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?

There is a debate about whether everything provided by the NHS should be free for everyone. Singling out prescriptions for one group is a drop in the ocean but of course baby boomers are a favourite target on MN.
Some believe that the NHS should remain as it is - free and paid for only out of taxation. I doubt any political party would have the guts to have a genuine debate about this.
I think there is a case for asking whether those who can afford to should pay for some services, particular none medical ones such as free transport to hospital.
The problem with means testing is that the associated bureaucracy costs a huge amount. Sometimes it's actually just cheaper to have an arbitrary rule which is simple to operate even if it means some gain who don't need it.

Gilead sorry but I don’t understand your point. Many, many benefits mean you are except from the charges anyway, as it should be.
Yes they do, but the op was suggesting a change to the system and others have posited the theory of alternatives; including everybody paying, paying the way they do in Belgium etc.
Apart from this, PiP and DLA do not mean that you don't have to pay for prescriptions; so if you are over sixty, only able to work part time due to your disability, you may not be able to afford prescriptions if the amount of medication you require is significant. Again, that tenner a month can make a huge difference.

There are also some forms of ESA (contribution based, I think) that mean you have to pay for prescriptions.

I live in Sweden where all adults have to pay for prescriptions - there is a maximum annual amount and you are issued a free card for any prescription costs over this

I think that means testing would be expensive to administer, and given the extent of pensioner poverty in UK, unlikely to bring in as much as OP thinks (has anyone done the number crunching?)

What is the projected net gain, once cost of means testing has been taken off expected additional revenue.

Remember cancer patients of any age get free prescriptions (for all their prescriptions) as do those with certain other conditions, so the number who would receive that exemption instead would also need to taken off the theoretical net gain.

If we start mean-testing everything, I might just give up and take the kids to Disneyworld. Some people work hard all their life, make careful choices to try to have a secure retirement whilst others just splash the money and relay on everybody to pay for them when they need it. On which planet would a mean-tested system be fair on anyone?

Why is it that everyone agrees the rich should pay more tax, and when the OP suggests that the rich elderly should pay for their prescriptions this is suddenly wrong? Surely if you are rich you are rich, and your age is irrelevant?
Means testing was originally designed to ensure the rich didn't get benefits which they didn't need. Granted, the whole system is incredibly badly organised and does not do what it should, but can anyone answer the question which was actually asked, which is why should rich elderly people get something for free which they do not need to be free, when people who cannot afford it (and should get it for free) are suffering, and when they are rich younger people they should be taxed harder?

Why should someone contribute all their life and not be entitled to
anything when they need it?

Then define a "rich elderly".
Amounts aside, will you look at their life spending? Will you penalise someone who has saved all his life, but reward someone else who just splashed money all his life?

OK, then I think that child exemption should end for rich families, as should maternity exemption for rich women. It's the same logic.

Are you proposing to extend it to rich cancer patients too?

How much will this extra means testing cost?

How would the theoretical extra income compare to the theoretical extra income if NHS ceased the practice of throwing away all returned prescription drugs, and instead put unused in-date full blister packs back on the shelves?

How much could be saved if NHS bought more drugs centrally and used hard negotiators (who recognised the 'value' of agreed large supply contract) to hammer down purchase costs. Instead of smaller units within NHS doing it piecemeal?

(has anyone done the number crunching?)

90.6% of prescriptions are free. 450m is raised on the 9.4%.

I don't have any figures for age groups or anything.

If we got rid of free prescriptions we could raise 4 billion.

Nothing compared to the 61 billion we spend on obesity. It's obvious to me how we solve the NHS funding issues. We all keep our selves in a healthy BMI range.
Whilst people in that range get ill, it is a lot less likely.

I would rather 10 elderly people who are actually rich (whatever that means) get an extra £100 worth of prescriptions 'free' a year than 1 elderly person who is poor be embarrassed at the till, be hassled by confusing paperwork, skip necessary medication, or be afraid to see the doctor because of what it might cost in prescriptions.

But I'd guess the proportion of elderly people who are 'rich' vs those who are poor is more like 1:10, rather than 10:1.

Yes, of course over 60s should pay if they can afford it

And FWIW I'm in my sixties ...

I've had a life long medical condition requiring daily medication which has meant I have always been exempt from paying for medication from childhood onwards. Would you also want those to be means tested?

I also agree, why just the over 60s? There are plenty of people who can afford to pay for medication whilst they are pregnant and/or for their children.

