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?

Higher taxation is one way but wouldn't come into effect quick enough to scoop up the astronomical care bill we have in front of us when the baby boomers hit the age where care is needed. Simply because the older boomers are already at that age.

Ok, so those who are saying care should be free for everybody are voting to pay MUCH higher taxes to pay for this in full ?
Or do you believe in the money tree ?

You can't gather effective data about care while considering ethnicity irrelevant but that's a whole different thread.

Things that people fundamentally need should be available to everyone, but the only people who get it 'free' will be those that don't pay tax. Everyone shoudk have access to state funded health care in the same way that they have access to state funded education, because those are basic things that society recognises that everyone needs.

Something as basic as nursing or residential care should be paid for by the state. But the state should pay for the basics, and it is wrong that self funders subsidise others. If people do save their money and have it available to pay for them to live in a nicer building with nicer surroundings and more activities available, then that's fine, but people deserve to have a choice.

I'm saying slightly higher taxes and more care about how they are spent. More encouragement for everyone to work. I think it would be fantastic if big companies were stopped from opening offshore call centres to avoid paying living wages to UK people in the UK. Something needs to be done to ensure companies based here, making profits from UK customers, should have to employ UK based staff who would then pay tax. They could also influence educators to ensure enough young people were coming through the system to do these sorts of jobs. Industry has declined significantly yet the jobs that replaces it are being sources off shore in developing countries. Utter madness that our governments have allowed this to happen. I would be prepared to pay more for services to ensure UK people were in work and that actually I got higher standards of customer service too.

There would probably have to be emergency tax increases if most baby-boomer property owners have to be fully state-funded.
IIRC (I was early teens) under Harold Wilson the highest tax rate on investments income was 98%

So, property-owners and those wanting to inherit are in favour of that kind of taxation?

Or do you mean that everyone should be state-funded, but those who have been on benefits a long time should be put separately in lower standard care homes, in more crowded NHS wards ?

Tbh the boomers are the ones who will mostly be self funding I'd have thought. Simply because they're the ones that hold a large chunk of the wealth due to property etc.

I just wonder how my generation will manage. We haven't had the luxury of investing in property, pensions have been screwed by higher contributions and lower pay out, taxes and childcare costs are disproportionate to income... I'm wondering if actually it's my generation that will cause the bigger social care bill.

btw, governments and even the EU seem powerless to control multinationals, where they send jobs, how they avoid tax.
The proposed TTIP legislation will give multinationals even more power.

Property owners should be self-funding. However, posters here seem to think all wealth should be ignored and care should be free. That won't be a "small" tax increase, but it will be paid partly by those on Generation rent.

It is simply not possible to avoid discovery of deliberate disposal of property assets!

It's the easiest disposal to trace.

That's what I'm saying. My generation would again be screwed. But hopefully my children will benefit from the mass sell off of property.

maninawomansworld seems to have organised disposal of assets successfully for his DF, but I agree the average property-owning boomer won't be as wealthy, or in as good a situation to avoid tax and care costs.

Everyone should be entitled to a private room with adequate facilities for an agreed weekly rate - this would include specialist nursing if required. If some patients can afford to top this up to get a nicer room, with better furnishings, better laundry, better food then I don't see the issue providing the basic standard is adequate. People have the freedom to have what they can pay for in their private homes; why shouldn't they in a care home?

Personally, I've never understood why meals are free for all in hospitals. if people were at home they'd be paying for their food.

But why should they get for free (as in a room, food and utilities) what everyone else regardless of income has to pay for? I firmly believe once you're in a care home you should continue to pay the same bills as you did at home and only the care element is means tested.

Way upthread, Jassy said "It's so remarkably like health care: not everyone will need it, and not everyone who needs it will need the same amount. But we all pay for it so that if and when we do need it, it's there."

Yes - basically it is health care. If we need a lot of it for a long time, we do lose everything unless we happen to be extremely well off. It happened to me, as to thousands of other people. Each of us feels pissed off that this happened to us. You can probably imagine how frightening it is to realise most of the rest of the country resents what we cost and wants to reduce it still further.

