Why should taxpayers have to fork out tens, or even hundreds, of thousands of dollars to pay for the care of someone who is wealthy enough to meet the cost of their retirement but would prefer to pass their wealth on to their children?

Rhian,

Most care of badly disabled and frail elderly people goes on in families. Half of all nursing homes admissions are for respite care. Very often people are only admitted permanently when the family is unable to cope, because they need specialised care or may be unmanageable due to Alzheimers. Without the family, they would have been admitted years earlier. Currently, people are held responsible for a spouse's nursing home bills, and only have their own assets protected up to $38,500. The house is protected, but only while the spouse is living in it. If he or she has to move out for any reason, nursing home bills are means tested against the house as well. If a son, daughter, or daughter-in-law acts as a long term carer, the relative may get a small pension, but sacrifices his or her own opportunity to acquire superannuation and savings. Currently, the inheritance may partially compensate for this.

Some carers may be willing to act as saints and martyrs, to end up homeless and penniless to help their relative, but such heroic virtue may be beyond most people, who are also often confronted with competing obligations. In the US, there was a documentary several years ago on divorces among elderly people with 50 year marriages when one of them has to enter a nursing home, so that a judge can divide the family property and preserve half for the spouse. I would have serious doubts about whether a user pays policy would really save the government money in the end, because it is likely to inspire the family to give up faster.

Your argument could equally well apply to cancer therapy and other expensive forms of medical treatment for younger people. Why not financially wipe out the family before the taxpayer steps in? In the current arrangements, we all take a relatively small hit so that people don't end up bankrupted through no fault of their own and so that we are protected in case we have to confront an expensive health problem in our own family.

First you get the business or "market share" by offerring the lowest tender, in a nationwide industry whose neccessity is unquestioned.

Second, you establish a reputation as a good supplier.

Third, become "too big to fail".

Fourth, request either a pricing restructure or more government funding, for something that should always have been means-tested.

Not criticising, it just seems like a strategy.

Rusty

Divergence,
The comparison with health care is an interesting one. Tax rules mean that most people on above-average income have health insurance which covers at least some of the cost of their treatment, so there already is an approximate “user pays” system with a safety net for those on low incomes.

You seem to imply that inheriting the family home is some form of compensation for family carers. If so, it is very inefficient. Family members who carry most of the burden of aged care will typically inherit no more than those who don’t. Your logic would also suggest that the offspring of wealthy parents have a greater incentive to care for their elderly parents than those whose parents lived I rented accommodation or a low-value house. Yet I see no evidence of the children of poor parents neglecting their frail parents.

Carers probably deserve a better deal in our society, but surely a fairer system would be to pay them for their efforts and require wealthy retirees to pay for their own accommodation.

An increase in the medicare levy to cover the cost of aged care would be alright if we could be sure the revenue would go directly to increasing quality age care services (more nursing staff, more beds) including community nursing to enable older people to live at home. Or to support families caring for their elderly relatives at home, especially those who are in full time caring roles, unable to work.

As a nation we should also look to cuts in other government spending that might be considered 'waste', ensuring that 'real' public services (to the actual public) are not cut further adding to the perception that the more taxes paid, the less services rendered.

Get rid of baby bonuses, subsidies of any sort and ensure the economy is configured in a way that makes housing more affordable and that people are able to stay at home to raise families or care for loved ones if circumstances demand.

Home care is preferable but it is not always possible, so agencies like Uniting Care are to be applauded for offering their services. I think it is reasonable for a wealthy person to contibute more to their nursing care.