Rehabilitating the Rehabilitation Delivery System: A Commentary on the Voucher System (1995)

The purpose of this article is to discuss the advantages and potential problems of implementing a voucher system in rehabilitation. Among the major advantages of implementing such a system would be increasing client choices and expanding the roles, responsibilities, and utilization of private rehabilitation agencies and practitioners. Major problems would include developing a structure to administer, fund and monitor such a system and resisting the temptation to treat clients as potential sources of revenue rather than as individuals needing rehabilitation services. In view of the apparent congruence between the voucher-system concept and American ideals such as free trade, private initiative, competition, and individual empowerment, it is recommended that an effort be made to develop and field test the voucher system on a limited, experimental basis. The concept of school choice has been an issue in American education since 1955 when Milton Friedman first proposed the idea of educational vouchers. Implementing choice through educational vouchers has gained support from presidents, governors, state legislators, and a variety of special interest groups throughout the country. Currently, several states such as Minnesota and Wisconsin have experimented with educational vouchers. In Minnesota, parents are allowed to enroll their children in any public school within the state. In Wisconsin, the Milwaukee Parental Choice Program provides state monies to subsidize tuition at a private school for students who come from households with incomes less than 1.75 times the poverty line. Both of these model programs have the goal of increasing educational quality, increasing parental involvement, and providing individuals a choice in education. Trends in vocational rehabilitation have also stressed the need for increasing client involvement, client empowerment, and the quality of services provided. Emener (1990), for example, stated recently that it would be critical for proposed legislation and enacted public laws and policies to empower rehabilitation systems so that they would have the power and control they needed to establish and implement negotiations with other systems in ways that facilitate effective and efficient services to individuals with disabilities. The purpose of this article is to discuss the advantages and potential problems of implementing a voucher system as a viable means of reforming the current state-federal vocational rehabilitation system and empowering clients so that they can receive the maximum benefit from rehabilitation services. History of Educational Vouchers Milton Friedman (1955) originally proposed the idea educational vouchers as a method to improve the educational system in this country. Instead of tax monies being distributed directly to the public school systems, parents would be issued vouchers that could be spent at any acceptable school the parents preferred-- either public or private. During the 1960s numerous proposals for educational vouchers emerged, both from the political left and right. Each of these proposals promised major benefits from such reform, including better education and lower costs (Krushinsky, 1988). Under the Republican administrations of Ronald Reagan and George Bush, the idea of educational vouchers surfaced as a primary strategy for providing meaningful educational reform. In 1985, Education Secretary William Bennett unveiled a proposal that would give poor children a $600 voucher to be used each year at either a public or a private school (Krushinsky, 1988). Vouchers have also been proposed for use at the university and college level (Friedman & Friedman, 1980). Qualified students would receive a voucher equivalent to what the state or federal government was already contributing, or would have contributed, toward their education at the local state university, which students could then use at the local state university or any other university of their choice. …