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?

We seem intent on keeping people alive even when they don't know who they, where they are or which anyone else is. If society chooses to keep me alive in that state then it can pay - where is my choice? The new bill will do nothing to allow people to due when they want, even if they've stipulated their wishes.

I haven't seen stats on how many are council funded, how many self pay and how many self payers subsidise the non payers. But let's face it with more renting there simply won't be the homes to sell.

With the massive, and continuing, spike in children with disabilities who won't be able to look after themselves as adults this is a ticking time bomb. IMO families should be responsible for their children even when they reach adulthood.

Society needs to shift from 'what am I entitled to' to 'what can I do to support myself'.

i find it very sad when someone has worked their whole life for a home, never taken a penny off the state and then has to sell everything to fund their care. A lot of people work hard to leave a property to their children as a legacy and then that is taken away, which is extremely sad.
I understand the debate about everyone paying for “their” care when they own property, but that is already taxed by way of stamp duty and housing costs, so it’s unfair to use it again. Also to get a mortgage and pay off your house you will have worked and paid tax, so again it’s about getting you again with taxes and then demands you sell up to pay for the care you have funded for others throughout your lifetime.

These problems are what happens when investment in social infrastructure gives way to the profit that has decimated it.

This country and others have been defecating in their own shoes ever since idiot politicians decided that deliberately conflating socialism with communism and denying the existence of society was the way forward.

You can't run a country like a business.

My grandma needed to sell her home to pay for her care, she had dementia and needed that care. I have no problem with that.
I did have a problem with the speed at which the money was used up to pay for her care, because as a "self funder" she was subsidising other residents who didn't have any money with her fees, however when her money ran out, there was talk of having to make her leave because there weren't enough self funders to subsidise her!
That is not right.

Personally I think the state should pick up the tab.
If people are deemed to need 24hr care it should be provided.

I disagree with insurance based schemes because you'll always get the people who pay it but never need it or the people who didn't pay but do need it?
A civilised society doesn't leave elderly people sitting in their own poo because they don't have insurance money to pay someone to assist them.

I do think costs should be reduced by allowing people with complex needs and zero awareness to pass away peacefully.

I could see the logic in this in times past where houses were a modest multiple of salary. But since 2008, asset prices have been hugely inflated due to QE and house price gains have outpaced anything else-and completely Capital Gains Tax free for a main residence. So if you view a house as an ‘asset’ to pass on to children while taxpayers pay for residential care, then maybe we should treat it like an asset and tax any gains.

I've got a selection of ideas how we could fund elder care better

stop subsidising MPs via their restaurants which costs millions of pounds a year.

house of lords would no longer be able to claim £340 a day just to turn up, eat lunch and go home as apparently they do

a massive overhaul of the expenses system and the ability of MPs to claim for second homes

vat on lottery tickets which I believe is currently paid as lottery duty at 12%.
tax on lottery wins over £1000. If it's fine for people to be taxed at source, taxed on stamp duty and taxed when they die on their house then I'm pretty sure we can tax lottery winners twice.

an overhaul of vat in general to impose it on a variety of products which are clearly unnecessary such as magazines like vogue, heat, playboy

This is work women used to do for free. Enrages me how women’s work has been undervalued over the years - Dh granny for example nursed her own and her in laws herself at home and I think that was normal. Women rightly aren’t prepared to do this any more or aren’t able to as they are still working. Now the individual or the has to pay the full extent of their unpaid labour is revealed isn’t it.

Very few people actually need to go into a care or nursing home. Of my four grandparents only one went into a care home

This. The stats I recall are only 4-5% of older people require care homes. They may need some sort of assistance in their own home as they get into their nineties, for example, but this notion of old age invariably requiring a care home is a misapprehension.

The NHS (which I think should be hugely reformed, or dismantled, but that's a separate debate) was set up to be "from cradle to grave". Elderly care should fall under its remit, just as birth does. Your initial post nails it OP, the discrepancy between a tax-funded NHS system and then private funded social care is a recipe for disaster.

My mother has dementia and so far 5 years live in carer plus daytime carer support, £500,000 so far.