"If we got rid of free prescriptions we could raise 4 billion"

That's based on abolishing all exemptions, which goes rather beyond what OP was suggesting. And does not allow for rise in unfilled prescriptions for those who cannot afford some/all of theirs, nor the costs in more complex treatment for conditions left unmedicated, which would both reduce the expected cash yield and increase NHS costs as a consequence. It would increase the already shocking difference in life expectancy between rich and poor as well.

I'm still wondering if any organisations have number-crunched the OP's proposal (and what definition of 'rich' was chosen and why?)

The biggest problem for us over 60s is that we have automatic exemption if our age and DOB are computer generated on the front of the prescriptions, we only have to tick the box, sign the declaration and provide proof if there I no age and DOB on the front or if it has been hand written on.

I used to have a medical exemption card as I have an underactive thyroid, in 2014 I got a chest infection, was prescribed antibiotics, steroids and an inhaler, I didn't present my medex card and paid for the lot.

One year later same infection, same meds but this time I was over 60 and as my age and DOB is on the front of my prescription I was unable to pay even though I was happy to . If I actually had the choice whether to claim or not I wouldn't have claimed I would have paid

In all other cases of free prescriptions you have to provide proof of entitlement, if you don't have the proof on you then the Pharmacist ticks evidence not seen you still get your meds but your claim is checked by the NHSBSA, so why cant they do that for age exemption claims

Everyone should be means tested and contribute to their healthcare costs of able to.

NewYearNewMe18

Students at age 19 have to pay.....as shocked as they usually are!

Everyone should be means tested and contribute to their healthcare costs of able to

Flash news, people who pay tax do contribute already. Mean-tested is the most unfair system of all.

Speaking as a millennial with many axes to grind against the older generations: no. I don't begrudge anyone the healthcare they need, and anyway prescription charges are small beer.

As I see it the problems with the NHS aren't caused by lack of money exactly. They've been caused by about a decade of Tory policies outright hostile towards the people who work in the NHS and in social care, driving them away and discouraging new young people from careers in healthcare.

Destroying trust is easy, rebuilding it is hard. The NHS won't be fixed quickly and it won't be fixed by throwing money at it. Step one would have been to get rid of Jeremy *unt; by repeatedly letting him stay in his post Cameron and May have given NHS workers giant slaps in the face.

I believe the Conservative Party wants to wreck the NHS so private healthcare can swoop in and be portrayed as a saviour, while the owners of private health firms cash in.

Some of this talk on here terrifies me.

I'm with you crunchymint

I made the mistake of trying to be reasonable on a Baby Boomer thread... and seem to have allowed myself to become personally annoyed! I think I'll just hide similar small minded, selfish posts in future!

The trouble is, it was New Labour who introduced private provision to NHS, and introduced the enormous ongoing PFI costs.

Now, Corbyn Labour might do differently, but there isn't much of an alternative strategy floating round at the moment so it's hard to evaluate how a government he leads might go about it.

Given that the trend in the devolved regions is the removal of prescription costs completely, and it has not been a major factor in their budgets, then perhaps that's the direction England should be moving in.

I am now also feeling frightened. I am in my 60s and have to take 14 different meds each day. Some are to counteract side effects from other meds. If I had to pay for them, I wouldn’t be able to afford them all. So which should I miss out? The ones that stop the side effect of osteoporosis? The ones that help me so that I won’t kill myself?

None of my conditions are my fault. I didn’t drink to excess, didn’t smoke, ate healthily and exercised a lot. Then I hit 50 and my health totally collapsed with multiple conditions.

Ah, but I am one of those dreadful baby boomers who had it so good...

meditrina
The trouble is, it was New Labour who introduced private provision to NHS, and introduced the enormous ongoing PFI costs.

Thank you for pointing that out. I am sick to death of labour voters on here crying about the impending doom of the NHS because of the Tories. It's total bullshit but they don't care. Pitiful really.

Blackteadrinker I believe you have the numbers you keep reiterating wrong.

If you are referring to the study I think you are, the Public Health England blog reports the estimate that the cost of overweight and obesity related illness in 2014-2015 was £6.1 billion.

Not £61 billion, £6.1 billion.

That blog entry, written by experts, also points out that considering obesity and overweight as a public health problem reveals that there aren't simple solutions, as at the population level "... there is no silver bullet for tackling obesity. Its causes are complex with many drivers including behaviour, environment, biology and physiology and culture."

There may be simple reasons why any one person is overweight or obese and there can be very complex ones. It can be easy for one person to fix, or difficult, or impossible. But judged epidemiologically, it is a rather complex problem to explain for a whole population, and there aren't simple solutions to it at the population level.