It was dismaying to hear No 10 meet this powerful report by murmuring that care was 'complex and difficult'
Fear of death is, perhaps, part of the human condition. But it is a bitter irony that our collective success in postponing the inevitable stirs avoidable anxieties. Foremost among them, in England at least, is being ruined by stratospheric care costs. The Dilnot report reaffirmed the terrible nature of the financial risk which the elderly run, and produced a practical plan for banishing the worst of the fears.
Rich in evidence and pithy in prose, it was dismaying to hear No 10 meet this powerful report by murmuring that care was "complex and difficult". Yes, the byzantine current system defies comprehension and common sense, but that is why ministers appointed economist Andrew Dilnot to head the commission which has now reported. The insight he has applied is in fact arrestingly simple: that the core problem here is the reality that we are all uninsured.
Where a quarter of us will need no old age care at all, and half will incur bills that ought to be manageable above the breadline, one in five retirees will go on to clock up total costs of more than £100,000 – sometimes several times that. It is no use hectoring people to save prudently. No one of ordinary means can afford to put aside enough to foot the biggest bills, which is why a minority see out their days by losing everything they ever had. Mr Dilnot points out that life is littered with potential financial catastrophes, from costly-to-treat illnesses to house fires, but that in all other cases the risks are pooled, whether through the state or the insurance market. With care, however, the market balks at the virtually limitless liabilities involved. The state, meanwhile, tries and fails to muddle through, under the auspices of 1940s legislation which was concerned with humanising the Victorian workhouse.
The consequences are dire – and legion. Frail people are effectively forced to sell their houses, even as councils restrict entitlement so savagely that judges rule the retrenchment unlawful. Nobody knows what they will be entitled to should they need help, so all must live in dread. Everyone agrees that it cannot go on, but then everyone has for years – and yet nothing has happened. Money, of course, has always been the problem, and in appointing Mr Dilnot, a former director of the Institute for Fiscal Studies, the coalition no doubt wanted to make sure it would receive recommendations that were properly mindful of the austere public expenditure outlook. And so it has. But if, as some grumbles emanating from the Treasury now suggest, Whitehall had been banking on Mr Dilnot regarding the deficit as a reason to do nothing at all, then it was sorely mistaken.
The proposition is not that taxpayers should foot everything. There is no delusion about some sacred right to bequeath property. The big idea is rather the community insuring individuals from catastrophic costs in return for individuals paying a very sizeable excess of up to £35,000. Often the state will take that excess by claiming a share in the home. That will be controversial, but so be it. The vast profits made from bricks and mortar must play their part in meeting this pressing need. The point is no one should lose everything. Besides the universal £35,000 cap, that same principle leads Mr Dilnot to propose smoothing the cliff-edge of a means test which poorer pensioners are currently shunted over.
This is in many ways a modest agenda. Questions about the fit with the NHS, excess charges for board and lodgings, and the lunacy of running care homes as property investment vehicles are for another day. But a narrow focus on staving off the ruin of an unlucky minority keeps the price down to 0.25% of state spending. That is affordable, particularly if pensioners' blanket exemption from national insurance is qualified. David Cameron is desperate to prove he can be a social reformer as well as a deficit cutter. Mr Dilnot has provided him with an opportunity that will not be bettered.
Source http://www.guardian.co.uk/
Rich in evidence and pithy in prose, it was dismaying to hear No 10 meet this powerful report by murmuring that care was "complex and difficult". Yes, the byzantine current system defies comprehension and common sense, but that is why ministers appointed economist Andrew Dilnot to head the commission which has now reported. The insight he has applied is in fact arrestingly simple: that the core problem here is the reality that we are all uninsured.
Where a quarter of us will need no old age care at all, and half will incur bills that ought to be manageable above the breadline, one in five retirees will go on to clock up total costs of more than £100,000 – sometimes several times that. It is no use hectoring people to save prudently. No one of ordinary means can afford to put aside enough to foot the biggest bills, which is why a minority see out their days by losing everything they ever had. Mr Dilnot points out that life is littered with potential financial catastrophes, from costly-to-treat illnesses to house fires, but that in all other cases the risks are pooled, whether through the state or the insurance market. With care, however, the market balks at the virtually limitless liabilities involved. The state, meanwhile, tries and fails to muddle through, under the auspices of 1940s legislation which was concerned with humanising the Victorian workhouse.
The consequences are dire – and legion. Frail people are effectively forced to sell their houses, even as councils restrict entitlement so savagely that judges rule the retrenchment unlawful. Nobody knows what they will be entitled to should they need help, so all must live in dread. Everyone agrees that it cannot go on, but then everyone has for years – and yet nothing has happened. Money, of course, has always been the problem, and in appointing Mr Dilnot, a former director of the Institute for Fiscal Studies, the coalition no doubt wanted to make sure it would receive recommendations that were properly mindful of the austere public expenditure outlook. And so it has. But if, as some grumbles emanating from the Treasury now suggest, Whitehall had been banking on Mr Dilnot regarding the deficit as a reason to do nothing at all, then it was sorely mistaken.
The proposition is not that taxpayers should foot everything. There is no delusion about some sacred right to bequeath property. The big idea is rather the community insuring individuals from catastrophic costs in return for individuals paying a very sizeable excess of up to £35,000. Often the state will take that excess by claiming a share in the home. That will be controversial, but so be it. The vast profits made from bricks and mortar must play their part in meeting this pressing need. The point is no one should lose everything. Besides the universal £35,000 cap, that same principle leads Mr Dilnot to propose smoothing the cliff-edge of a means test which poorer pensioners are currently shunted over.
This is in many ways a modest agenda. Questions about the fit with the NHS, excess charges for board and lodgings, and the lunacy of running care homes as property investment vehicles are for another day. But a narrow focus on staving off the ruin of an unlucky minority keeps the price down to 0.25% of state spending. That is affordable, particularly if pensioners' blanket exemption from national insurance is qualified. David Cameron is desperate to prove he can be a social reformer as well as a deficit cutter. Mr Dilnot has provided him with an opportunity that will not be bettered.
Source http://www.guardian.co.uk/
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