Where should the cost burden for care of the elderly lie in society - with the state or individual

[mids2019]

I was watching an item on a politics show about the long standing problem of funding elderly care. There was some woman who was strongly critical of the funding middle as her mother had to swell her house to find care home fees. Could one argue that the parent had no need for her house with regrettably a very small chance of return so it is fair for that a set to be used in paying for free instead of the tax payer picking up the cost? It was an elephant in the room during the interview but the person losing the most in the scenario was the daughter who ultimately would inherit less but obviously this was not said.

I don't think there is a simple answer hence successive governments pushing this into touch but where should the cost burden lie, the state of the indiividual?

I think this subject is really co.implicated by the fact that we have universally free healthcare yet a private model for social care. There really is a sinking here. Hospitals will in future not be able to fill in for shortcomings of social care and there are many cases of the elderly taking up beds in hospitals as they can't be discharged without an adequate care package and I wonder if these cars packages are materialistic because of cost? We also get the situation where specialist nursing care is free yet caring in a care home is not so how do we square that circle?

Ok, you are not going to answer the question about where your "expertise" comes from so I'll politely wish you a good evening and not engage with you about this again

I think the answer is probably part of the question “what’s the future of the nhs?”

We need a national health and social care service, to join up care, with NI contributions for elderly care split out. These contributions can then be “cashed in” when needed, in a similar way to pensions, but needs based rather than age based.

Like pensions, those who can, should top up with private care plans. Those who can’t, sadly, would have to manage with less frills care.

not sure how else it can be done, really.

I think the answer is probably part of the question “what’s the future of the nhs?”

We need a national health and social care service, to join up care, with NI contributions for elderly care split out. These contributions can then be “cashed in” when needed, in a similar way to pensions, but needs based rather than age based.

Like pensions, those who can, should top up with private care plans. Those who can’t, sadly, would have to manage with less frills care.

not sure how else it can be done, really.

This.

MIL is miserable in a care home, with dementia which means that she can't remember yesterday. She is being given a cocktail of drugs to keep her alive,.

Another woman in the Care Home is 106. She sits in a reclining wheelchair, is fed mush and spends a lot of time screaming. I don't blame her. I'd scream if I was her.

I'm looking into a living Will. If I can no longer care for myself and need to go into a home I want to stop all drugs that are artificially keeping me alive like blood pressure medication. Pain killers, yes, keeping me alive, no.

Why do you think how they lived their lives shouldn't matter? Of course it should. Why would people bother to be responsible if they could be as irresponsible as they fancy and the state would make provision for them.

Do you honestly think it is worthwhile fighting to save lives of people who will always need 24hr care, who's communication abilities are that of a tiny baby?
I have no doubt these children are loved but at what cost to the parents, getting up every night to turn him, never being able to have a normal family life, go out to dinner or go to the pictures. Respite care is very limited.

Who really benefits from the huge effort that goes into fighting to keep these children alive?

I'll let your own comments speak for themselves. If you can't see that they are crass, I have no words that I think will help you

I can see the way this assisted dying bill is going to go if its brought in!

So what should happen to them?

Exactly. This thread is quite chilling.

I don't mind the individual paying for their care but it doesn't stop there, an individual who pays for their own care also has to also subsidise the people who get free care. That is so wrong.

I agree with you self finders should not subsidise others who don't pay a bean for their care. Going forward an insurance model would be best that everyone had to pay into through their lifetimes.

Like NI?

No something specific like Care Fund. To be paid in addition to NI.

Why does it need to be separate?

One reason for kicking this into touch in my opinion is the fact that the government is that different parties will have different solution depending on their left right bent. Also cynically I don't think any party wants an electoral hit by taking tough decisions.

The solution has to be something consistent for decades and parliament may be in reality unable to change fundamentally the agreed policy of it is finally enacted.

I do wonder if this debate is taking us to a place where we reconsider the premise of an NHS free at the point of delivery as some of the cafe arguments are equally valid for health (in fact as has been pointed out there is a significant overlap). It may be as a society we consider some charge for the weight of medical treatment that may be needed in later life but there would obviously be another huge argument about this. An over 80 means tested NH S for particularly expensive treatment. It would be exceptionally harsh but one could argue why should millionaires get absolutely free health care on the NH S when they could contribute a little more taking some of the burden off the state allowing lower taxes and more economic growth?

