Insurance scheme is letting me down, say Gai

Are people like Gai falling through the cracks?

Insurance scheme is letting me down, say Gai

YourLifeChoices member Gai is one of 11.4 million Australians living with a chronic disease. She says her condition is a challenging one – both physically and financially – and asks why the National Disability Insurance Scheme does not cater for people like her.

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Gai writes:

Like a lot of people, I was over 65 when the National Disability Insurance Scheme (NDIS) came in and was, therefore, not eligible. I have a chronic disease and, while living independently without the need for assistance, there are certain things I require, which, unfortunately, I need to pay full price for.

For instance, my condition requires me to exercise.  However, while those on the NDIS may attend a gym and be fully covered, anyone else has to pay the full cost. A one-on-one session with an exercise physiologist would cost me $180 per session and a group session would cost $50 per session. While I do attend a gym specialised for my condition, and it is subsidised to a point, it still costs me to attend.

Last year, I tripped on an uneven footpath and broke my shoulder. I have only recently been able to return to the gym, but not before I had a two-hour assessment with a physiotherapist that cost $150.  I am unable to claim this through my private health fund. Again, those on the NDIS are able to have this assessment at no cost to them.

My gripe: Why is it that the Government says it would love to see more people able to age in their own homes, yet there is this division of under/over-65s for financial assistance for chronic diseases and many over-65s live on a pension, as I do. Where does the Government expect us to find the extra money to pay for these services?

A Department of Social Services spokesperson provided the following response:

The NDIS is aimed to address the chronic and unmet needs of people with significant non-age-related disabilities. It is not intended to replace the health or aged care systems.

The NDIS design reflects the Productivity Commission’s recommendation that a person needs to have acquired their disability before the age of 65 and meet other eligibility criteria in order to be an NDIS participant. To the extent that eligibility for the NDIS is limited to people under the age of 65, those limitations are considered reasonable and necessary because they support the broader intent of an integrated system of disability and aged care supports through different phases of life.

For those 65 and over, there is a range of supports available within the aged care system that can be accessed through My Aged Care, which may be suitable for older people with disability. Examples include the Commonwealth Home Support Program and the Home Care Packages Program.

Do you think the NDIS should be extended to over-65s? Are many parts of society failing to adjust to Australians’ longevity?

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    COMMENTS

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    TREBOR
    16th Jul 2019
    10:10am
    Well - like ever so many extra benefits ariound these days - it can be fairly said that it is the work and taxes of the generations before that have been built on - without the once-solid underpinning of THIS economy with industries and such and generally more even prosperity, and thus taxes, such things as the wonderful PPL and childcare subsidies and such would never exist.

    Now, of course, they are only propped up by endless government borrowing.... because the solid underpinning has been removed....

    So - the NDIS is but one of those lovely social enterprises (carried on at prodigious expense, BTW, with fine salaries and conditions for many), that would not be here unless Gai's taxes had been part of the overall tax base that used to sustain the nation.

    I see no argument for EXCLUDING (note that is the opposite of not including - same as affirmative action is a policy of exclusion and inclusion in one) those older than pension age... it's not as if they receive a huge amount to cover their almost inevitable costs for healthcare at that age (despite what that stupid sheila in the social security minister spot said about it being 'a generous payment'...LMAO - let her live on it for real - entitled twat).
    maelcolium
    16th Jul 2019
    12:32pm
    Rubbish.

    The Government is a fiat currency issuer and doesn't need to borrow or tax to spend. You've fallen for the old neoliberal narrative that taxes pay for services …… they don't. The balanced budget mantra is an ideological position taken by Governments so they can claim they are being fiscally responsible. The only limits are the availability of resources, including labour, and Australia is a resource rich country.

    So the choices of who gets or doesn't get NDIS services is not of affordability, but at the whim of politicians and bureaucrats, who hve been misleading us for decades.
    lasaboy
    16th Jul 2019
    12:57pm
    Exactly
    TREBOR
    16th Jul 2019
    8:29pm
    Ah - so you are proponents of perpetual debt... fine... the POINT still remains:-

    Taxes paid in the past have worked to create current situations - without those taxes, no amount of government borrowing would ever be repaid, and thus would not exist.

    Thank you for coming... your attempt to cast this as a simple black and white issue is noted....

    So... boys... where do YOU imagine all that ready comes from?
    Rae
    17th Jul 2019
    7:36am
    Government insolvency and default is far easier solved than a full blown private banking crisis and default as well and it hurts far less people.

    Why the risk has been lumped onto the citizens instead of the government which can handle it is an interesting question. Once it was quite common for Nations to default on loans and then start all over again. We are being played for fools right now.

    Our high taxes that built solid, income producing assets have been squandered by privatisation sales. Time to demand a fair share of the profits.
    TREBOR
    17th Jul 2019
    8:09am
    A big issue, Rae.... or several issues....

