NDIS- When Care Becomes a Commodity and Lives Become Profit

Businessman pointing at chart showing IT contract cost increase from $10M in 2023 to $210M in 2024 — A businessman presents a sharp rise in IT contract costs from 2023 to 2024

By Andrew Klein

Dedicated to my wife, who taught me that real care can never be outsourced to algorithms or profit.

I. Introduction: A Young Woman’s Last Goodbye

On 6 July 2026, a young woman — a wheelchair user — posted her farewell in an NDIS social media group. Her wheelchair funding had been removed because the NDIS decided that Functional Neurological Disorder was not the “right” kind of disability for funding. She lost the wheelchair that allowed her to leave home. Then came the isolation. A broken second-hand wheelchair that caused pain. Fewer supports. Weeks alone. No friends. No community.

Her world became smaller and smaller.

She wrote: “I don’t want to be here anymore.”

“This will be my last post ever.”

“It’s now time to say goodbye.”

She locked her profile. She is likely dead in Logan, Queensland.

As one advocate put it: “If you’re in the group, over weeks and months, you can watch it happen. Because you are killing us every day.”

This is a snapshot of the NDIS crisis in 2026.

II. Where Has the Money Gone? The NDIS Financial Black Hole

2.1 From $13 Billion to $63 Billion: A System Out of Control

When the NDIS was launched in 2013, it was expected to cost approximately $13 billion per year. By 2025-26, the scheme will cost approximately $52.3 billion, rising to $63.4 billion within three years.

This is not growth — this is runaway spending.

2.2 Billions Flowing Offshore

More troubling is the amount of taxpayer funding flowing overseas. If $20 billion of NDIS funding goes to overseas-owned providers, at a 25% profit margin, that represents $5 billion in profits leaving Australia. Aged care spending is $36.4 billion, and childcare funding is approaching $18 billion annually. In total, over $100 billion annually flows into the care economy.

2.3 The Consulting Bonanza

The government has paid over $60 million to large law firms to fight NDIS participants — participants who are appealing decisions about their care packages. In 2024-25, the government paid over $60 million to large law firms to fight NDIS participants. The NDIS Quality and Safeguards Commission issued a software maintenance and support contract in September 2024, reflecting ongoing technology spending.

This is not care. This is wealth transfer.

III. Consultancies and IT Contracts: Billions Wasted

3.1 The Salesforce Contract: From $10 Million to $210 Million

In 2019, the NDIA approved a software contract with US tech company Salesforce, estimated to cost $9.5 million. By November 2022, the contract had blown out to $208.5 million — a 20-fold increase in three years. An Ernst & Young (EY) review found the contract “normally” should have started with a small number of licences, but this was “not observed” in the NDIA contract documentation. The EY report warned that “hidden costs could significantly increase the project budget”.

The contract has been referred to the National Anti-Corruption Commission. Then-NDIS Minister Stuart Robert approved the proposal. Salesforce executives had met with Robert multiple times.

3.2 The Role of EY

EY conducted the review of the contract. EY has also been involved in other NDIS-related work. Ernst & Young (EY) audited the contract.

3.3 The Cost of Consultants

Typical consulting costs for NDIS providers include: compliance audits at $550, digital growth strategies at $1,200, and marketing plan development at $1,800. For NDIS providers, registration costs range from $3,000 to $60,000.

IV. AI and Automated Decision-Making: “Robo-Planning”

4.1 Computer-Generated NDIS Plans

In late 2025, reports of “computer-generated” NDIS plans raised serious concerns. “Computer-generated” NDIS plans refer to Automated Decision-Making (ADM) — the use of computer systems to automate all or part of administrative decision-making processes. Advocates criticised the changes as “robo-planning” and warned they endangered the lives of NDIS participants.

4.2 Lack of Transparency and UN Concerns

Australia still lacks a comprehensive legal framework to regulate the use of AI and automated decision-making in public administration. There are no clear, enforceable requirements for algorithms used in the NDIS to be transparent, explainable, challengeable, and accountable.

In October 2025, a submission to the UN Committee on the Rights of Persons with Disabilities raised urgent concerns: “Are algorithms or automated processes being used at any stage of any NDIS process?” The rationale included: the “unprecedented speed and scale” of participant reassessments since September 2025; an unusually high number of adverse decisions subsequently overturned by the Administrative Appeals Tribunal; and the government’s significant investment in “AI-enabled service delivery.”

4.3 Violations of the UN Convention

The use of algorithmic decision-making in the NDIS raises multiple serious risks of breaching Australia’s obligations under the UN Convention on the Rights of Persons with Disabilities:

· Article 3 (General Principles): Automated or category-based decisions deny autonomy and dignity, treating people as data points rather than individuals.

