Social care - who should pay?

How odd. I just googled the topic, this reference came up and I read it. I certainly do not have a subscription to the FT online (or in print).

Paying a lower fee doesn't mean that you are subsidised by others - in the case of care homes it often means that you are enabling an organisation to continue to exist.

I worked for a number of years in a major private hospital - can't remember the exact figures but BUPA/PPP/etc patients would be charged say £100 per night but self-pay patients would be charged £700 per night, both excluding treatments.

You can't say that self-pay patients (high fees) were subsidising the insured (low fees) because without the insured patients the hospital wouldn't survive. It must be all factored in the business model.

As an economist Monica you must know how these things work.

Other than investing in a property or other major asset, how exactly does a person plan for the expense of a residential care home which may cost between £2,000-£4,000 a month?

I think there should be some sort of separate insurance scheme to which everybody (including retired people) contributes according to their income and assets (payable from estate after death if necessary). This to cover anybody who requires either care in the home or residential care - social or medical because I think it is very difficult to differentiate between these two types of need. I think it is unfair that only people who are unfortunate enough to need this sort of care should have practically all their assets used up while others are left untouched.

Some people will object to paying for something they may never need themselves but hopefully others will take the view that if they need the care it will be available and if they don't they are very fortunate - and their contribution has helped others.

Baggs Since you feel that nobody has an entitlement to inherit money, then presumably you would have no objection to the inheritance tax threshold being substantially lowered to ensure that enough money is available for everybody to receive proper care in old age if they need it?

I believe I read some time ago that the number of elderly people going into residential care is not as high as many people suppose - around 1 in 10 I think was quoted.

No one has addressed the reason for the different treatment of, say, cancer v dementia. Why should one type of illness be paid for by the state but not another?

The problem with insurance schemes is that, unless it is state backed, it is very difficult to organise. Few/no insurance companies want to offer these policies because they would either be so expensive no-one would take them out, or, if they reduced prices they might well end up with making an enormous loss on them.

The insurance companies did introduce some products, I think about 15 - 20 years ago, but there was very low take -up because of the cost and, with lengths of time in care lengthening with the increase life expectancy, some got their fingers burnt when they ended up having to pay out far more than they have expected..

Yes state backed insurance scheme.

But I wouldn't hold your breath with this government. As it would be anathema to them, regardless of sense.

I cannot imagine that any of our sons and daughters are planning how they might pay for their social care later in life - they are struggling to pay their rents or mortgages.

Those of our generation were under the impression that care was from cradle to grave and did not expect to find themselves in this situation. But there is now a huge disincentive to save for old age and a very large one to spend spend spend, or to give money to children very early on. The more people who do that, the more the government will have to get their act together.

The issue of inheritance is an interesting one. I can appreciate the argument that whatever assets we have should legitimately be available for paying for care - that makes logical sense. But the desire of folk like us to be able to pass something on to help our children is a very entrenched and a very powerful one - so much so that any government who wishes to stay in power is likely to duck the issue or fudge it - as indeed May did during the election.

What we need to do is to go back to square one, take a long hard look at those countries (viz. Scandinavian) who have proper social care systems throughout life, and bite the bullet on increasing taxes to achieve this. We do not need any of this "insurance" nonsense, where the "contributions" have simply been used as tax revenue and spent on other things. We need a true honest upfront higher taxation system to fund proper social and health care; and a system of hitting tax avoiders that really works.

It is wise to start such a scheme now but too late for thousands of us. We have acted wisely all our lives and have savings and a decent pension income ,paid for over many years. The goalposts have moved for us as they have for many and the result is that our prudence means that everything we saved for will go.
If my H's pension has to provide his care, I will not have enough income to maintain the house we live in. Therefore I sell this for something smaller to cut down outgoings, BUT the money raised from the sale, after buying me a flat will go towards his fees. I would have to spend my savings, down to a level below £10,000 before I could claim any benefits.
If I also need care I think I would have to resort to a camp bed in his room. There certainly wouldn't be enough money for 2 of us,and I like to think we made what we thought was adequate provision for our old age.

"But there is now a huge disincentive to save for old age and a very large one to spend spend spend, or to give money to children very early on. The more people who do that, the more the government will have to get their act together." That is the point I was making earlier on, as more and more of us have to pay for care the message to those following will be to not save.

I can't agree that all of our children are struggling more than we did, mine are not. They have good jobs and have bought their own homes. They appear to be better off than their colleagues but maintain that is because they cook and take their own lunch to work, take their own coffee and other drinks and don't often eat out. Their prudence means they can afford lovely homes which their colleagues cannot. They don't buy prepared food but cook healthy meals from scratch and even grow some of it themselves.

Of course I can only speak for my own family who are happy to live within their means.

Far from spending or giving money away to avoid paying for my own care. I am so relieved that the value of my house and my savings are sufficient to give me absolute control over how I am cared for in old age, should I need it.

While I undoubtedly want my estate to be shared between my children, if that is not possible, to spend the money on ensuring that DH and/or I have the best care possible when our need is greatest and that we are not dependent on what the state may or may not be willing to supply. seems to be a very satisfactory way of spending it.

I'm not entirely sure how one "plans" to provide for ones potential care ...apart from extortionality bad insurance deals where all money is lost if care is not needed or one dies before it runs out so family lose any potential inheritance!) I'm not aware of alternative options ...other than saving like mad , hoping there is enough to cover ones care costs (unlikely if one lives any length of time!) and Ofcourse hoping that care isn't needed!!!!

I really think it can only be state run - like the NHS.

Did anything ever come of this?

I think health and social care should be merged and paid for all, by all.

I couldn't see the problem with Teresa Mays idea where everyone could keep 100k of "worth" to pass down to their children (assuming they needed care of course) I would be overjoyed to be able to leave a legacy if this size to my children. No one helped me out financially in my life ever.

There are always plenty threads on GN asking how best to squirrel assets away from the tax man .

Health and Social Care Act came in on 1st April 2013. Why has it not been joined up yet?

I'm quite happy for my flat to be sold to pay for my care, should I need it.

I agree with Norah

We pay our taxes and so if we are in need of social care we should have access to it.

I actually believe that if you pay your tax 's it is only fair that if you need social care you should receive it as you have paid in regardless of your bank balance.

So WHO should pay for social care, well we all should put into a kitty that we can all use.

It depends on whether the taxes we pay are intended to cover social care as well as medical care. That is the nub of the discussion.

The government (all parties) has always been insistent that the state will provide health care from cradle to grave without charge, but that social care should only be state funded if the recipient has insufficient resources to fund it themselves.

If the state is to take on the responsibility of social care then there should be an explicit tax increase to fund it. The big problem is that so many people want Scandinavian levels of state support on US tax rates and cannot see that these two aims are incompatible.

Some people not many M0nica. Quite a few on this thread had suggested an additional insurance from commencing work to death and an estate tax for some years to make up for the fact that older generations haven't paid this all their lives.

I think people are prepared to look at this but there is no reality coming from the government.

The Conservative government keeps getting re-elected because it promises low tax rates and that means an awful lot of people choosing to vote for them and then wanting high class services.

I do not think I am saying anything surprising when I say that if a poll was taken of active GN members, it would find that, politically, they are broadly centre to left leaning and not entirely representative of the electorate as a whole.

However, like the rest of the population, not all GN members are active. When a poll was taken, the majority were to the right.

Depends on ones definition of right and left. I am to the right of you, DJ, but left of the Conservatives.