💬👤 💬 11. NDIS as Neoliberal Care (Interactive Excercise)

Introduction: NDIS as Neoliberal care

What is the logic or rationale behind Australia's National Disability Insurance Scheme (NDIS)? One way to analyse this is using the concept of neoliberalism. In what follows we'll:

• study 5 neoliberal principles,
• get an overview of the NDIS,
• apply the 5 principles to the analyse NDIS
• reflect on the usefulness of this neoliberal analysis

By doing this, you'll develop your skill at using this theory to analyse care.

5 Neoliberal principles

First, pick one of these 5 principles at the heart of neoliberal care:

1. Marketisation  Where do you get your care?

Instead of receiving care directly from the government, you enter a marketplace. Different providers compete for your business, and you become a consumer of care.  Neoliberal pioneer Friedrich Hayek stated:  

“The more the state ‘plans’ the more difficult planning becomes for the individual.”  

The idea is that giving you choices in a market gives you greater control than having the government decide what services you receive.  

2. Individual responsibility & choice  

Who makes the decisions that affect you?  You do. You choose and manage the services you use. Your autonomy and choice are celebrated, while dependence can be problematised.  British PM Margaret Thatcher, whose government implemented major neoliberal reforms, famously stated:  

“There is no such thing as society. There are individual men and women and there are families.”  

This is sometimes called responsibilisation: rather than someone else managing things for you, you are expected to take responsibility for making choices and managing your own life.  

3. Cost–benefit & efficiency  How should the money for your care be spent?  

Your care should achieve the best possible outcomes for the resources spent. You—and the organisations providing your care—are expected to use resources efficiently.  Neoliberal economist and Nobel Prize winner Milton Friedman famously stated:  

“Nobody spends somebody else’s money as carefully as he spends his own.”  

The neoliberal argument is that you may spend resources allocated to your care more carefully than a distant government bureaucracy would spend them for you. Care therefore becomes associated with ideas such as efficiency, investment, measurable outcomes and sustainability.  

4. Smaller state & outsourcing  Who actually provides your care?  

Not necessarily the government. The government might fund your care, while you receive it from a business, NGO, contractor or community organisation.  Friedman argued:  

“I think the government solution to a problem is usually as bad as the problem and very often makes the problem worse.”  

Applied to care, the argument is that businesses, NGOs and other organisations may provide your care better or more efficiently than a centralised government bureaucracy.  This doesn't necessarily mean that government disappears. Government may still fund and regulate your care, but it doesn't provide that care directly. The role of the state changes.  

5. Moralised citizenship  What kind of person are you expected to be?

 You are expected to be a “good citizen”: independent, active, responsible and self-managing. You should look after your health, make sensible choices, contribute where you can, and avoid unnecessary dependence on government support.  As Buch (2015) explains, elderly people are:  

“encouraged to adopt techniques of the self intended to help them remain healthy, active, productive, contributing members of society as long as possible” (Foucault 1988).  

We can see this in ideas about “‘successful’ and ‘active aging’”, which are:

 “intended not only to improve elder well-being, but also to reduce the amount of labor and material resources expended in their care” (Buch 2015).

 

Now to make sure you understand use one of the principles and apply it to reforms we have seen in:

• Higher Education:
  • user pays / individual responsibility--HECS 1989- students not taxpayers pay
  • marketisation / competition--unis compete for students and funding
  • commercialisation--commercial research, international students industry partnerships
  • managerialism--unis run like corporations
  • Audit, measurement, and performance--quantifiable outputs 
• education: primary, secondary
• public transport

Australia's National Disability Insurance Scheme

So can these 5 principles help us analyse Australia's NDIS? First of all, what is the NDIS?

• For people with ongoing disabilities 
• Called "insurance" because: 
  • Everyone contributes through taxes → shared risk (anyone might need support). 
  • Focuses on lifetime supports (housing mods, equipment, personal care, therapy), unlike Medicare’s short-term treatment. Uses maths to predict future needs and costs (actuarial approach). 
• Aim = reliability and sustainability, not profit. Ensures funds will be there across a person’s whole life. Promised security, fairness, and national consistency: no more “lottery” of services depending on state, year, or disability type. 
• Emphasises individual choice and control, giving people more say in their supports. At the same time, designed around markets, efficiency, and cost–benefit planning → connects to neoliberal care logics.

The NDIS was piloted in 2013, phased in nationally from 2016 and fully rolled-out by 2020. 

What was the result? Let's consider Carl Thompson, who has cerebral palsy. The Guardian reports:

When the National Disability Insurance Scheme began, it allowed Carl Thompson to finally move out of home and into his own place. He says the move was only possible because his funding had increased to about 10 times what he received under the previous state-run system. “I need help with everything, really, from getting dressed and showering and then eating, and all that type of thing,” says Thompson, who has cerebral palsy. “That’s why I’m so passionate about defending the original idea of this scheme, because it’s had such a beneficial impact on me and others that I’ve worked with.”