· Article 5 (Equality and Non-Discrimination): Algorithmic systems that classify participants by statistical similarity rather than individual need create indirect discrimination and systemic inequality.

· Article 12 (Equal Recognition Before the Law): Delegating decisions affecting rights and entitlements to algorithms constitutes a denial of equal recognition and legal representation.

· Article 13 (Access to Justice): Automated processes obscure reasoning, making it impossible for participants to understand or challenge decisions, thereby violating the right to a fair hearing.

4.4 Algorithmic Bias

ADM and AI systems are only as reliable as the information inputted. If historical data fails to adequately represent specific groups, automated decision-making will replicate and amplify these gaps. Algorithms built from “average” cases consistently fail those on the margins. Computer-generated decisions also fail to explain how they reached their conclusions.

V. Profit and Poverty: The NDIS “Self-Licking Ice-Cream”

5.1 Industry Profits and Provider Losses

In 2025-26, NDIS revenue grew by 0.7% to $45 billion. However, nearly half of providers reported financial losses in 2024-25. 81% of respondents providing NDIS support stated they could not continue to deliver services at current prices. The NDIA sets the hourly price at $70.23, while the actual cost is $77.24 — approximately 10% higher.

Providers are leaving the market — the number of businesses entering administration, downsizing, or closing NDIS services has increased. Meanwhile, large providers are under significant pressure.

5.2 The “Self-Licking Ice-Cream”

The NDIS has been described as a “self-licking ice-cream”. In 2025, NDIA Integrity Head John Dardo revealed in Senate estimates: “Approximately 90% of plan managers are showing signs of fraud.”

This is not a scandal — it is a system.

5.3 Fraud and Enforcement

As of 2025, there were 43 active NDIS fraud cases, with an estimated fraud value of $35 million. The Fraud Fusion Taskforce has investigated over 100 cases involving over $1 billion in NDIS funds.

VI. Government Promises vs. Reality

6.1 The NDIS Review

The final report of the Independent Review into the NDIS, released in December 2023, made 26 recommendations and 139 supporting actions to restore trust, confidence, and pride in the scheme. However, the government’s response to these recommendations has been slow and inadequate.

6.2 Cuts and Deaths

In 2025, funding cuts caused “ongoing and irreversible harm.” One participant suffered torn hand muscles, loss of mobility and stamina, recurring infections, hospitalisation, and two suicidal episodes.

The Productivity Commission found that mental health services are failing to meet standards, leading to the “well-known but still shocking” outcome: 3,000 suicide deaths annually. After the NDIS rollout, the government withdrew most funding for psychosocial support, leaving 500,000 people with mental illness without support.

6.3 Ministerial Inaction

When asked about NDIS participants dying as a result of cuts, ministers claimed that “nobody will die” — but the evidence says otherwise. As one advocate stated: “You have been warned and warned and warned.”

VII. Conclusion: The Commodification of Care

The NDIS was designed to support Australia’s most vulnerable citizens. Instead, it has become an uncontrolled spending black hole, while generating a complete consulting sub-industry.

· Money: From $13 billion to $63 billion, with billions flowing offshore.

· Consultancies: The Salesforce contract blew out from $10 million to $210 million; $60 million paid to law firms to fight participants.

· AI: Automated decision-making and “robo-planning” have been introduced without transparency, accountability, or a legal framework.

· Profit: 90% of plan managers show signs of fraud; nearly half of providers are losing money; billions in profits flow offshore.

· Death: 3,000 suicide deaths annually; cuts cause “ongoing and irreversible harm”; participants die from funding cuts.

When a system designed to care becomes a profit engine, care itself is destroyed. Those who should be supported are instead exploited. Those who should be heard are instead silenced. Those who should be protected are instead sacrificed.

The NDIS is not failing — it is working as designed.

The question is not whether the system has failed. The question is: who is responsible for the deaths?

Andrew Klein

References

1. The Saturday Paper. (2024, July 6). Exclusive: NDIS contract blew out by $200m.

2. The Guardian. (2025, September 23). NDIS under pressure: Exclusive: The federal government paid big law firms more than $60m in 2024-25 to fight NDIS participants.

3. Submission to United Nations Committee on the Rights of Persons with Disabilities. (2025, October 22). Use of Algorithmic Processes in NDIS Funding Decisions.

4. Disability Advocacy Network Australia. (2025, December 5). Disability representative organisations call for transparency on ‘Computer-Generated NDIS Plans’.

