To get annoyed when people try to avoid care costs

[paramedicswift]

People deserve good care in old care, potentially in their own home or in a care home.

While it is completely rational thing to do, people try avoid this cost by spending as much money as they can before they need this care or they give it away to family.

On one side, it is completely rational. I understand that people have paid taxes, national insurance and worked for their entire life. They have a desire to see this work to be passed onto their children for them to benefit from their hard work.

One the other side, it is incredibly entitled. To me, your care in old age is just another cost of life. It is like cost of food, cost of shelter. I wish I did not have to spend money on rent, food and travel to work. But I have to. This is just life.

It makes me even more angry when family inheritances come into it. It is just so greedy and horrible. I do not know why it is unacceptable to some people to apply for benefits and never work but completely acceptable to avoid paying for social care.

It is a bit of tragedy of commons because if everyone did it, then taxes would be wasted on caring for old people that COULD HAVE afforded the care themselves rather than important things such as education for children, public infrastructure projects and healthcare that benefit everyone.

To everyone according to their need. If someone cannot genuinely afford old age care and they did not deliberately avoid the costs, then I have no problems with state subsidised care.

Am I being unreasonable?

*had

If you are 40 and not able to work (either because there is no work available, or because you can't do it due to illness, disability, etc), and if you do not have sufficient money to pay for somewhere to live then if it works properly the current benefits system will pay housing benefit for you so that you are not homeless. This system works imperfectly, but that's the general idea.

If you are 80 and not able to work (presumably because you are 80), then you will also need somebody to pay for somewhere to live and (this is the different bit) be cared for.

All those people here complaining that your PILs who have money and pay for their own care homes are "subsidising" those who are having their housing and care paid for by the state - do you claim for housing benefit even though you have jobs and don't need the money? And if not, why not?

The social and medical care should be paid for by the state. The housing costs should be paid by the person, if they have the assets to pay for it, and by the state of they don't.

Shakey Sorry, typo. 1200-1500 pw. No Savoy for mum.

I'm in my 30s and have a property and a rental property as well.

It came at rather a high price, though.

The housing costs should be paid by the person, if they have the assets to pay for it, and by the state of they don't.

But my father was paying someone else's rent as well as his because of the limit on council funding. Is that fair?

That money you are handing over for your care is "for your care."
The cheapest private nursing homes are only slightly more expensive than state run, for same care level. So, not a huge profit you are handing over to anyone.
May as well say why do people work to pay rent, food and extras. We all have to pay to live, at any age.

BigChoc Easy done The Savoy cucumber sandwiches aren't all they're cracked up to be anyway.

If self funding was guaranteed to get you a higher quality of care home than state funded homes then people would have an incentive to keep the value in their house and keep their savings in the bank.

But it's a fact that people who do save their money in case they need care can end up penalised by paying for something that others get for free, and to rub salt in the wound they can actually pay more than the state for exactly the same thing.

The problem isn't people spending their money however they want to, it's the blatant injustice that runs through our whole welfare system.

I'm years away from having to worry about this, but at the moment I feel determind to make sure I don't pay inheritance tax or pay care home fees assuming the system is the same then as it is today. If I didn't see other people getting something for nothing from the state all over the place and I felt that taxes were spent wisely and fairly, then I'd be happy to contribute over and above my fair share when the time comes. But as it is, I see people being penalised for making sensible choices and rewarded for making negative choices, so my money is better spent benefitting my own family.

YANBU. signing houses over or gifting 'inheritances' early explicitly to avoid these assets being used to pay for care is reprehensible. The amusing straw man arguments along the lines of 'so you're saying old people shouldn't be allowed to buy anything then' are easily dismissed because that is clearly not what those of us who abhor intentional deprivation of assets to force the state to meet essential costs that you could have met yourself are talking about.

Can't be bothered to read all of this.

In response to the OP. There is a difference between clinical care and social care for the elderly. Advanced dementia is a clinical mental health issue. If a younger person were so incapacitated they would be cared for under the NHS free of charge. This should be also so for an elderly person. Many many health conditions elderly people suffer are clinical and this is what the NHS should be there for.