@StiffyByngsDogBartholomew the money claimed by MPs for expenses is miniscule compared with the money needed to fund health and social care.

Honestly it is hard to have conversations about funding public services when people simply have no idea of the scale of the money involved.

It's like saying you will stop buying a takeaway coffee a week and use the money you save to pay your mortgage.

The last course I went on the stats were 10-15% need care longer than 2 years for the majority it’s a year or two at the end of life.

I never recovered financially from 2 marriages- 1 where he ran out on 3 small children and paid no maintenance and 1 with DV. I have worked and will work till I drop.
2nd ExH died. First still with the wealthy woman he ran off with.
Should I just live in a gutter after paying taxes since 1979, and continuing to do so until at least 2029? No benefits.
Each case is individual and always has been. All of my forebears paid for their own care. Hence no inheritances etc for me.
I do my best to look after my health. At 62 I have no regular medications, I walk and run, and hardly touch alcohol. I don't want to be a burden to anyone. I am hoping that assisted dying is in the table in the next 30 years tbh.
Then my worry is what will happen to my disabled DD27 who cannot work.

You haven't really touched on unpaid carers in all of this. Family members who give up or cut down work to care for loved ones. All for the princely sum of £81.90 a week and NI contributions. We have no way of paying into a private pension for our own retirement and are limited in part time work capability by DWP restrictions anyway.

In addition, no one has mentioned that self funders in care pay more than council funded. They are expected to subsidise the non payers. Why? Why would you work and save for your old age, to then have to pay notvonly your own fees, but someone else's who hasnt? This is inherently unfair and is taxation in another form. I don't think this is well known by anyone outside the system.

Given the state of the public finances, I believe that those with assets should pay for their care.

What I resented when my parents were in a care home was the fact that they were being charged double what the local authority was paying for council funded residents in the same care home. So they were effectively paying for themselves AND a council funded resident.

Regardless of income, the state is contributing to the cost of private care homes through state pension and attendance allowance, and sometimes CHC funding.

Its absolutely ridiculous thus happens, but of course you'll get the 'oh this never happens... and even if does its absolutely fine because amazon/the banks/etc....'

The insurance scheme seems the only fair option. It would have to be deducted out of benefits too. Agree it seems so unfair to punish the hard working and those that planned ahead.

Our economy and social mobility is so utterly fucked that many people are relying on inheritance to bolster their pensions and secure a decent standard of living in their retirement. This is why I feel it's unfair to take people's inheritance away from them without fixing the broken economy first. I don't know anybody with any spare money to save for their old age. Hard working people are being forced to spend almost all of their income and living month to month.

If people could just get their heads above water then they wouldn't feel so hard done by when their parents money is taken by the state.

Slightly away from the topic, but regarding adult social care, I was surprised to discover that the majority of monies spent isn't for the elderly but for younger adults. I assumed it was to pay for care homes.

I was shocked (stunned in speechless actually) when I came across details of a special boarding school for SEN - the prices charged were eye watering. Bearing in mind the majority of the costs come from the LA the one school I found would have cost the LA £11 MILLION a year. For 1 school!

No I have no idea of an alternative, but just putting the figures out there.

So it's fairer to raise taxes for all of us, including those of us who will get little or no inheritance ar all, so some can keep theirs?

This is one of the major dilemmas of our time isn't it ☹️ The money has to come from somewhere. You can have Sue who has burned through the savings she carefully gathered over her career and has had to sell her house to afford the eye watering sums of her care, living in the same home as Pam who didn't save much in her lifetime, always rented and has been state funded from the beginning. It's not a judgement on either, just a demonstration of one of the difficulties. Sue is about to run out of funds so both will now be state funded. Which means taxpayers. And so the next issue starts and so on.

I do wonder if some kind of insurance model as per pps could work? Although that would likely intrench inequality in a different way.

It would be interesting to know how many older people still living at home are having constant high-level assistance by family members.

Shopping, cleaning, errands, gardening, laundry, cooking etc.

If you would have to pay for all this help, you would run into financial issues as well.