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?

I honestly have no idea but I am becoming increasingly convinced that there will be no decent social care/NHS care/much of a pension when I'm old (I'm early thirties)

The population is aging and I feel like I'm watching the birth rate crisis in real time among my peers (ranging from late twenties to late thirties). No one's having kids and how will it be paid for once we are old? I'm trying to build up a good nest egg - savings, investments - so we can pay for ourselves if ever we need it. I don't want my children having that stress hanging over their head or having such an overwhelming tax burden - I'm generally pro-state funding for health and social care but I can't see it being possible under the current framework when I'm an old woman.

Agreed. It is depressing. Everyone here on this thread is saying the state should fund everything and over on another thread people are raging at the very concept of paying tax on unearned windfalls of hundreds of thousands of pounds.

I am not sure where we go from here.

I read some really strange stuff on here.

You think that the family of prisoners, who have done nothing wrong, should pay for their family to be imprisoned?

You think that people who cannot work, because they're in prison should pay for prison?

We paid a lot of IHT on my mother's estate, largely because of the semi they bought in a London suburb in 1966. It didn't seem unreasonable, given they had both had lengthy periods of NHS care, including chemo.

Someone has to pay and I'd rather my children weren't taxed even more than they already are, with student loans, etc.

You’d be surprised though how adaptable human beings are and how soon many people become accustomed to living with physical limitations, and indeed find meaning and fulfilment in a life like that and want to live it. And who are we not to support that position, even with all the financial expense it brings?

And I think we can only really make judgements like that when we are in that situation ourselves and not from a theoretical position of rude good health.

And who are we to say they can’t and not support that position? Then a debate about opens up about how valid a person’s life is based on their bodily health and productivity which is disabilist in the extreme.

There’s plenty of money to go around if it was distributed evenly. Neither of my parents cost the state anything as one died suddenly while living independently at home, and one spent a week in a hospice funded by charitable donations. So if everyone paid an obligatory small amount from early adulthood in to a state administered non-profit-making fund; including people like my parents who needed no state help, it would theoretically cover the cost of people who need more support.

@Itsjustalittlebitfunny555

You say neither of your parents cost the state anything.

So they used no healthcare, had no state pensions, never claimed benefits and had no state involvement at all - I don't find that likely.

I agree there is money to go round if it is distributed evenly - and Inheritance tax is how we do that.

It ensures that privilege is not carried down through generations to the continual benefit of the rich who are the most likely to live long lives, helped by the money of their ancestors.

You are suggesting that poorer people who are likely to live shorter, unhealthier lives pay for these wealthy people to live longer - as well as being the ones who are far far more likely to be the ones caring for them on minimum wage.

It's a bit much to insist your carer not only cleans you up, but also pays for it.

"People should aim to be financially independent" says a pp.

That's all well and good in principle, but in practice there are many people who don't earn enough to be able to set money aside. And it isn't any good saying 'well they need to find a better-paid job then' because that's not how the economy works.

I don’t think many people would wish to live years with advanced dementia. It is not being a bit dotty, or forgetful. Mil was violent, scared, doubly incontinent and spent several years not knowing her dh, her dcs or even her own name. There was no dignity or meaning to her life.

She had repeated infections but was she allowed to fade away? Was she hell. The nursing home kept packing her off to hospital where she was pumped full of antibiotics and was good to go for another few months. A DNR apparently only applies to heart attacks/strokes, not illnesses that are treatable with drugs.

Dear God. Can we finally put to bed this idea that all pensioners were once in the trenches in the First World War? Someone who signed up at 15 on the last day of fighting in WW2 would now be 94. Hardly anyone aged 75 actually fought in a war.

I think there does need to be some sort of insurance to cover the costs. The whole thing is complicated and has been a mess so far. The current generation of olds have mostly not needed long term care but that may change in future, and Boomers and Gen Xers may have very different old ages, possibly living longer but unhealthier lives, or life expectancy may reduce again with things like the obesity crisis. It really is a bet on the unknown.

At the moment those who are funding their own care in care homes - by selling their house or using up other resources - are subsidising those whose care is paid for by the state and I don't think that's fair at all. People should pay a fair price for their own care and the costs of those who can't pay should be covered by everyone, not just those who are unlucky enough to be in a home themselves.

This is a concern for me too.
Dementia patients kept going because nature isn't allowed to take its course, Dr's and nurses are obligated to treat them when it would be kinder to treat the pain but not the cause.

A serious conversation needs to be had

Why should family members pay to house prisoners? Madness.

I think obesity, and antibiotic resistant superbugs will bring life expectancy back down but a serious conversation needs to be had about how much treatment people with advanced dementia receive

How would that conversation go? People with long term or degenerative illnesses are refused treatment after a certain amount of money?

Well said @Beepbeepoutoftheway and why do they get paid!
In 22/23 the cost to the uk taxpayer of one prisoner was just short of £52,000 / year.

@menopausalmare - yep- I think we are going to have to have an insurance based system - maybe 2% and ringfenced-

I too think there needs to be some form of social insurance paid from every paycheque during a working life to fund senior care, but ring-fenced for the purpose. However, with the largest generation in history on the brink of retirement, it needed to have started 40-plus years ago.

And adult social care is an even longer overhead cost currently borne by local authorities. Many of those who need that care will never earn a pay cheque at all. Do we bring back asylums?

I accept all the arguments about preserving life too long when the quality has gone, but even with LPOA in effect and a move to legalise assisted dying, no medical professional is going to allow a person with dementia to exercise that right. It is one of the big issues of our time, and it's not being sufficiently discussed. Not helped by muppets who think we can save enough to make a dent in the costs of senior care by closing Parliament's bars and taxing Playboy and lottery tickets/wins.

I think people in the future will need to have some sort of insurance / private health care that pays if you can’t live independently in your home and carers visiting isn’t enough.

“People should pay a fair price for their own care and the costs of those who can't pay should be covered by everyone, not just those who are unlucky enough to be in a home themselves.”

The majority of a funded person’s costs are covered by the LA/public money (aka everyone), though. And an LA, like any bulk purchaser, can negotiate a discount. Plus any state pension paid goes towards care, barring a few quid a week for toiletries etc.

So yes, a funded person may be covered at less per week than a self-funding person, but there are some reasons for that.

It’s similar to how nurseries used to cover the shortfall in funding for 3 year olds per hour with a higher rate for younger children etc.

Unless the state controls the whole cost base by having extensive numbers of its own care homes and nurseries (which is doesn’t and hasn’t for years) then there will be pricing anomalies.

Why should family members of elderly people be made to pay? Madness.

I never know why we don’t look at what other countries do really well and copy their systems rather than trying to reinvent the wheel.

@StandingSideBySide It's disgusting, isn't it? Work all of your life, pay tax, save etc and get sod all.

Commit a crime, get put in prison and have 3 meals a day, funded by the tax payer!

Would this be the case for disabled young people on a cocktail of pills that can’t care for themselves ?

Yet you're expecting elderly people to give up the homes they've worked bloody hard for?

People don't choose to get old or ill. People choose to commit crimes.

Its a great question. Ideally it should be state funded and will be much easier to control than the black hole abyss of the NHS.