    Good work...
    busybee
    16th Jul 2019
    10:28am
    NDIS doesn't even give support to those with narcolepsy who cannot work. Everyone should be able to get support no matter what age.
    TREBOR
    16th Jul 2019
    10:40am
    This reminds me of the argument I have with TPI for Veterans - if you get it one day before pension age, you get it for life - if you get it one day after pension age, you never get it... I knew a bloke who was on 150% disability - count it - and he lived in a shed and managed a firing range rather than put himself in the position of being a beggar. When he finally applied he was a walk-up for TPI despite his bad leg.

    One Afghanistan Vet a week takes his own life. If you knew the conditions 'on the ground', and who are being killed as 'enemy', you would understand why. If you know such a one, tell him to talk with an older mate.

    What difference does that one day too late make to the disabled one? Especially when other things, such as pride and not wanting to be a freeloader, can delay making a claim until things are desperate?

    Same applies here - does the disability suddenly go away at Pension age?
    Rae
    17th Jul 2019
    7:46am
    We should never have gone into Afghanistan or Iraq. The issues there can't be solved. Too many mouths to feed and nothing left including enough water. It's Easter Island without the sea but with a nutty religion that forbids contraception.
    The Middle East is all like that. They cut down the last trees centuries ago for warfare and insist on having huge tribes of kids with nothing to do but fight each other over the few remaining resources.

    We should leave them to sort it out themselves as they have been doing for centuries. Fighting a population seeped in warfare and with networks of underground and above ground supply lines is insane.

    Government refusal to help returned vets is despicable TREBOR but as the Liberals were established purely to fight Labor I'm not surprised. They do exactly what they state is the objective. Prevent Labor from governing. Anyone thinking they are there to help the people have failed to understand the history of the Liberal Party.
    TREBOR
    17th Jul 2019
    8:14am
    In Afghanistan neighbours fight neighbours and any 'intruder' is met with armed force and grudges go back centuries and every petty tribal lord seeks an advantage over his neighbouring lords..... very petty tribal and the social environment is complex beyond words and nobody in the world can lie to your face like an Afghan ... troops are often fighting, not 'Taliban', but local farmers who think they need to defend their fields and such - thus troops are sometimes killing the mainstay of a family etc...

    Since our armed forces only recruit civilised people, this is very demanding to say the least... and the cost is high in many ways.
    TREBOR
    16th Jul 2019
    10:43am
    NDIS? NDIS ia a joker! She sets the rules, and then adds more rules in opposition.... says "look - but don't touch".... "touch... but don't taste!".... "taste ... but don't swallow!".. and while you're down here jumping from one leg to the other, she's up there laughing her sick, falcon head off! Worship that? NEVER!"

    (stolen from The Devil's Advocate)...
    Buggsie
    16th Jul 2019
    11:01am
    Interesting - about the Commonwealth Home Support Scheme - my wife accesses this scheme but using it for personal care was hopeless. She is in a wheelchair and her level of disability is too great for the supposedly trained carers to manage. So we were told to apply for a Home Care package, Level 4. Apart from the more than 1 year waiting list, our contribution to the $50,000 package was to be about $20,000. In the meantime we were told to continue to use the CHCS which was relatively useless. Talk about Alice in Wonderland stuff. However i acted laterally and its amazing how much private support you can find and fund for much less than $20,000. Roll on government Aged care Bullshit!
    Rae
    17th Jul 2019
    8:00am
    Yes. It's yet another privatised way of transferring public funds into provider hands and not much else. At least half of all the money is spent on the provider office, salaries, computers, costs to tick boxes and run interviews.

    Exactly like the job providers who can't find people jobs or the welfare cards that cost as much to provide as they give to the recipient.

    Privateers and carpetbaggers have taken over. Still people wanted this rather than a strong public service. This comes from being jealous that others are getting decent pay and conditions. Now almost everyone suffers so those green eyed must surely be happy.

    Best way is to go it alone as you can't trust the private providers in it for the profit. Why anyone thought it would be better indicated high levels of stupidity.

    People might have to give up their little spends on little pleasures to pay for themselves. It's what they voted for after all. Small government and privatisation.

    There are cheaper and less greedy services out there as you say that don't need half the money spent on report writing nonsense and profit gouging.
    Tanker
    16th Jul 2019
    11:13am
    The fact is that you cannot expect both tax cuts and better support for those who need it at the same time. The government has given priority to tax cuts, the biggest beneficiaries will be those who don't need the extra money.
    Paddington
    16th Jul 2019
    12:05pm
    Welfare to the wealthy needs to be cut off! Close all loopholes.
    TREBOR
    16th Jul 2019
    12:09pm
    Indeed.... pork barreling trumps putting pork on the table for the disabled every time...

