AIBU - Should people 60+ be means tested & pay for prescriptions

[monopoly5]

Considering the NHS is so stretched as are lots of other public services should free prescriptions for the over 60s be means tested?

I agree that the NHS is mismanaged but there is still no money. The tax paying population is shrinking & wealth is increasingly held by the older generations.

Yes there is the argument that people have paid their taxes so are entitled but I don’t believe a 20 year old of today will have any state pension/NHS available to them.

In an ideal world the 1% would be taxed more but can’t see that happening. Don’t we all need to chip in?

www.ons.gov.uk/peoplepopulationandcommunity/personalandhouseholdfinances/incomeandwealth/articles/persistentpovertyintheukandeu/2014

Poverty has been falling in the over 65s, but it is still the age group with the highest level of poverty in Britain.

I’m so glad we get free prescriptions in Scotland.... I’ve had a chronic condition since I was 38 (so no baby boomer) where I require 5 regular prescriptions and 2 top ups as needed. 3 of these are controlled drugs, so have to be given in relatively small numbers (I.e. they may only last me 3-4 weeks.) I would really struggle to pay all that - and I’m on a reasonable (though not higher tax bracket) salary.

Many study's show boomers are taking out far more than they ever paid in. It's not sustainable to have people retired for 20-30 years

Would you mind putting up links to them?

Here's the link I posted earlier:

www.ageuk.org.uk/torbay/aboutus/news/articles/2017/unclaimed-benefits/

www.independent.co.uk/news/uk/home-news/elderly-benefits-allowances-finances-struggling-unclaimed-welfare-uk-a7922781.html

If UK Gov suits your book:

www.telegraph.co.uk/pensions-retirement/news/millions-miss-2000-per-year-unclaimed-pension-credit-tops-33bn/

You do know those figures are just for the moment and don't include all the future benefits taken by boomers in the future?
So not very useful in this discussion.

Taking 118p out for every 100p they paid in

www.theguardian.com/business/2011/mar/15/babyboomers-welfare-politics-tax

Why only those over 60? Plenty of younger people with big incomes take advantage of free prescriptions.

I think the NHS could do more to encourage people to buy over the counter medicine. I was prescribed saline nasal spray for my dd, which it turned out was less than £3. I paid the charge rather than use the prescription.

Means testing is usually a hugely expensive process. If you're going to do it, then do it for everyone. But personally I'd rather see a campaign to get those who can afford to pay for prescriptions to do so.

You do know those figures are just for the moment and don't include all the future benefits taken by boomers in the future?
So not very useful in this discussion

Yes I do, and the figures for unclaimed benefits are real and have happened while the future..er hasn't and is speculation. Sort of thing.

Yes. Wealthy baby boomers who are reaping the rewards of the boom years should be paying their way medically. They live in large houses, drive expensive cars and go on annual foreign holidays - under 40s, even if working to the bone, will never get to enjoy such wealth. It's fair to even things out for future generations.

But I suspect too many will be too selfish to vote such a policy in

That wasn't aimed at you.

But how do any of your figures show that most boomers aren't claiming all they can? The kind of pensioner that is too proud to claim (not boomer) are still around at the moment.

So age UK in their own dubious report say 1 in 4 face money worries. So doing much better than the 7 in 10 workers that face money worries.

www.theguardian.com/money/2018/jan/25/uk-workers-chronically-broke-study-economic-insecurity

That's not true across the board, Squaredot. I know plenty of people under 40 who are in that position. Just as I know plenty of boomers who pay for their own private healthcare. And there are some people who put in far more than they take out. Sweeping generalisations don't always help. Not everyone is the same.

However I do think means testing and contributing appropriately to NHS healthcare or encouraging private insurance policies, say by giving employers incentives to provide them to more staff, is one way to assist with the NHS (it's not a fix - it's far too big and complex for just one idea!).

Yes. Wealthy baby boomers who are reaping the rewards of the boom years should be paying their way medically. They live in large houses, drive expensive cars and go on annual foreign holidays - under 40s, even if working to the bone, will never get to enjoy such wealth. It's fair to even things out for future generations

You would then need to define wealthy, which is fair enough, cost the means testing to see if it works out as a benefit to the country, rather than an easy political point, dog whistle politics, oh look, a windmill.

Everyone here (Australia) pays for prescriptions unless they qualify for a low-income health care card, or unless the drug is covered under the pharmaceutical benefits scheme, in which case people pay a maximum of $39.

It works. Those who truly cannot afford the prescriptions only have to pay a token amount (I believe it's $6-7 maximum), but those who can afford it foot the full cost. If you choose to take out private health insurance - as many people, including myself do - you pay $39 on the prescription and the rest of it is covered by your insurance. This obviously doesn't apply to inexpensive medications etc. but it does apply to something like the Yaz contraceptive pill, which is around $70 for three months.

No complaints here. It should be the same in the UK.