Yet, as you get older, the likelihood of this happening to you escalates. If you stay fit & healthy until after you've cleared your mortgage, brilliant, but how does that entitle you to keep hold of your assets if you need care? Those of us who got sick sooner had to flog everything: the timing shouldn't entitle you to get out of paying towards your own health care if you can.

It's not fair because ill-health isn't fair. That's it, really.

Oh, and before I read the posts since my last one I was going to say that if and when I get Alzheimers I hope there will be a little window available where I know it's happening and I have sufficient wherewithal to knock back a cocktail of sleeping pills and painkillers with enough to whiskey to see me off the mortal coil. I don't want to be burden and I don't want to lose my faculties with my daughter potential wiping the crap from my back. I certainly don't want to end up in some ghastly home that has a whiff of pee, not enough trained staff and left in excrement for an hour or three and talked about as though I never had a job, a family, a good mind, or any respect as a fellow human being. Unfortunately that's where we seem to be heading.

I wouldn't mind paying higher taxes if I knew it was going to be spent fairly and wisely.

It's fair for people to pay their own living costs that they would have regardless of where they live, so I have no problems with people paying to cover their rent and their food, and for any extras that they might benefit from. But the actual care that people need ought to be funded. I don't see it as any different to providing teachers in schools or doctors in hospitals.

At the very least, it should be made illegal for care homes to charge councils one price and individuals another for exactly the same thing.

I see that as being no different to me walking into a shop with a friend, and her being charged £1 for a chocolate bar and me being charge £5 for the same chocolate bar just because the shop keeper likes to charge less to people who choose to dye their hair blonde.

On another note, the cost of cheaply-run care homes is shameful. I've just looked up how much it would be to hire 24-hour personal carers: between £1,000 and £1,500 a week. You could live at a hotel and have your own carers for £2,000 a week. There's no way on earth it should cost £1,000 to endure reduced facilities, with thinly-stretched shared staff, in a home

But other sick people regardless of income don't have to pay for their healthcare under the NHS. You don't if you have cancer. You don't if you have motor neurone disease. You don't if you have all number of illnesses or required hospitalised mental health care for schizophrenia or bi-polar disorder. Why should sick people with Alzheimers disease which is a disease rather than old age have to pay for the essential clinical care they require in a clinical setting?

x-posted with Beaufort and Ptolemy

Alzheimers is viewed in the same way as arthritis. It's a slow and natural deterioration of the body due to aging which is why I think it falls under social and not health care.

But other sick people regardless of income don't have to pay for their healthcare under the NHS. - No, but I still had to pay my living expenses and house myself until I'd spent everything of mine. A care home is (supposed to be) appropriate accommodation. The medical care is still (supposedly) free.

"At the very least, it should be made illegal for care homes to charge councils one price and individuals another for exactly the same thing.

I see that as being no different to me walking into a shop with a friend, and her being charged £1 for a chocolate bar and me being charge £5 for the same chocolate bar just because the shop keeper likes to charge less to people who choose to dye their hair blonde."

Is it not more about economies of scale? People buying 100 chocolate bars will get a better deal than someone buying one. It's easier and cheaper for a care home to (as an example) invoice a council for 100 people than to invoice 100 separate individuals.

I'm sure I'm simplifying it, but I can see how that makes sense from a business POV.

What is most upsetting - for me anyway - is the fact that severe dementia entailing double incontinence, constant distress, inability to self care/eat/drink etc still does not count as a health care issue. The person is still deemed to only require social care -at a cost of £900 per week.

In addition to this, the individual has life threatening physical conditions that are being aggressively treated - thus keeping the person alive for years in a state that I consider absolutely horrendous.

If the person in question had a malignant condition they would be moved to a hospice and their other conditions would not be treated - they would be kept comfortable and allowed to die with dignity.

My relative has no quality of life, no dignity at all, every time she is given injections for her other conditions she becomes even more distressed because she has no understanding of why complete strangers are sticking a needle in her.

We cannot take her out any more because her behaviour is uncontrollable.
She has been in this state for 3 years and could well continue for at least another 3 years. It is soul destroying and I have told my family that if I get into anything approaching this state I would prefer to die by whatever means possible.

It isn't just about the money, but I think we really need to think about the best use of funds and how we manage dementia when it gets to this stage.