Utility, economic rationalism and the circumscription of agency.
Chasing the cheapest average support quietly steals choice from people with intellectual disability.
01Research in Context
What this study did
The authors wrote a think-piece. They looked at how money rules shape services for people with intellectual disability.
They asked: When we chase the cheapest average option, do we erase real choice?
No new data. Just a sharp warning from watching the system.
What they found
Cost-saving tools push staff to pick the middle-of-the-road support.
That middle fits most people a little, but no one well.
Over time the person stops asking for anything different. Choice shrinks.
How this fits with other research
Capaldi (1992) saw this coming. That paper told us to redesign the whole service space, not just move it. Porter et al. (2008) show why: money rules now run the space.
Reid (2020) adds the PBS layer. It says unclear lines between PBS and ABA let weak plans slip through. The 2008 paper says the same market logic invites those weak plans because they look cheap.
Leaf et al. (2017) spot the same risk in the RBT model. Fast, low-cost staff can flood the system. A et al. warn that the system will reward that speed over real fit.
Whiteside et al. (2022) offers a fix. Pay and train people with disabilities as co-researchers. This flips the money rule: value the person’s voice, not just the lowest bid.
Why it matters
Next time you write a plan, ask who the budget is really serving. If the answer is the spreadsheet, push back. Add one real choice the person wants, even if it costs a little more. That single push keeps agency alive.
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02At a glance
03Original abstract
BACKGROUND: Great strides have been achieved over the past few decades in service provision for people with intellectual disability (ID). However, there has also been a growth in the use of economic rationalism and a related rise in managerialism in forming service provision outcomes. METHOD: An account of the focus on process and means of provision directed within the managerialist agenda to determine how individual authority has become subsumed within patterns of dependence. RESULTS: An underlying influence of utilitarianism has led to a focus on servicing the average through service provision trajectories which in turn have weakened the pace for social change and perpetuated a vulnerable conception of people with ID. CONCLUSIONS: There has been a qualification of the idealised intent of providing individualised support, choice and recognition of the moral worth of people with ID into relative features of equality. There remains an overriding static conception of the person with ID within funding frameworks and service provision which relies on economic and rationalist depictions of the individual.
Journal of intellectual disability research : JIDR, 2008 · doi:10.1111/j.1365-2788.2008.01069.x