The Dementia Tax

[mercalia]

Do you think that the tax payer ( meaning you ) should pick up the tab for expensive end of life care for those who are sitting on assets like homes worth maybe £0.25M+?

These days homes should be classified with the Van Goghs and other valuable items?

I have been surprised at the hoha and blatant self centred arrogance of those objecting to Mrs May proposal to include assets in the forms of homes in paying for the expensive care that eg dementia needs. I am totally puzzled that some ( that i heard on news reports ) think they should be able to pass on such valuable assets to their children while expecting the state ( you and me rich and poor as tax payers ) to pay for their care.

[bovlomov]

I am totally puzzled that some ( that i heard on news reports ) think they should be able to pass on such valuable assets to their children while expecting the state ( you and me rich and poor as tax payers ) to pay for their care.

It's a good point, not very different from arguments supporting increased inheritance tax. Those arguments are usually shouted down pretty quickly.

If we agree that the state needs to raise money, it has to come from somewhere. It could come from duties, income taxes, land taxes... ...or from dead people, who, let's face it, don't need it any more. I can't see how taking more from the estates of dead people is more unjust than taking it from living people buying trousers.

Regarding care costs: There are two people. One has worked hard to buy a house, while the other has been lazy or squandered their money. Should the former have to subsidise the latter's care? No! Should the state pay for care, to save assets for the beneficiaries? No! No! Should the children's hope of buying a house for themselves - however hard they work - depend on their inheritance? No! No! No! Is the whole system unbalanced? Yes!

[tatanab]

I believe that EVERYBODY should be treated the same. The minimum acceptable level of support should be available to all, but if you want more then you pay for it.

[thirdcrank]

I suspect that in the very short term, ie between now and the General Election, the problem for anybody raising this issue is that anybody who has not been directly affected by this may only have a vague idea of what the current rules are, which doesn't make for informed debate about any proposed changes. I can't put a date on serial-resigner Blunkett being in charge of this but I remember pretty clearly his announcement on the lines that he knew people were worried about being forced to sell their homes to pay for care so he would put an end to that. What he didn't say, which was obvious to anybody involved in the matter, was that people would be able to obtain a loan secured against their house or other assets. I'm unclear what extra the current proposals involve on that specific issue, other than that TM has included the phrase "in their lifetime."

One point about loans is that there are no loopholes: previously, some heirs with the right lawyer were able to find reasons to resist a sale of assets, which a local authority might balk at contesting with the threat of an expensive judicial review.

Among the perceived iniquities is the fact that local authorities buy care at much lower rates than is available to self-funders. The result is that self-funders may be directly subsidising others in care in the same premises.

I think one solution will come a lot quicker than expected in the form of a revised definition of death to include those with severe dementia. I'm not talking about euthanasia, but rather accepting that anybody whose mind has gone is dead, even if their body would be OK for another decade or so. The reflex response is that it couldn't happen here, but it could and will. Also when it does, I think it will be the floodgates scenario. Shipman threw a spanner into the works by apparently doing it for his own fun and he perhaps concentrated attention on something that had been happening discreetly for a long time, but I'm convinced that's only been a temporary break in the trend. I'd point to the change in attitudes to abortion in the 50 years since 1967.

[Cunobelin]

I believe that EVERYBODY should be treated the same. The minimum acceptable level of support should be available to all, but if you want more then you pay for it.

When my Mother is being paid for by the Council it is £450 per week. However when the Council (erroneously) withdrew the funding tenth cost became £1600 per week for the same care.

Which is the minimum?

[mercalia]

I am totally puzzled that some ( that i heard on news reports ) think they should be able to pass on such valuable assets to their children while expecting the state ( you and me rich and poor as tax payers ) to pay for their care.

It's a good point, not very different from arguments supporting increased inheritance tax. Those arguments are usually shouted down pretty quickly.

If we agree that the state needs to raise money, it has to come from somewhere. It could come from duties, income taxes, land taxes... ...or from dead people, who, let's face it, don't need it any more. I can't see how taking more from the estates of dead people is more unjust than taking it from living people buying trousers.

Regarding care costs: There are two people. One has worked hard to buy a house, while the other has been lazy or squandered their money. Should the former have to subsidise the latter's care? No! Should the state pay for care, to save assets for the beneficiaries? No! No! Should the children's hope of buying a house for themselves - however hard they work - depend on their inheritance? No! No! No! Is the whole system unbalanced? Yes!

is very different I think, with inheritance tax the newly dead person didnt get anything to justify taking anything away? with the dementia tax they have, a very great deal in fact and are just paying for the extra service that the state could never afford to give to every one?

[bovlomov]

is very different I think, with inheritance tax the newly dead person didnt get anything to justify taking anything away?

We get taxed for all kinds of things. The dead person benefited from the taxes paid by previous dead people. If we are to be taxed, they might as well to do it when we're dead. It's more meritocratic, as the living people get to keep more of their hard earned money.