So what was the original idea? 

The Welfare State

The impetus for the NDIS came from the Productivity Commission. 

What does this indicate about the rationale behind NDIS? 

In 2011, it presented the "Disability Care & Support, Productivity Commission Inquiry Report". The commission noted that under welfare states of Australia disability care varied from state-to-state.:

People wait years for specialist wheelchairs, need to stay with their parents instead of moving into independent supported accommodation, and do not get timely or sufficient access to support. Carers have among the lowest levels of wellbeing of any group of Australians... People with similar levels of functionality get access to quite different levels of support, depending on their location, timing or the origin of their disability — what some call the ‘lottery’ of access to services

 Care for the disabled also varied from year-to-year:

Current funding for disability is subject to the vagaries of governments’ budget cycles. People with disabilities have no certainty that they will get reasonable care and support over the long run.

 

The commission justified the NDIS partly in terms of cost-benefit:

The main function (and source of cost) of the NDIS would be to fund long-term high quality care and support (but not income replacement) for people with significant disabilities. Everyone would be insured and around 410 000 people would receive scheme funding support. ...The benefits of the scheme would significantly outweigh the costs. People would know that, if they or a member of their family acquired a significant disability, there would be a properly financed, comprehensive, cohesive system to support them. The NDIS would only have to produce an annual gain of $3800 per participant to meet a cost-benefit test. Given the scope of the benefits, that test would be passed easily...The cost of doing nothing would be the persistence and increasing intensity of the above deficiencies. Moreover, governments could not feasibly do absolutely nothing. They would need to patch up their systems to arrest the vicious cycle produced by systems in crisis. In effect, all governments face future liabilities with their current unstable systems. The implication of this is that the upfront fiscal costs, while significant, are partly offset by eliminating the hidden future liabilities of the current system. Moreover, from an economic perspective, the benefits of the NDIS will exceed the costs.

An example of the wastefulness of the old system was:

Under-servicing in one area — such as not enough access to respite and home modifications — results in costly additional servicing in another less appropriate area or at a later time (such as someone staying in hospital because their home has not been modified)

 

The focus of the NDIS was on the individual's choice to receive the care they want, not the care they are told to receive:

There is a strong rationale for people with a disability to have much more control over what and how support services are delivered. As one participant said: ‘[NDIS] is for people with disability, not for service providers. Not for governments, not for empires or private agendas. This scheme is for people who are as individual as their fingerprints.’ The Commission agrees that a new scheme should reflect this goal. The Commission proposes an ‘individual choice’ model, in which people with a disability (or their guardians) could choose how much control they wanted to exercise. There would not be one model that forced people to take full control or none (p. 30).

The person with a disability is to receive funding from the federal government arrange their own care with local organisations:

Services would be provided by non-government organisations, disability service organisations, state and territory disability service providers, individuals and mainstream businesses. Increased funding, choice and certainty are the key features of the recommended scheme...People would have much more choice in the proposed NDIS. Their support packages would be tailored to their individual needs. People could choose their own provider(s), ask an intermediary to assemble the best package on their behalf, cash out their funding allocation and direct the funding to areas of need.

As of 2025, out of Australia's population of 26 million, roughly 717,000 people (about 2.8%) Australians receive NDIS funding.

So it seems that the NDIS is governed by neoliberal principles. Granted, the government pays. But it uses market mechanisms to organise provision.

 

Discussion Questions 

So it seems that your task is to use one of the five concepts associated with neoliberalism to analyse the NDIS, as described above. 

1. Marketisation of care

• In what way does the NDIS use market principles?
• Where does “individual choice” fit in?
• What is gained and lost when care is organised like a marketplace?

2. Individual responsibility & choice

• How does “choice and control” appear in participant experiences (e.g. Carl Thompson)?
• What kinds of skills, literacy, and supports are assumed for self-management?
• In what ways are participants  “responsible” participant the scheme imagines?

3. Cost–benefit & efficiency framing

• How was the NDIS supposed to lower costs and be more efficient?

4. Outsourcing & smaller state

• The state used to directly provide care. What's it new role? 
• Care is outsourced to NGOs, volunteers, and businesses. What is their role?

5. Moralised citizenship

• Is the “ideal” participant being imagined as self-managing and independent? What happens to those who can’t perform that ideal?
• How might dependency be reframed as failure, burden, or irresponsibility in these systems?

What do you think?

 NDIS might be good or bad--that's not our concern here. What we are concerned with is how useful is the concept of "neoliberalism" in analysing NDIS. Given that:

• How does the concept of "neoliberalism" help explain both the strengths and the problems of the NDIS?
• Which, if any, of the 5 lenses do you think is most relevant in understanding Australia's NDIS? Why?