There are a lot of comfortably off pensioners. And lots of poor ones. And there are a lot better ways of finding money for elderly care than Theresa May’s manifesto commitment to whipping the houses off people who need care at home.
Under the Conservative’s plan, people needing either domiciliary (aka at-home) or residential care will have to pay for everything until the value of their assets, including their home, is down to £100,000. The Tories promise that no one will be forced to sell their home in their lifetime to pay for care, with the cost instead deferred and taken from their estate after death.
The plan is superficially seductive. The older generation have benefitted from spectacular – and largely unearned – increases in the value of their property. Why should younger working people, through income tax, pay for the galloping costs of elderly care when they can’t even dream of affording to buy a home themselves? Doesn’t it make more sense to instead take the money out of the congealed wealth sitting in property? And, indeed, there can be no justification for the state protecting the inheritances of the well off by taxing hard-pressed working people.
But there are two major drawbacks. Firstly, there is the risk that the elderly will delay seeking support at home because they won’t want to enter into a domiciliary care plan involving a charge on their property. They won’t get early treatment and will fall on the NHS.
The second drawback is more serious. No one chooses Parkinson’s or Alzheimer’s – they choose you. Health inevitably deteriorates in old age, but the conditions that will result in intensive care costs, whether domiciliary or residential, are largely random. A quarter of the over-85s are likely to develop dementia and a third will need constant care. But that leaves large numbers not in need of intensive care. Indeed, only one in eight over-85s are in care homes.
We don’t for a moment think that someone in their 50s with breast cancer should have a lien put upon their home to pay for their care. We share the risk by paying through our taxes for the NHS and community care services. Why, then, should we think that a random third of the over-85s should have charges added to their homes but the other two-thirds not?
But that doesn’t take away from the fact that the increasing cost of care for the elderly needs to be found somewhere, and it would be unfair for the young to shoulder all the burden.
One of the oddities of the tax system is that we stop paying 12% national insurance on our earnings once we reach state pension age. The idea is that NI is basically a savings system that pays for our pensions, so once we’re in receipt of a pension we stop paying in. But NI, when first set up, was a system of insurance against illness and unemployment. If NI is supposed to help fund the NHS and care services, there is no reason why pensioners – the better off at least – shouldn’t be paying it, albeit at a reduced rate.