ll be told the answer: 20%. 20%. 20%! I am a huge admirer of Stella Young’s work, so don’t get me wrong if I choose to disagree with her on this. The 20% figure gets quoted so frequently it must be true. Well maybe. People questioning this figure are directed to the 2009 ABS Census report on disability where the self-reported disability figure is 18.1% (+/-1.3%). So a round 20% is not too bad, right? Well like all statistics, the details are important. Firstly this includes people of all ages and, not surprisingly, many more older people have disabilites. From 40% at 65-69 to 88% at 90+. For those under 65 the figure is 13.2%. It increases with age and, in the 45-54 age group, is about the average 18%. Anyway why does it matter if the true figure is overstated? Well one reason is that while there is widespread support for the NDIS, the one concern that keeps coming up is who is eligible.

According to the Productivity Commission report they estimate 440,000 people on the NDIS of whom 330,000 would be disabled, and the rest made up of carers and people on preventative programs.

This report has a deeper analysis, which takes the figures at face value. It also includes breakdowns by disabling condition. I have paraphrased these in the following table based on some of the major causes of disability. And look, there are those perennial favourites of those who think all disabled people are really bludgers: back problems,stress and depression, making up about 18% of the total. Not quite bankrupting the country then.

Disability table 1

But what constitutes disability? It is basically a lack of normal activity rather than a set of diseases per se. The ABS report has 5 activity based categories, four of which are based on “restrictions on core activities: communication, mobility, self care”. There are “profound”, “severe”, “moderate” and “mild” levels of disability. A fifth category is  “schooling or employment restriction”, but overlaps with the first four. Here is a table with the breakdown by category and age group. Combining those with a core activity limitation with employment/school limitations the figure is 15.3%. The difference between this and the higher self-reported 18% figure I suspect comes from peope who feel a bit crap a lot of the time, but aren’t signficiantly prevented from their activities. So I would estimate the number of disabled people to be more like 15% than 20%. For those under 65 this is 11%. The NDIS has a similar definition but includes social activities as well, but don’t yet provide any breakdowns.

Disability table 2

So much for the figures from the ABS, which I think we can all agree are definitive, right?  Looking at the ABS figures for this group (under 65) they total 345,000. But wait! The figure of 15.3% is based on a total number of respondents to the census of only 9.5 million people. If the reportage rate was the same as the general population of 22m then there would be about 700,000 severe or profoundly disabled people. But the Productivity Commission only estimates 330,000 or half this number on the NDIS! The alternative to the unlikely event that less than 50% of profoundly or severely disabled people will end up on the NDIS is that the reported ABS figure for people in this category is correct but the rate is wrong. While the overall reportage rate is about 50% it looks like the reportage rate for disabled people in the severe and profound category is closer to 100%. If this was also true for the other categories of disabled people then that suggests that the real rate of disability is less than 9% and maybe as low as 7%. Assuming the reportage rate is the same as the rest of the population, ie 50%, for the other categories then the disability rate might be as high as 13%. So lets split it and say 10%. In any event the widely reported figure of 20% is well above the highest estimates based on the ABS and Productivity Commission data. The real rate of disability is closer to 10% than 20%.

Does it matter? Maybe. If you claim that 20% of the population are disabled, people start quickly calculating that the cost is unsupportable if all of those people are on the NDIS! Which of course they won’t be. Fewer than half of disabled people are already on the DSP. Less than half of those will transfer to the NDIS. Overstating the percentage of disabled people isn’t necessarily a good argument for the NDIS if it reduces support from otherwise sympathetic people.

A final thought: in the large Australian organisation I work for, there are a fair few disabled people, some of whom I think would be categorised as severe. With proper support many disabled people can gain suitable education or training and hence employment and support themselves and contribute to the economic activity of the nation. The more people with disability who are employed the fewer on the DSP or NDIS, the more money for those who really have no choice. Supporting people with disability into employment is as important, in my opinion, as supporting them in living and care through the NDIS.

[This article was rewritten following some comments and some further research. In line with all my articles on Stubbornmule this article is about estimating rough numbers from scarce data “back of the beercoaster” style rather than disability politics, it just happens I have a personal interest in this subject]

 

Have wheelchair, will travel…probably

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Spending couple of weeks down the south coast of New South Wales, spotting dolphins and echidnas, has slowed down my blogging. Fortunately, regular contributor James Glover has once more come to the rescue with a guest post. This time his topic is wheelchairs and air-travel.