No one who gets 9 items a month should be paying £80 per month. I get 2 or 3, each month, do have a prepayment certificate which is £104 for the whole year.

Everyone here (Australia) pays for prescriptions unless they qualify for a low-income health care card

Many in the UK hate the idea of equality and treating people the same regardless of age. It's a shame as you say it works well in other countries.

The population in Australia is much smaller though - about 1/4 or so of the UK, I believe? Would be interesting to see the demographics, i.e. whether the numbers of people who could/do pay are the same % as the number who couldn't/don't.

Universal means testing is hugely expensive to administer which is why successive governments have avoided it.

The NHS is funded from general taxation not from prescription payments. Wealthy people pay tax on their incomes irrespective of their age. Older wealthy people are taxed on their homes if/ when they go into care and on their estates when they die. The government gets the money in one way or another.

If we start down the path of taxing different groups differentially where does it end? Should we get drinkers, smokers, non exercisers and the obese to pay in more on the grounds that these are all life style choices and they will be costing the system more? What about people who are injured doing particular sports? Those who choose to have more children?

The 100/118 figure is meaningless as there will be older people who pay in much more than they take out (the wealthy) and those who take out more than they pay in ( the poor/ unfortunate)

I have paid more than the pre payment certificate. Pre payment certificates are great if you have a diagnosed illness where you need regular medication so can estimate the annual cost. But if you have one off things, you can look back and realise that a pre payment certificate would have saved you money - but you didn't realise you were going to need that medication ahead of time.

If we start down the path of taxing different groups differentially where does it end?

No one is taking of taxing different groups differently. We are talking about just giving state help to people that need it. That already happens extensively for everyone not of pensionable age.

Pensioners aren't taxed the same anyway with the con of NI that still exists and no government has the balls to roll ni and it into one even though it would be much fairer.

The population in Australia is much smaller though - about 1/4 or so of the UK, I believe? Would be interesting to see the demographics, i.e. whether the numbers of people who could/do pay are the same % as the number who couldn't/don't.

It's about the third of the size, population-wise. But the overwhelming majority of people pay for their prescriptions. The number of those on low income health care cards is very low, and then not all drugs are covered under it, so you could have a health care card and not have your scripts subsidised at all.

It still works.

It sounds all right in principle, but means testing always hits those with a moderate income.

In Italy everything is means tested (even school dinners on a sliding scale). One of my relatives frequently complains that she has ended up quite a bit worse off than a friend who has no income but gets free dentistry, prescriptions, healthcare, etc etc.

Of course the boomers in my road with jaguars and three cruises a year should not get free everything, but no doubt any means testing would result in hammering those on very modest pensions.

I do think that things will change: my fil for example has been retired for 35 years. If the current retirees are all going to live as long and longer then the country (and other Western nations) are going to be bankrupted.

The argument that the boomer generation are taking out more than they put in are spurious. the same argument will likely apply to Gen Xers, Millenials and future generations. Everyone, as they get older, will require more in the way of help, whether that be healthcare, transport, social care etc. These costs go up so of course the amounts paid in during a working life will perhaps not cover the costs of hospital care 20+ years after retirement.

The argument that the boomer generation are taking out more than they put in are spurious. the same argument will likely apply to Gen Xers, Millenials and future generations.

It's highly unlikely it will happen to future generations with the rising pension ages and the expected state pension and tax rise changes.

Students aren’t exempt - as we found out when DS was ill when he was home from uni over Christmas.

You have to apply under income rules, then they are. Fill the form in and send of the receipt for the prescription.

OP

What about the cost of means testing 20 MILLION people, most of whom will be eligible because their only income is a state pension.

The cost of means testing didn't seem to be an issue a couple of years back when they stopped our child benefit easily enough (DH high earner).

@small business

Are you arguing that no-one should take out more than they pay in? If so, where does that leave the poor, disabled, disadvantaged? They all take out more than they pay in - and the principle that people should receive according to their needs underlies Western welfare states. Age is irrelevant in this context.

Many people pay in far more than they take out. That is also fair in the context of the Western welfare state. They pay in more through general taxation of income and that continues irrespective of age. As I said above, people also get taxed on the wealth they have accumulated either through care home fees ( where they subsidise LA Residents) or through inheritance tax

Tinkering around the edges with prescription charges is a waste of time and effort and costs more than it produces. Are you also arguing for younger wealthier people to no longer receive exemption certificates, or for children of wealthy parents no longer to receive free medical and dental care?

The logical extension of this approach would be to abolish the NHS completely and have a system in which those who can pay do pay - directly or through insurance - and only those without money receive free access at the point of delivery. This would inevitably lead to a two tier system.

I find the constant “othering” of certain groups (those we are not personally a part of) profoundly depressing. We started off with “scroungers”, “immigrants” “ the feckless poor” Now it looks as if we are moving on to the elderly and baby boomers.