User pays may be the only way the aged care system can be put on a sustainable footing.
The federal government’s recently released Draft National Strategy for the Care and Support Economy is a breath of fresh air for the aged care and disability sectors.
With both sectors having faced years of often-reductionist and reactive policy making driven by crisis and royal commissions, the national strategy steers the conversation about our rapidly expanding care and support economy to the forefront.
It signals a shift from crisis-driven decisions to an ongoing dialogue for a (hopefully) better future.
It outlines a vision for a sustainable and productive care and support economy that delivers quality care and support with decent jobs.
The strategy explicitly acknowledges: that high-quality care and support services enable people and their families to actively participate in the workforce; the economic and social impacts of care and support systems; and the critical importance of social infrastructure investment decisions, which “provide long-term benefits (returns) as well as wider public benefits that accrue beyond the direct users (infrastructure)”.
The strategy is ambitious and the government is showing it is open to all ideas, hosting a financial sustainability summit to debate the best funding model for aged care over the next 20 to 30 years.
My own view has been aired in this column before.
It’s time to reconcile with the fact that, for the aged care system to be sustainable, we need to seriously consider a user-pays system.
Demand for aged care services is growing, yet 70 per cent residential aged care services operate at a loss and some are quietly closing their doors, particularly in rural and regional areas.
Such an unsustainable trend not only endangers the quality of care provided but also threatens the accessibility of these vital services.
A user-pays aged care system will, no doubt, stir concerns about affordability and access to care.
Yet, at its heart, the idea is rooted in principles of fairness and equity: those who have the capacity to contribute more to their aged care should do so, thereby freeing up public resources for those most in need.
The strategy roadmap reflects the government’s commitment to the sector.
However, a user-pays aged care system should also be part of this road map.
Such a move would necessitate delicate balancing.
It demands innovative thinking, rigorous research, comprehensive public consultations and, most importantly, transparency.
This is not about shifting the burden of care to those who can least afford it, but about creating a system that can ensure the highest quality of care for all.
A user-pays system has the potential to introduce market dynamics that could drive efficiencies and innovation in the sector, while also encouraging competition and improving choice for consumers.
This proposition has always been a hot potato for politicians.
However, there has been a significant shift in public sentiment towards aged care.
The Australian public is now increasingly advocating for high-quality, accessible aged care services and robust discussions about how this might be funded are now possible.
The challenge lies in the government’s ability to articulate clearly and empathetically why such changes are not only necessary but also beneficial, explaining how a user-pays system could function effectively in practice.
By adopting a user-pays system for aged care, we could alleviate the financial strain on taxpayers and the government, foster a more equitable distribution of resources, and drive improvements in the quality of care by ensuring providers are adequately funded.
This is not about offloading responsibility onto our older generation.
Rather, it’s about acknowledging the economic realities accompanying our ageing population and exploring sustainable avenues for delivering high-quality care.
So, the draft national strategy represents an encouraging start, but it needs to engage with the hard truths about our aged care system.
The success of the strategy and the future of that system hinge on our willingness to take on the tough conversations, to include all stakeholders, and to make decisions that reflect our collective values and aspirations.
Only then can we create a care and support system that is truly productive, sustainable, and equitable.
- Amber Crosthwaite is a commercial lawyer specialising in seniors living, aged care and disability