John Major talked about wealth cascading through the generations (as if that's a good thing). But wealth only cascades from the wealthy.

[djnotts]

The detail (i.e. lack of) is such that impossible to make any serious judgement on the proposal. How on earth will it be administered - and by whom? Who will value the asset? How will what in effect be a bridging loan be provided? What will happen to co-ownership versus joint tenancies? How far back will it go in undoing Trust Arrangements? Will only the wealthy be able to arrange their affairs so that buried in a legal morass that will not be worth untangling?

In terms of administration yet another policy disaster in waiting. I doubt it will ever see the light of post-manifesto day!

[thirdcrank]

One very obvious point is that no matter how it's been dressed up, spun, rubbished, it's not a tax on dementia as such. Rather, it's a charge which may be imposed on the increased value of a dwellinghouse. What makes it so sensitive, especially for potential Tory voters, is that they have been brought up to believe that rising house prices are a good thing, from which they will benefit. It's the proverbial Daily Mail take on any news story - "Hole discovered in ozone layer, UK house prices unaffected."

As it's said to be a dead cert that it will be a landslide for our beloved leader, sorry, strong and stable leadership, I'm at a total loss to understand why she's putting her foot in her mouth then shooting herself in the foot now. It risks exposure to leadership coups from the likes of Bozzer who has shrewd understanding of the views of local conservative party associations. The Conservative Party may need to extend its welcome beyond them at a General Election, but they hold the keys to their party's leadership.

djnotts

That's what I meant about many people not knowing what goes on now. 99% of your post is already in place.

[pliptrot]

It is an issue about what we have become as a developed nation. Should a person of any age get cancer then the NHS -the best health service on earth (and test that; look up any criteria you choose on how the NHS performs)- they will be treated for free. " for free" which means free at the point of delivery. Why dementia and the other diseases which strike us down in old age are treated differently is a construct of Governments that choose to avoid their obligations.

[meic]

is a construct of Governments that choose to avoid their obligations.

Their obligations are paid for out of our money. If they meet their obligations, we must pay for it. Dementia can go on for half a decade, needing 24 hour support. The state will still be paying a large fortune meeting the bill for the care of the fraction of the sufferers that they remain fully financially liable for.

[Mick F]

I don't agree with paying anything for health care.
Why is it called Health Care?
It should be Ill Health Care.

You become ill, and the NHS will pay to care for you until you get better no matter how long it takes.
You get a brain injury and remain in a coma, and the NHS will care for you free of charge for the rest of your life.
Cancer? Free of charge to get you well, or they care they for you until the end.

Why is dementia any different?
Is it because there is no cure?
It's an illness just like any other illness.
Is it because the NHS see it as a blank cheque?
Why the discrimination?

No cure for cancer ............ but the end is sooner and cheaper?

I speak with experience.
My mother died of cancer in her 30s.
My father had dementia and died the day after his 70th birthday.
Mrs Mick F's mother had dementia and died in her 70s, and her mother before that who died in her 90s.

[thirdcrank]

I think the official view would be that there's no difference between the way people diagnosed with cancer and dementia are treated (in the financial sense.) When in hospital it's free, which is part of the reason for so-called bedblocking. Elsewhere, medical treatment is free, personal care is means-tested. People with dementia tend to need more personal care and less medical treatment.

A couple of examples of my own from 2015. My mother was in care for the last year of her life. Except for two periods in hospital, the first a few days, the second a few weeks, she had means-tested personal care, with some medical treatment. When her fortune dropped under the magic £23K the tab was eventually picked up by the local authority, with deductions for her pension income. Some time after her death, I received notification from the NHS that for the last fortnight of her life she had needed continuous nursing care so her estate received a refund equal to two weeks deductions. Around the same time, my sister-in-law was diagnosed with terminal cancer. She was moved from hospital to a nursing home paid for entirely by the NHS because she needed continuous nursing care. That's in spite of having an estate large enough to pay inheritance tax. In theory, she was entitled to be in a hospice but was incorrectly told she did not meet the criteria for admission to a hospice when the fact was there was simply no hospice bed available.

[Mick F]

............. medical treatment is free, personal care is means-tested.

Not quoting you personally or picking holes, but the words used.

Personal care?
ie you are fit and healthy, but have a brain disease and need care?

Name some other brain diseases.
Are they all "free"?

https://en.wikipedia.org/wiki/List_of_n ... _disorders

[thirdcrank]

I'm saying the system differentiates between medical care which is free, and personal care which covers things like bathing, help with the lavatory etc., is provided "in the market" and paid for by the recipient, subject to means-testing.

When the situation is reached where continuous nursing is needed, then the NHS pays for the lot.

https://www.gov.uk/government/publicati ... rsing-care

I'm not sure my link is as good as I thought because it includes and emphasises "healthcare" which isn't synonymous with nursing.