5. Australian Government Department of Health and Aged Care. (2025). Release of the final report of the Independent Review into the NDIS.

6. Northern Daily Leader. (2025, November 27). Billions of taxpayer dollars meant to support older Australians siphoned offshore every year.

7. IBISWorld. (2025). National Disability Insurance Scheme Providers in Australia Industry Analysis, 2025.

8. NDS. (2025). State of the Disability Sector Report 2025.

9. ABC News. (2025, November 12). National mental health agreement failing, Productivity Commission finds.

10. Australian Parliament. (2025). NDIS cuts and harm to participants.

11. NDS. (2025). State of the Disability Sector Report 2025 – provider losses.

12. The Weekly Source. (2025, December 3). NDIS price caps spark provider exits and losses.

NDIS：当关怀成为商品，生命成为利润

作者：Andrew Klein

献给我的妻子，她教会我：真正的关怀，永远不会被外包给算法或利润。

一、引言：一个年轻人的最后告别

2026年7月6日，一位年轻女性——轮椅使用者——在NDIS社交媒体群组中发布了她的告别。她的轮椅资金被削减，因为NDIS认定“功能性神经障碍”不属于“正确”类型的残疾。她失去了让她能够离开家的轮椅。随后是隔离。一把破旧的二手轮椅带来疼痛。支持减少。数周的孤独。没有朋友。没有社区。

她的世界变得越来越小。

她写道：“我不想再留在这里了。”

“这将是我最后一次发帖。”

“现在是时候说再见了。”

她锁定了自己的资料，很可能在昆士兰州洛根市已经去世。

正如一位倡导者所说：“如果你在群里，几周、几个月，你可以看着它发生。因为你们每天都在杀死我们。”

这是2026年NDIS危机的一角。

二、金钱去了哪里？NDIS的财务黑洞

2.1 从130亿到630亿：一个失控的系统

NDIS在2013年启动时，预计每年成本约为130亿澳元。到2025-26财年，该计划将耗资约523亿澳元，并在三年内上升至634亿澳元。

这不是增长——这是失控。

2.2 数十亿流向海外

更令人担忧的是，越来越多的纳税人资金正流往海外。如果NDIS的200亿澳元资金流向海外拥有的提供商，以25%的利润率计算，仅此一项就代表着50亿澳元的利润离开澳大利亚。老年护理支出为364亿澳元，托儿资金接近每年180亿澳元。总的来说，每年有超过1000亿澳元流入照护经济。

2.3 咨询业盛宴

政府支付了超过6000万澳元给大型律师事务所，用于与NDIS参与者抗争——这些参与者正在对他们的护理方案决定提出上诉。在2024-25年度，政府支付超过6000万澳元给大型律师事务所，用于与NDIS参与者抗争。NDIS质量和保障委员会一份2024年9月的软件维护和支持合同反映了持续的技术支出。

这不是关怀。这是财富转移。

三、咨询公司与IT合同：数十亿的浪费

3.1 Salesforce合同：从1000万到2.1亿

2019年，NDIA批准了一份与美国科技公司Salesforce的软件合同，预计成本为950万澳元。到2022年11月，该合同成本已飙升至2.085亿澳元——三年内增长了20倍。安永的审查发现，该合同“正常”应从少量许可开始，但NDIA合同文件中“未观察到这一点”。安永报告警告：“隐藏成本可能显著增加项目预算”。

该合同已提交给国家反腐败委员会。时任NDIS部长斯图尔特·罗伯特（Stuart Robert）批准了该提案。Salesforce高管曾多次与罗伯特会面。

3.2 安永的角色

安永对该合同进行了审查。安永还参与了其他NDIS相关工作。安永（EY）对该合同进行了审计。

3.3 咨询公司的成本

咨询服务的典型成本包括：合规审计550澳元，数字增长策略1,200澳元，营销计划制定1,800澳元。对于NDIS提供商而言，注册成本从3,000澳元到60,000澳元不等。

四、人工智能与自动化决策：“机器人规划”

4.1 计算机生成的NDIS计划

2025年底，有关引入“计算机生成”NDIS计划的报道引发了严重关切。“计算机生成”NDIS计划指自动化决策（ADM）——使用计算机系统自动化全部或部分行政决策过程。倡导者批评这些变化为“机器人规划”，并警告其危及NDIS参与者的生命。