    An argument for tax cuts is 'economic stimulation' from increased discretionary spending... actually the same argument applies in offering more SERVICES.... the difference beting, firstly ideological, but secondly that thosest with the mostest get to horrd some or most or all of their new 'discretionary' into non tax-paying ventures, such as offshore holidays, offshore purchases, offshore properties, offshore tax havens, dead stock such as house hoarding, improvements to their tiny little retirement home worth $7m so they can pull the pension as well, filling up their personal superannuation fund so as to pay no tax on a luxury income for life...... you name it....

    The only hope lies with the proles, as John Smith in 1984 said.... the proles, given a few bucks, will spend it instantly back into the economy - gee, it's good to see on ABC News last night Deloitte stating the same thing as I've been saying for ages now... the peons pay all their discretionary straight back into the economy, thus are a far better bet, given that they vastly out-number the Cashocracy ... funny how when a tax is levied, the concept is to take as much from as many as possible to 'even' it out - yet when it comes to cuts, the majority goes the other way - towards Trickledown Town.

    Just getting in touch with my inner politics of envy .....don't want to see some fat bastard pay too much tax after already living off the business, whatever that may be, including being a 'shareholder' 'playing' the stock market etc........

    I recommend one or two more tiers of income tax on the higher incomes and a boost to company tax with at the very least a mandatory minimum - so as to actually capture some of that lost revenue...

    Welcome to Around The World With Trebor .... so many issues - so little time....
    Rae
    17th Jul 2019
    8:13am
    TREBOR I 've often thought there should be a tally of gross income or profits and deductions and taxes added up as well for a bottom line sum of contributions and earnings. It would be very interesting. The business owners I know paid very little tax ever but managed affairs to get every government give away they could.

    The big multinationals now take billions away in profits and pay no taxes. I pay more tax than the likes of Energy Australia owned by China which takes billions away to subsidise Chinese business electricity costs.

    At the very least the high tax paying ordinary workers could wear a medal or something because that is often the only thing they might get for all their contributions to the joint pot.
    TREBOR
    17th Jul 2019
    9:02am
    Been saying for a long time now that a total overhaul of business tax is needed.

    I also noted with concern a reference on the ABC (in passing) to 'industrial reform' in the midst of discussion of something else - which is LNP shorthand for 'rob the workers' (who pay tax)....

    Maybe company tax does need to be lowered - to a 'floor' below which a company cannot go and must pay .... 25% of net profit sound all right?
    Intellego
    16th Jul 2019
    11:13am
    I am 57 and an NDIS participant. The NDIS is as big a disaster as Centrelink.
    lasaboy
    16th Jul 2019
    12:56pm
    No it is worse, much worse
    TREBOR
    16th Jul 2019
    8:30pm
    A little explanation would go a long way, lasaboy.... actively contribute if you know it all....
    QuickeyeQld
    16th Jul 2019
    12:03pm
    As a beginner user of the NDIS, for my husband with dementia, who joined under 65, but has recently turned 65, I have found it a very frustrating experience. Most of the people who work in the industry do not seem to know how the NDIS operates, here in Qld. So the NDIS is possibly not the best option.
    We are about to start an exercise program for him at a gym, but it will be interesting to see how it goes. We have already had one false start, where he was dropped at the wrong location, and was lost for a bit.
    Recently, yesterday, he was supposed to go to a short term respite centre for a few days, to give me some space for a medical procedure. That was a disaster. I turned up to drop him off to a totally deserted establishment. Even thought the drive was sealed, there was a horse float and a van packed out the front, and I wasn't sure if I was perhaps at someone's private residence, not that it looked nice. I certainly was not welcoming, was all locked up with blinds drawn, no sign to indicate I was at the correct address, a rusty sign frame on the fence, but the actual sign removed, not even an indication of where the entrance was, and no sign of a welcoming presence. I was shocked and confused. I did not feel comfortable about leaving my husband there. If I leave him at a care facility, I expect it to look like one, and I expect to be confident they are registered qualified carers, who know what they are doing. I was told I was early, and the staff weren't arriving for another hour or so. So they weren't prepared to maintain a presence there a minute before someone was to arrive. I expected it to be an ongoing establishment, ready for anything, including an early arrival. When you are managing someone ill,or frail and specifically someone with dementia, you can't plan to the minute, because even the best plans can change with a person with dementia. I understand some care facilities try to create a discreet appearance, but I don't think that is acceptable. I gives them opportunity to drop their standards. Now they claim they say they are going to charge me 90% of the charge anyway, which will probably be a few thousand dollars. Its not like I prevented them from other business, by booking and withdrawing, they didn't have any other clients. The service providers under the NDIS are out to get maximum profit by charging to the limit of your NDIS funding.
    Rae
    17th Jul 2019
    8:21am
    The joys of privatised businesses out for profit. It's always been like that which was why we set up public service in the first place back after WW11 wrecked the world.

