Potentially, another national insurance tax increase to pay for social care

[Toodaloo1567]

Just stumbled on this and wondered about everyone’s thoughts. Essentially, the government is being advised to increase national insurance to pay for elderly social care. I’m not keen. apple.news/AQkrJ_mvnRmClZjz_HJzA9w

“New figures show that since the pandemic there has been a triple digit percentage point rise in patients paying out of their own pockets for hip and knee operations.”
“Self-funded hip replacements increased 165 per cent, when comparing July to September 2019 figures against the same period in 2021, while self-funded knee replacements saw a 122 per cent rise. The third largest increase was cataract operations at 64 per cent.”

Of the 3 relatives I mentioned 1 had a hip replacement & the other was a knee replacement.

That you again Elon?

👋

Buying insurance upon retirement is obviously just impossible. When you consider many people don’t have pensions of £5,000 a month so how can they insure for care home fees which are exactly the same or more when they are in receipt of a pension? People would need to, in effect, make large contributions to “life cover” for decades. This is probably what’s needed but people will shriek “death tax”. So we get no further forward.

And what’s wrong with that? I self funded my cataract surgery and it’s our intention to do the same for any future surgery we need. Are you suggesting we shouldn’t spend our money as we choose? Equally I see no reason why people with assets shouldn’t fund their own care, why should the taxpayer foot the bill for people with assets who aren’t happy with the state offer?

In their 90’s and had to release equity to care for themselves? The horror! They had their whole lives ahead of them!

You pay a seperate amount right from the day you start working. These funds are kept separately and of course some will die before they ‘use’ it. Thing is that most people want what they want now, be that be nights out, latest gadget, take ways, going to the pub, going on holiday etc. They don’t want to think about old age. That is for others to think about and fund.

Not a chance in hell will it happen. Labour are completely clueless - who thinks that prioritising growth and then hitting the business sector with tax after tax is going to achieve that needs to go for some economic training URGENTLY

You cannot buy an insurance policy just at the time you might well need to call upon it! It would be ridiculously expensive! No one would buy it.

It’s the way everyone buys travel insurance. You don’t just buy it every year on the off chance you might go on holiday.

Blossom - to cover you for social care costs is really not the same as travel insurance. A monthly cost at a care home is at least £1.5k a week.

If you buy at at say 65 years old it would cost thousands and thousands.

It would depend on whether you had any existing conditions, any family history of dementia, life expectancy taking into account the age at which your parents died. It could cost very little for people perceived as low risk. It would be untenable for me because I’m highly likely to develop dementia, it’s in my family. There’s none in my bloke’s family.

Fully agree with this.

Yes. Even older people without eg a family history of dementia are at risk for strokes, fractures and other such happy events.

The difference is that the NHS treats people with fractures and strokes and recovery is possible. There’s no treatment for dementia which is now the highest cause of death in the UK and involves years of 24/7 care.

They can't even get the young to join the workplace pension schemes. Very high rates of people "opting out". This is what happens when you have decades of "cradle to grave" care paid for by the state - people just assume/expect that someone else will always bail them out and won't make provision for themselves.

What is needed is for the government and life/pension/insurance firms to come up with some form of "lifetime" insurance policy. Yes, it will be costly, but my idea would be for it to cover life insurance if you die young, pension if you make it to pension age and care fees if you end up needing to be in a care home. Different "risks" and "needs" at different points in your life.

Wrong. This is what happens when the cost of housing is out of reach and employers pay as little as they can get away with.

Why not just have a small death tax? This takes absolutely nothing from the money you have to spread thinly to make ends meet while alive. I really don't understand the problem so many people seem to have with this. It seems bonkers to me that so many people would rather live on less money and have poorer public services for themselves and their children while alive than pay some tax after they're dead.

My understanding is that NHS treats the acute episodes, not the aftermath. Both fracture and stroke often precipitate involvement with social care

It’s bonkers to me too. The aversion to IHT is completely beyond me, it’s completely illogical.

@poetryandwine Depends on the age and frailty of the elderly person. DM had several episodes as an in patient in her 90s but no SS involvement ever. Hospitals don’t if they find out there’s a relative that’s around. Seen it all the time. I wasn’t that near but no one consulted me about care for DM at home, ever. The only discussion with SS was when she was 99 after 7 weeks in hospital. And then the social worker lied about her needs. Until then SS didn’t even do a home assessment to inform me about her needs. It was only at the penultimate stay in hospital that I persuaded DM that care in her home was needed. SS refused to get involved. At all. They never did assess her needs. So I found a private provider who had 2 hours a week available and she paid. No other option. It’s a complete mess. She needed more hours but they hadn’t got them.

My mother's care costs £8640 per month as she's in an emi unit.She shares one bathroom with 6 residents and it's hardly surprising that the toilet is usually dirty.Her clothes are all labeled with iron and sew on labels but she was recently in a man's Tesco t shirt because they've lost so much of her clothes.We have to call a few times a week at mealtimes, this is obviously frowned upon but we need to check if she's getting enough food.She's been admitted to hospital on several occasions without us being notified.
The public purse should not have to contribute to this quality of care.

The current issue is that IHT is 40.% of taxable assets. Not that many pay it. Therefore I have some sympathy with a more progressive percentage and taking far more estates into the taxation bracket. However I’m not sure this idea would raise anywhere near enough. You can hear the howls now! It would be deeply unpopular because most people think it’s a tax on the rich - and that isn’t them! I think a lifelong insurance scheme is better, to be honest but it’s more money required from people who are struggling, so not likely to get support either. Most people who want others to pay more IHT won’t pay it of course! We could say 20% of all estates is tax but I don’t know if that would be a drop in the ocean in terms of paying for social care. What happens if you’ve paid for all your care and then get taxed on the bit that’s left? That would feel very unfair.

First, @TizerorFizz , I am outraged over your DM’s story and I am sure it is far from unusual.

I think mandatory insurance would be much more acceptable than increasing the IHT pool, even with a very low banding. You are also correct that as a one time tax the latter would not raise much money. On the current death rate and with an average estate value amongst adults just below the IHT threshold - the median is lower, possibly significantly lower - I calculate that any modest IHT will raise £1- 4B pa. That’s only a drop in the bucket towards the estimate I saw this week of social care costs of £20B pa.

Annual insurance as a very small per cent of salary or equivalent benefits averaging to about £400 pa (many would pay less) would go a long way towards covering social care costs.

@poetryandwine I spent years being outraged! It’s all so hard without help or advice.

I rather felt IHT would not raise enough. I think we could alter it as I outlined (as a start) but it will create fierce opposition. As will mandatory insurance. This is, of course, why the issue is firmly in the long grass again. It’s not politically acceptable to sort it out and so we have a nhs that’s impossible to run and isn’t efficient. We need governments to grip the issue but they won’t (unless Elon Musk tells them to!)

Exactly.
Let's sort out where what's already there is going, alongside improving funding.
I quit social care because of the issues described above, everyone was getting the bare minimum because there weren't enough resources - including us on the floor - to provide the level of care that a) everyone should expect and b) I and many of my colleagues wanted to give but couldn't.
Where is that £8k a month going? Multiple times?
It's certainly not on resources to care for people properly.
Yet people would rather argue about inheritance tax and too many people being lazy and feckless, when raising more money, than look at the problems within social care, that are causing the high prices and low delivery.
When something goes wrong it's usually the staff on the floor blamed for poor decisions, or being nasty people or any number of reasons to make them the scapegoat for an industry that's got profit at the forefront when it should be people.