Draw another parallel. Person smokes 60 a day for 30 years and gets cancer - should they pay for their health treatment because that is what you are saying an elderly person who becomes too ill to look after themselves should do. Sell their home and lose all their savings.

Two families - one on benefits, never worked, never paid tax never contributed a single a thing to the services they might receive yet get care free. The other family - two people work all their lives, go without, save up, buy a little house hope to leave a better start for their children. They should lose it all to go out with the same as the family who have contributed FUCK.

Nope, sorry I don't agree with you. Our capital will largely pass in trust to our children. There will be just enough to care for us left and no more. If one of us is left on our own, there will be nice flat for us. A nice flat that can be rented out at London rates to fund our care if necessary so the children have the capital value. We will not pay a penny more than we have to to subsidise a system that is not providing what it promised at its inception.

I think you have a point.

To be honest I would like savings by the time I am elderly because I've seen how crappy the state provided minimum carers can be. I want choices!

I think people busy avoiding contributing might regret it in the end.

ChuffinAda - agreed that being 'instiutionalised' in a ward isn't as nice as being in a care home (but I'd argue having then had another grandparent go through the end of life care with the care home system, it's also insitutionalised) but that's why I believe noone made a fuss at the time that dementia care moved from the NHS to social services - Care homes on the whole were much nicer than being in a hosptial ward. And to start with, they were fully funded for dementia sufferers, so it seemed like a better result for the elderly.

It was only over the following 20 years that we've seen that sort of care move from being seen as something that should be universally provided to being means tested.

We could afford (at a stretch) to pay for private education for our DCs, we could have paid privately for each time I've had a baby. But noone has questioned our choice to use state schooling and NHS hospitals to give birth rather than private schooling and private birth centres.

Just on this thread, very few people seem to think it's a bad thing that end of life care has moved from being universally provided to being means tested, only if you should be therefore avoiding having the means or not.

It is scary how few people realise this isn't how it's always been and the chipping away of a universal benefit, a part of the welfare state (the other end of "cradle to grave") happened without any public debate.

Anyone who claims we could never end up with a privatised NHS, or that if it moved to companies providing it, they'll be no difference for the end user if it's an NHS hospital providing the service or a private company needs to take a long hard look at how dementia care and society's views about what should be provided by the state has changed in 30 years. It provides the template of how you could do this for the whole NHS. Start with moving services to being provided by the private sector first, which will be a better experience for the paitent (particularly if it makes it easier to pay a bit to 'top up' for additional things the NHS doesn't provide without having to pay the whole cost, like paying an extra £20 to book appointments when it suits you, or an extra £50 for drugs not available on the NHS etc get middle class people used to paying something towards their health costs...).

And once we no longer have an NHS option, then start talking about "rich people paying their own bills", and the state reclaiming some of the costs via health insurance policies. Bring in an "NHS insurance policy" that the poorer people will get, start with just those earning below £100k getting it entirely for free, everyone else on a sliding scale of how much the government will pay for, then slowly lower it so that only the unemployed/earning NMW and those with no savings are entitled to free care policy...

Give it 30 years, and we will be the pensioners whinging about wanting a fully free at the point of use health system, and our DCs saying we can't afford to pay for all those hip replacements, drugs and physio needed for the 'expensive older generation', what's the point of all those life savings the older generation has if they don't spend them on their health care, and those with nothing are able to see their GP for free, so what's the problem...

Mamus, it's attutudes like yours that are making me think very seriously about making over all our assets ASAP.

Pay for my care? Fine. Subsidise someone else in the same home? No, why should I? The state should pay the full care not expect self funders to pick up the tab.

And the difference between self funders and council paid clients in my father's nursing home was £200+ a week.

I agree, Dinosaur. I know someone in healthcare who attended a conference on the problems of an ageing population. The only conclusions were that the prospect is so horrendous that it's best to bury current heads in the sand. Once the baby boomers start getting dementia in their droves, the system will collapse.

