Paying for Social Care

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There is a psychological fact that prevents a sensible economic solution to the problem of paying for social care. It is that people in the UK do not think it right that the value of their house should be frittered away in paying for a pretty pointless existence in a care home. Maybe that care should be paid for out of their assets, maybe not. The fact is that they think it wrong that the value of their house – in most cases their only substantial asset – should disappear needlessly without much being gained in return. They think that the wealth they had hoped to pass on to their children should not be taken away needlessly.

They have a point. A few years in a care home prolongs the end of their lives, but it doesn’t do much else, except drain away their wealth. Kingsley Amis famously said, “No pleasure is worth giving up for the sake of two more years in a geriatric home in Weston-super-Mare.” I don’t know why Weston-super-Mare came in for such stick, but there was a point to his observation. What is the value in a life they see as empty of pleasure, empty of meaning? Mrs. May’s advisor, Nick Timothy, inserted into her manifesto a threat to take away people’s homes to pay for such care, and many showed they preferred Jeremy Corbyn to that happening. Nick Timothy was fired, though some think he should have been burned at the stake for that piece of stupidity.

We should give people the choice. If they prefer to end their life quickly and painlessly and pass substantial wealth to their heirs, we should let them do it. If they prefer to spend what they have on what they see as a valueless existence to delay the inevitable end, we should allow them that alternative. If they were given that choice, polls suggest that the great majority would choose a dignified euthanasia, rather than transfer their money to care home personnel instead of to their children.

The solution to meeting care home costs might be difficult and complicated, as well as expensive. But it should incorporate that choice, and allow people to choose a dignified exit that passes on an inheritance to their heirs. Society should facilitate that choice instead of preventing it.

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17 COMMENTS

  1. A false dichotomy.
    If folk were prepared to care for their parents, there would be no need to divest property or to euthanise our elders. More people could demonstrate how much they love theri folks by caring for them in their dotage. Whilst still maintaining the family’s wealth.

  2. Nick Timothy was another example of people sucking on the state’s teat.

    I have no idea why politicians need SPaDs – aren’t they supposed to be there to represent their constituents not do what some clown with a PPE degree and no experience of the world tells them?

    A better reason to burn him at the stake would be the decision to go for a general election. Although, you could argue that the outcome was what was wanted to water down Brexit.

  3. Dr. Walter E. Williams writes another column today (https://townhall.com/columnists/walterewilliams/2018/05/30/capitalism-vs-socialism-n2484341) starting with the “first principle” that we all own ourselves. He has noted that ownership includes the right to dispose. There is no fake principle like duty to the Homeland or My Values that justifies interfering with a person’s decision to end his life — It is all virtue-signaling by people with no knowledge of the situation.

    I don’t agree that “society should facilitate that choice.” Not legislate physician-assisted suicide (which, like abortion, promises to trample the values of physicians who don’t wish to participate, while maintaining their professional racket by dictating that you can’t do it yourself). Just get out of the way.

    Incidentally, I don’t agree it’s ever true that “There is a psychological fact”. How people feel about selling their homes for end-of-life care is not the issue. That care is overpriced might be. (Home versus Weston-super-Mare might be a gigantic False Choice.) Still separately, Theresa May’s continuing tendency to make keynote policy proposals that enrage her base is remarkable.

    • I don’t see why physicians should not be allowed to assist with suicide. As when you euthanase your pet, the physician would first administer a general anaesthetic before injecting the lethal drug. It is the unpleasantness of most forms of suicide that deters most of us from taking that option.

    • Southerner, I am arguing against “physician-assisted suicide” (the institution, implicitly foreclosing other options and perhaps barring physicians from refusing to participate) — not against physicians to assist with suicides.

    • I wouldn’t let doctors within a mile of this. It’s such an obvious and huge conflict of interest, it amazes me that so many people are convinced that doctors should be the ones to kill us. And that’s before one takes into account what a lot of doctors are actually like.

      Licenced executioners with independent witnesses. Or we’ll end up like the Netherlands.

  4. There’s at least two other issues. Firstly, those who’ve wasted their money or never worked get it for nothing. Secondly, those who pay subsidise the lower fees of those who don’t.

  5. I don’t really understand the objections. Every time I’ve moved from one home to another home I’ve had to dispose of the previous home in order to pay for the next one. Why should it be any different for the very final home I move into?

  6. It is estimated that 16% of people aged 85 or more end up in care homes (Laing and Buisson survey 2016). I assume you are more likely to stay in your own home and receive assisted care? They say care home residents stay an average of 3 years, although one in ten can linger for 8 or more years. A bummer to draw the short straw and end up in a home, but it seems unfair to ask other taxpayers to meet the cost when you have the money yourself … Of course you can say the same thing about elderly patients with assets who are treated in NHS hospitals at great cost to the same taxpayers.

  7. What paulscottrobson said.

    This has nothing to do with paying for your own end-of-life care. Most people who own homes have spent their lives working and paying taxes, and quite justifiedly believe they have already paid for their care. People with assets are in fact being made to pay for the care of those with none, who get their care for free.

    How should we raise our children? Should we raise them to believe they should have a work ethic, become productive members of society, earn money and pay tax on it? Or should we tell them to sponge off the state? If their assets are forfeit for end-of-life care, then the state is actively penalizing the former and incentivizing the latter.

  8. ‘… and quite justifiedly believe they have already paid for their care.’

    Based on what?

    It was understood certainly by my grandparents, parents and my generation that NIC paid for NHS, State pension, unemployment benefit. Nobody believed it would provide non-health related living expenses in old age, which is why people saved and had additional pension plans. When did this change?

    • > Based on what?

      Based on confiscatory levels of taxation. Based on a lifetime of being lectured by every government that their money must be taken to help the less fortunate, and therefore reaching the entirely reasonable conclusion that the same would apply to them if they became in some way less fortunate. We saw in the last election what happens to any party that dares to tell the truth to the electorate over this. That that was the first election that phenomenon was ever observed in implies that previous governments have not tried telling the truth about it.

      > non-health related living expenses

      Well, that begs the question. If you’re in an old-age care home and you get a health problem, do your fees suddenly stop?

      And the rules are much the same for health-related care.

  9. “People with assets are in fact being made to pay for the care of those with none, who get their care for free…”

    I suppose you could say the same about people who send their kids to fee-paying independent schools while being obliged to pay taxes to fund the local grammar. Ditto those who use private medicine.

    • Yes to all of the above. Advocates of government welfare religiously point to the fact that we are “free” to opt for health care when and as we want it, and schools that teach rather than coddle and propagandize. All we have to do is pay twice. That is cold comfort and no justification for some things to be provided for “free.”

    • > I suppose you could say the same about …

      Whilst I agree with Spike, there is a difference here. In your examples, we are talking about paying taxes to pay for others and getting to keep the money you have left over after the taxes. In the case of end-of-life care, we’re talking about the confiscation of the little you have left after that lifetime of taxation.

  10. People who have some money pay their bills. That is called honesty.
    If the community, as a whole, decides to subsidise those who need residential care and cannot pay for it, that is a separate issue.
    I have worked for 50 years so that I can pay my bills and leave something behind as my younger son isn’t good at interviews and is likely to be employed far below his ability for the rest of his life. Regardless of what I should like my wife & sons to do with my spare cash, I think paying my own bills is my responsibility and if it costs money to keep me in a home when I am no longer capable of looking after myself then we shall have to balance out the value of the care home against the cost.
    Anything that gives Jacob Rothschild free residential care at the cost to taxpayers on £15k a year is an abomination.