4.2 透明度缺失与联合国关切

澳大利亚仍然缺乏全面的法律框架来监管公共行政中AI和自动化决策的使用。没有明确、可执行的要求规定NDIS中使用的算法必须透明、可解释、可质疑和可问责。

2025年10月，一份提交给联合国残疾人权利委员会的通知提出了紧急关切：“算法或自动化过程是否被用于任何NDIS过程的任何阶段？”。理由包括：自2025年9月以来参与者重新评估的“前所未有的速度和规模”；异常多的不利决定随后被行政上诉法庭推翻；政府对“AI赋能服务交付”的重大投资。

4.3 违反联合国公约

在NDIS中使用算法决策带来多种严重违反澳大利亚根据《联合国残疾人权利公约》所承担义务的风险：

· 第3条（一般原则）：自动化或基于类别的决策否定自主权和尊严，将人视为数据点而非个体。

· 第5条（平等与非歧视）：按统计相似性而非个体需求对参与者进行分类的算法系统制造间接歧视和系统性不平等。

· 第12条（法律面前平等承认）：将影响权利和权益的决定委托给算法，等同于否定平等承认和法律代理。

· 第13条（诉诸司法）：自动化过程掩盖推理，使参与者无法理解或质疑决定，从而侵犯公平听证权。

4.4 算法偏见

ADM和AI系统仅与输入的信息一样可靠。如果历史数据未能充分代表特定群体，自动化决策将复制并放大这些差距。从“平均”案例构建的算法始终无法服务于那些处于边缘的群体。计算机生成的决定也无法解释它们如何得出结论。

五、利润与贫困：NDIS的“自舔冰淇淋”

5.1 行业利润与提供商损失

2025-26财年，NDIS收入增长了0.7%，达到450亿澳元。然而，近半数提供商报告在2024-25财年出现财务亏损。提供NDIS支持的受访者中有81%表示，他们无法以当前价格继续提供服务。NDIA将小时价格定为70.23澳元，但实际成本为77.24澳元——高出约10%。

提供商正在退出市场——进入管理、缩减规模或关闭NDIS服务的企业数量有所增加。与此同时，大型提供商承受着巨大压力。

5.2 “自舔冰淇淋”

NDIS被描述为一个“自舔冰淇淋”。2025年，NDIA诚信负责人约翰·达多（John Dardo）在参议院预算听证会上透露：“大约90%的计划管理者显示出欺诈信号”。

这不是一个丑闻——这是一个系统。

5.3 欺诈与执法

截至2025年，有43起活跃的NDIS欺诈案件，估计欺诈价值为3500万澳元。欺诈融合工作组已调查超过100起案件，涉及超过10亿澳元的NDIS资金。

六、政府的承诺与现实

6.1 NDIS审查

2023年12月发布的NDIS独立审查最终报告提出了26项建议和139项支持行动，旨在恢复对NDIS的信任、信心和自豪感。然而，政府对这些建议的回应缓慢且不充分。

6.2 削减与死亡

2025年，削减措施造成了“持续且不可逆转的伤害”。一名参与者的手部肌肉撕裂，丧失行动能力和耐力，反复感染，住院治疗，以及两次自杀倾向发作。

生产力委员会发现，心理健康服务未能达到标准，导致了“众所周知但仍令人震惊”的后果：每年3,000人死于自杀。NDIS推出后，政府撤回了大部分用于心理社会支持的资金，使50万人患有心理疾病的人得不到支持。

6.3 部长的不作为

当被问及NDIS参与者因削减而死亡时，部长们声称“没有人会因此死亡”——但证据表明并非如此。正如一位倡导者所言：“你们已经被警告、警告、再警告了”。

七、结论：关怀的商品化

NDIS本应支持澳大利亚最脆弱的公民。相反，它已成为一个失控的支出黑洞，同时催生了一个完整的咨询子产业。

· 资金流向：从130亿澳元到630亿澳元，数十亿流向海外。

· 咨询公司：Salesforce合同从1000万澳元飙升至2.1亿澳元；6000万澳元用于律师事务所对抗参与者。

· 人工智能：自动化决策和“机器人规划”被引入，没有透明度、没有问责制、没有法律框架。

· 利润：90%的计划管理者显示欺诈信号；近半数提供商亏损；数十亿利润流向海外。

· 死亡：每年3,000人死于自杀；削减造成“持续且不可逆转的伤害”；参与者因资金削减而死亡。

当一个旨在关怀的系统变成一个利润引擎时，关怀本身就被摧毁了。那些应该被支持的人反而被剥削。那些应该被倾听的声音反而被压制。那些应该被保护的生命反而被牺牲。

NDIS并非失败——它是按设计运行的。

问题不在于系统是否失败。问题在于：谁为这些死亡负责？

Andrew Klein

参考文献