Also cynically I don't think any party wants an electoral hit by taking tough decisions.

Of course, look at the furore over winter fuel!

We have more over 65s than under 15s so people are going to have start funding more social care/NHS including care in the home which is far more common than care homes*. Or we need masses of immigration as we don’t have enough workers.

*house value is not currently included for care in the home.

Or the standard of living in the UK will continue to drop. There comes a tipping point where excess redistribution means that people pull back their contribution to society because it feels not worth it and unfair - and I think we're pretty much there. And then standard of living for everyone drops even more, because those people who were contributing no longer are. It's not sustainable.

An over 80 means tested NHS for particularly expensive treatment.

Means testing the NHS would destroy it. The NHS costs 11% of our entire GDP: £181billion a year. The reason the BMA say that it's underfunded is because spending growth has been below average since 2010. NHS spending both overall and per person has doubled in real terms in the last 20 years, and increased even more as a percentage of national income.

The main reason for that is increasingly expensive treatment of more difficult conditions, as well as demographics.

If the ever-shrinking percentage of people who have actually been net contributors into the UK for most of their working lives - ie the people you want to means test - no longer have expensive treatments funded, why on earth should they pay for them for other people throughout their working life?

Oh, and mass immigration is a ponzi scheme. You get cheaper workers now because you haven't paid for their expensive childhood years and education, but then you have an increased size of population forever who put ever-increasing pressure on the infrastructure previous generations built. Mass immigration is stealing from the future, and it needs to reduce not increase.

We need to accept that the UK isn't is rich as everyone in it believes. Not any more. The longer we put our heads in the sand and insist that everyone in the UK should have everything... paid for by someone else... the harder the landing will eventually be.

Bollocks. If someone has the assets they should pay for their care. No one has earned an inheritance either. The UK tax system is what is paid in today, is paid out tomorrow, and there are less people paying in today, so there is less to pay out tomorrow, and more people expecting a pay out.
Old people who don’t have to live off benefits should also be paying NI on their income as well.

It's a fundamental issue that whilst we want a safety net within society, there's a left wing drive to put that safety net as close as possible to the llifestyle people have when they are working and contributing. That's not by accident, it's a values choice: it's seen as a virtue to bring the safety net closer to 'average' lifestyle.

That kind of works when the economy is booming, as it was in Tony Blair's time, and everyone feels like life is great and doesn't look around too closely.

But as the economy drops (recently for macro reasons worldwide, but now worsened due to political choices) the standard of living drops, the gap gets even smaller... and people wonder why they're bothering, when it's much more pleasant not to work hard. So they pull back what they do... and the decline accelerates.

Remember poorer people did younger so is it fair that their taxes are used to subsidise expensive care for the middle classes? Unfortunately the longer life expectancies in wealthier areas are probably coupled with degeneration including Alzheimer's etc.

Noone has earned an inheritance. But the people who earned that money have earned it and should be allowed to give it to who they like without the state stealing yet more of it. I choose that money I've worked hard all my life to earn is for my DD. The state is stealing from me, not my DD.

If the issue is that house value growth is unearned, then by all means add CGT to all residential property. (Of course, allowing for inflation and money spent improving the house). Every time someone sells their home - no minimimum price exceptions.

If it slows down house value growth, that's a great benefit. The high cost of housing in the SE is a huge problem.

Yes, it will make moving house harder for people - but welcome to the reality of house ownership in the SE with punitive stamp duty. At least the CGT will be proportional to the actual value increase, and not payable full-whack even if someone has to move again 6 months later.

@Dirtyprotest

If someone is paying £180 a week then the local council are paying a big chunk on top, either making it up to £1800 or near enough.

Is not true though. That shortfall or some of it comes from the person who is paying the £1800, and therefore burning through their own money faster than they should. The hope is obviously they die before their own money runs out , otherwise they in turn need to be subsidised.