I also think that the hypocratic oath will have to be revisited. Mil, who does not know anybody, not her own name, and has even lost all memory of the past, contracted pneumonia. Now, this used to be known as "the old man's friend", but mil was carted off to hospital, pumped full of antibiotics, and was back in the nursing home strapped in her chair two days later. It's just not humane nor sustainable.

People want to claim as much as they can from the government because of all the people who want to claim as much as they can from the government...

ArcheryAnnie

We also have DMIL living with us. I have no idea how you managed to keep all those plates spinning.

YANBU. My father, who loves a good old Daily Mail-esque rant about scroungers was outraged when he had to hand over my mother's state pension to her care home. He had been used to letting it pile up in the bank while she was ill and kept going on about having to "fork out" endlessly. It only covered 25% of the cost!

He was also gutted at having Attendance Allowance stopped because she wasn't living at home. I couldn't get through to him that it was because all her food, shelter, council tax, bills and care costs (plus pocket money for hair etc) were being taken care of. As far as he was concerned it was her (his) money full stop.

It was quite shocking and sickening really, the level of entitlement, and that was without having to sell assets or pay for it from savings. Then again, when my mother retired five years earlier than he did, they promptly took out a loan for a new Landrover which cost the same as her state pension, so maybe they never thought of it as money most people actually have to live on.

It's not quite that simple Seffina, some people just don't see a problem with taking out of the system they pay into if or when they need to. If you need elderly care then you need it, no one chooses to need it.

The demographics have changed massively since the NHs was founded and pensions were started.
Unfortunately, most of the extra years of life we have will be years requiring personal care and hammering the NHS, not extra years that we are capable of working.

So, no great conspiracy: it's just there are now insufficient people of working age to subsidise the number of elderly the way that previous generations could.

We can afford to subsidise a small % of the working age population, but it is a VERY small % who have never worked.
We can't pay the full living costs of everyone who goes into a care home, which will be a large % of the population.

If people dispose of their assets early and the books don't balance, any government will just raise income tax, tighten & tax gifts, bring in a wealth tax including all property
There is no escape

Those who can pay will always be paying for those who can't.
That's the whole principle of the Welfare State.

As per usual anyone paying into the system and not taking anything from the state will be penalised, shockingly bad system, that only breeds discontent.
A good point was made earlier, that if you had contributed and made provisions for yourself,then the levels of care should be different as an incentive.
The baby boomers, are going to be our next major problem, but as i see the problem/entitlement has been created through the distinct lack of fairness in the situation.

fil has been retired for 33 years, on a generous public sector pension. I just can't see how this system can continue. Taxation will have to be 90% for working people in order to pay the pensions of millions of 100-year-old baby boomers.

But if people have spent all their money, then they count as people who can't pay. Therefore the state should step in as it does with anyone else who can't pay, and no one is treated unfairly.

mad The levels of care are different. My mum paid to go into a much better home. The average property will pay for a few years care - most old people in a care home die within 4 years

"If people dispose of their assets early and the books don't balance, any government will just raise income tax, tighten & tax gifts, bring in a wealth tax including all property"

YY, and then people will try harder to avoid paying this extra tax.

Someone used the example of two people in the same care home, one paying fees and one not, but their lifestyles prior to being in the home could have been vastly different, with one having a much higher income than the other. I presume the 'postcode lottery' applies to care homes too, I'm not sure though.

Pension reform has tried to address a similar issue with pensions - how to give incentives for private saving whilst simultaneously providing adequate provision for those without private savings. There is something similar in process for long-term care IIRC. The ageing population is a major issue for the NHS. It's a tricky situation, and as is often the case, most people would prefer to do what is best for them personally even if it conflicts with an issue in wider society. Because that's what we're told to do - work hard, look after yourself.

I don't know the answer. I'd be able to afford to save for long-term care provision if I did

BigChoc, sometimes the levels of care (and accommodation) are different, sometimes they are not. People have different experiences with it as it depends on provision available in each area.