Perhaps you’ve heard of a recent court case in which a wheelchair user, Sheila King, took Jetstar to court (and lost) on the basis of the Disabilities Discrimination Act? If you are a wheelchair user and you book a flight on one of our airline carriers then a fairly obvious thing won’t happen. Unlike say a bus you won’t be able to board the aircraft in your chair and be strapped in for the journey. What actually happens is that when making the booking you tick a box (or tell the booker on the phone) that you are in a wheelchair. If there are seats available for wheelies when you get to the airport you will give up your chair and be made to use a specially designed “wheelchair” (its a chair, it has wheels) that is designed to be fit the narrow corridor of most planes which I am sure you are aware of – their narrowness, for you, only apparent when the person ahead of you is blocking the aisle loading 3 pieces of carry on luggage into the overhead lockers while chatting to their new friends in the seat they are meant to occupy. We all suffer this situation. These “wheelchairs” are not designed to be used without help, they are more like children’s toy carts and cannot be operated by the user as the wheels are very small and low down. For a wheelchair user to be taken out of their wheelchair in a public place can be quite discombobulating. Many wheelchair users develop a personal relationship with their chair – it is after all a place you spend many of your waking hours.

Digression. The very first time I was in a wheelchair outside the confines of a hospital ward (it was a hospital wheelchair but is the exact same model I now own, like I said it is personal) I was being pushed by none other than the proprietor of this very website! Without going into the details let’s just say it was a pretty dramatic event and we both learned a valuable lesson in wheelchair use and the wheelchair repair workshop at the hospital was kept busy. But I digress.

So here is the thing. According to Google about 1% of the population uses wheelchairs. And a Jetstar plane has about 200 seats so they expect to get about 2 wheelchair users on average per flight. So what is the problem with only allowing this same number on each flight, as some airlines do? Well the problem is that statistically wheelchair users don’t travel in pairs and sometimes there will be less than 2 users and sometimes there will be more. Just as if you toss 10 coins sometimes there will be fewer than 5 heads (the average or expected number) and sometimes there will be more. Only on average will there be 5. In fact it is a simple problem to work out the probability of there being, say, n wheelchair users, given the average of 1% on a 200 seat plane. This is called the Binomial Distribution. If you have access to Excel then the function Binomdist(n,200,1%) will tell you this probability. Before I give you some numbers I admit that the overall population average may not be the same as the average flying on planes. It may be less than 1% due to wheelchair users being put off flying. But maybe on some routes it is higher: but I am guessing the annual “snowbird” migration of retired people from the northern United States to Florida at the start of Winter would track above the 1% rate.

So here are the Binomial probability figures.

Count Probability
0 13%
1 27%
2 27%
3 18%
4 9%
5 4%
6+ 2%

Binomial Probabilities (N=200, p=1%)

For example, assuming a 1% chance of any given passenger a 200 hundred seat plane being in a wheelchair, the probability that there will be exactly 4 wheelchair passengers wanting seats is 9%. To work out the probability of a passenger being denied a seat on their preferred flight, we will assume that we’re dealing with an airline where more than two wheelchair passenges book on a flight, then at least on passenger will have to change their travel plans. From the table above, the chance of the flight only having 0, 1 or 2 wheelchair passengers totals 68%, so there’s a 32% chance that there will be at least one wheelchair passenger who cannot fly. For any one wheelchair passenger, there is a (n-1)/(n+1) chance of being bumped if n other wheelchair passengers book on the flight. Weighting that by the probably that there are n passengers and adding it up for all n>1 gives a probability of 27%. As a frequent flyer in a wheelchair, you can expect to miss out on a seat quite regularly! [Note: these calculations have been updated: the editor’s “corrections” were undone. Ed.]

I am quite fortunate now that I no longer need to travel in my wheelchair. But as I still use a walking stick I wait for everyone else to get off the plane. You sit there, looking behind you to see if everyone else has left. But there are always these strange people who seem to sit there at the back of the plane and wait for 10 minutes or more, after everyone has disembarked, before even moving. You wonder why the airline staff don’t just hurry them off? I assume they aren’t disabled because they are sitting at the back of the plane. If airlines really had a problem with the extra time that getting wheelies off the plane then they could make this up by just moving these people along.

When I first read about this case my initial response was that being disabled and traveling is a bit of challenge anyway and you just get on with it. But the more I thought about it I wondered if the airlines just took it for granted that wheelchair users would change their plans to fit in with the rules. I am glad Sheila King took the issue up!