    Go take some photos of the joint before hours and refuse to pay. Let them take you to court and show the judge.

    I bet the thousands will be forgiven at that point. Judges are as pissed off as everyone else about now after all this nonsense has ended up tying their courtrooms into balls.

    Not only are the NDIS service provider managers fly by night operators but a lot of care establishments are after public funds too.

    At the very least take legal advice from your local courthouse.
    ceejay
    16th Jul 2019
    12:17pm
    I was 62 when my Doctor first filled out the forms for NDIS for me. Unfortunately, he was from a culturally and linguistically diverse community and did not really understand the concept of NDIS. Consequently he filled out the forms incorrectly. Based on these forms, I was knocked back by the NDIA. I was told I could appeal, which I did twice, but the NDIA kept saying they had insufficient information despite me providing them with more than enough to allow them to make a decision. Then six months before I turned 65, I again asked where I was at, only to be told I did not qualify despite physical and emotional limitations which were life long following cancer surgery and radiation. I asked the NDIA officer was it more to do with the fact I was approaching 65 and not because I had a rest of life disability requiring support from Blue Care and others. I never received an answer. Now I'm on the CHSP and having to pay an enormous amount of my pension for limited services despite trying to assist my husband to run a drought-affected property with no government help. The sad part of all this - I was involved in working in Queensland to bring the NDIS into being.
    ceejay
    16th Jul 2019
    12:17pm
    I was 62 when my Doctor first filled out the forms for NDIS for me. Unfortunately, he was from a culturally and linguistically diverse community and did not really understand the concept of NDIS. Consequently he filled out the forms incorrectly. Based on these forms, I was knocked back by the NDIA. I was told I could appeal, which I did twice, but the NDIA kept saying they had insufficient information despite me providing them with more than enough to allow them to make a decision. Then six months before I turned 65, I again asked where I was at, only to be told I did not qualify despite physical and emotional limitations which were life long following cancer surgery and radiation. I asked the NDIA officer was it more to do with the fact I was approaching 65 and not because I had a rest of life disability requiring support from Blue Care and others. I never received an answer. Now I'm on the CHSP and having to pay an enormous amount of my pension for limited services despite trying to assist my husband to run a drought-affected property with no government help. The sad part of all this - I was involved in working in Queensland to bring the NDIS into being.
    lasaboy
    16th Jul 2019
    12:51pm
    This is further government bullshit, the NDIS strung me along until I was 65, then said piss off you are too old, I am on the waiting list for My Aged Care and have been for a while, my daughter is only 23 and in the same boat as I am, the NDIS is refusing to accept her, the Government is limiting the number of people that can get NDIS or My Aged Care by design, in other words they are screwing all of us with a disability, I have spoken to or sent messages to a number of MP's, and they don't want to know, oh they say they will look into it, but never get back in touch, I am sick of the political bullshit
    lasaboy
    16th Jul 2019
    12:55pm
    Another problem is the assessors for the NDIS are trained for (6) that's SIX weeks, the supervisors get an additional six weeks training, yet they are vetoing judgements made by medical professionals, the whole system is Government bullshit
    TREBOR
    16th Jul 2019
    8:30pm
    Now you're talking .................
    Rae
    17th Jul 2019
    8:25am
    No it's not government at all. That's the problem. It's private enterprise running on public funding for profit. It was never going to work. Exactly like the private electricity network no longer works.

    What did people expect would happen when you let privateers loose?
    rtrish
    16th Jul 2019
    1:30pm
    When the NDIS was coming in I, like many, was too old. I was disappointed but a friend said, “You might be better off with My Aged Care.” Well, was she ever right. Every time I read about people of the NDIS waiting for help, I’m glad I’m not on it. I have needed a few things and so far have mostly received good help. I did buy something (bed cage, $100) which I wasn’t told till later would have been covered. But other things have been covered and I’m grateful.
    KB
    16th Jul 2019
    1:41pm
    It is extremely difficult to access help if you have physical issues if you are under the age of 65. Many of us fall through the gap due to age. My council said that I was eligible for the scheme to help to get cleaning services. Have not heard back form the council Was knocked back by Disability services as the only cover people for rheumatoid not osteoarthritis All systems need improving
    KB
    16th Jul 2019
    1:41pm
    It is extremely difficult to access help if you have physical issues if you are under the age of 65. Many of us fall through the gap due to age. My council said that I was eligible for the scheme to help to get cleaning services. Have not heard back form the council Was knocked back by Disability services as the only cover people for rheumatoid not osteoarthritis All systems need improving


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