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?

It’s clear it can’t be funded independently for everyone though.
Thats the issue.
Some just don’t have the money or assets.
So Currently people are treated unequally.

If the individual can afford it (assets/house or cash), then they should pay. If not the state should pay. I had to sell my dad’s home when he needed to go into a home. Annoying but necessary. 🤷‍♀️

If they don't have any money or assets care is provided. In the same homes that people pay privately for.

Exactly!

Dementia is a physical deterioration of the brain and it isn't always in the elderly. It can be a familial gene disorder unfortunately. And it can happen in relatively young age. Dementia is definitely not a disease of ageing. There are very many studies - even films like Still Alice show this, or Sally Magnusson's recent bbc documentary about her mother or a
bbc documentary - the Jennings v Alzheimers. Dementia is not an inevitable disease of ageing. It just isn't. Anyway, why would society not look after people unfortunate enough to develop dementia, a disease devastating to the person who has it and their family?

My sister is a carer and does work in a care home.

I don't believe they should. People should have insurance, or pay themselves.

Care homes and nurseries should be run as 'not for profit' or by charities.
Why are we allowing companies to make profit from these essential services? I've heard that directors of a large care home chain earning £1m, not the MD or CEO either.
Some of these chains are owned by hedge funds and some may use immoral accounting practices to avoid tax.

No one gets 'free' care. If they have little or no assets, the pay all their state and private pension towards care except approx £30pw for clothes, toiletries, newspapers etc. A husband or wife can claim half of their spouse's private pension, however.

Some pay hundreds every week and others pay half their state pension. It's so very unfair expecting the ones who pay entirely for themselves to pay for other random people too.

If we want care homes and nurseries run not-for-profit then the state needs to actually own and run them as well as fully fund them. As they do currently for the NHS (despite some private partnership ) and schools.

But that costs. The country needs to be willing to pay for it fully through taxation, including the cost of setting it up/buying it and then running it.

You can't just decide that you want to have something, and you want it run not-for-profit by someone else!

I actually agree that it would work better if both childcare and nursing homes were owned and run by the state - and available to all without means testing. It would take away some of the cliff edges which disincentivise people from working and saving, and importantly would be a good way to spread the cost across people's whole working life, being paid for out of tax.

As said earlier, that tax needs to come from the whole of our population, not squeezed from a tiny slice of the population, with the rest getting a free ride. Even if that means that state provision is cut back to a more basic level which the country can afford to give everyone. It's the only way the social contract is sustainable.

I honestly don't believe private businesses can provide care cheaper than the council's could.

Same as children's homes, how is it possibly cheaper, to have people creaming a profit from these services?

Has to be either they aren't providing the same level of service or the staff are being paid less than they would be under council services.

Have you actually read why councils have gone bankrupt? Complete incompetence in investment decisions and no governance or oversight. A private company run that way would have gone out of business years before it could burn so much money.

The government will need to actually pay for competent management and figure out how to run large organisations effectively, with checks and governance.

It won't be cheaper, but it will be under government control.

Unfair to those who have saved up to buy houses that they'd then be expected to sell.

Meanwhile others who have chosen not to save end up with it funded by the state.

The person who bought the house has most likely had a higher quality of life.
Regardless, if someone is sitting on an asset of say £250k, why should taxes be used to pay for their care? What use is that wealth if not to be used when most needed?

I think that’s the theory, you could say the same thing about childrens homes. Now because there is nowhere else to put challenging children you pay private providers over £500 000 per child per year for over 1500 children. Over £100 000 a head for residential care for adults. I think had these services been kept in house they’d be more affordable.

So many people with big money will have already passed big chunks of money on to their kids helped them get on the housing ladder. Others whose only asset is their house can't really do that.

It basically means people who's parents are the first generation to own property will not be able to benefit from the parents efforts.

It is like many things in the UK what is the point in trying to make a better life for yourself and kids?
Work hard long hours, overtime, save try to get ahead get a house deposit together etc and one period of unemployment your expected to use your savings.
Yet someone else who spent money as fast as they earned it get all the support they need?

It's almost like a way to keep the working class down keep them in their place

I’d agree with this, I own but grew up in a council flat. I bf want my children to benefit from my home so they can buy homes of their own. Honestly I’ve worked in a care home and it’s a pretty poor existence for the most part. I’m going to set up an advance directive saying I only want pain relief/ palliative care if I lose capacity. My hope for the future is that I die of something quickly hopefully after a long and happy life,

@HellsBalls

The aim isn't for everyone in the UK to have to same quality of life, regardless of what they themselves do and what their family circumstances are.

That was tried with communism, and it failed spectacularly. We've seen repeatedly that it doesn't work and structuring a society with that aim just gives everyone a worse life, and also creates conditions for some pretty serious disasters. The concept is fundamentally flawed on many levels.

if someone is sitting on an asset of say £250k, why should taxes be used to pay for their care?
Well why should taxes be used for the care of someone else who doesn't have an asset? Why should taxes be used for medical care, education, housing of someone who has contributed very little into taxes themselves?

The answer is the social contract. That social contract isn't fixed, and it does need to be considered reasonably fair by everyone. Otherwise it fails.

It's currently not fair, not sustainable, and in the process of failing - demonstrated by 'the great resignation', which is spreading.

I think what sticks in the craw is being in the same home whether you pay or whether you don’t. I read all this misinformed rubbish about money affording you the ability to choose your home. That’s only very partially true. And let’s say you (or your dcs more likely) find a decent place, it’s really galling to find that the person in exactly the same room, eating the same food, having the same care - is paying not a bean. It’s not even a sliding scale - it’s free or pay everything you own.

What happened to cottage hospitals? These were ideal for many. Also the ward aspect prevented elder abuse (I am sceptical of the value of housing very vulnerable people in individual shut rooms).

I really, really don't want the social contract to break down in the UK.

Have you spoken with friends and colleagues about their life in the USSR, and what happens when the government tries to enforce an unfair social contract?

Have you observed how hard it is for countries to remove a culture of tax evasion and kick-backs, and how badly that culture damages their economy and the lives of citizens?

Have you noticed countries which used to be successful going down that route as their economy fails?

We have a good culture here in the UK. I believe it's going down a wrong path. But we do have an incredible history of democracy, so hopefully we can adjust.

Taxes have to go up to mantain that social contract though as many many more elderly peolpe need care than was envisaged when tbr welfare state was set up (and care of the elderly was never part of that contract in the fiest place).

So what taxes do you want to raise?

@strawberrybubblegum You seem to be both agreeing with me and disagreeing.
The state should step in where required. But if someone has the means to pay for themselves, they should. Assets like property and investments should not be protected to be inherited if the result is the tax payer is on the hook for costs that the recipient can well afford.