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Wealthy residents should pay more for aged care: Taskforce

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Australia needs to adopt a ‘new approach’ to paying for aged care, according to a panel of experts tasked with reforming the way the sector is funded.
 
In its final report, handed down on Tuesday, the Aged Care Taskforce rejected a plan to introduce a tax or levy to fund aged care, instead saying older people should ‘make a fair co-contribution to the cost of their aged care based on their means’.
 
It said it was unfair to expect younger generations to pay for the care of older and wealthier Australians.
 
‘As older people are generally becoming wealthier, intergenerational gaps are increasing,’ the report said.
 
‘Superannuation trends, combined with high asset wealth through the family home and other investments, mean increasingly people still have accumulated wealth and income streams when they need to access aged care services.’
 
While it is yet to commit to the report’s headline recommendation, the Federal Government has already confirmed it will not impose any increased taxes or a new levy to fund aged care costs.
 
Federal Aged Care Minister Annika Wells also ruled out a ‘change to the means testing treatment of the family home for aged care’, but a recommendation suggesting ‘home ownership status’ could be considered when determining contributions has left the door open to other potential reforms.
 
Established last year to review the current funding arrangements for aged care – following a damning royal commission into the troubled sector – the Taskforce was designed to investigate:

• a ‘fair and equitable approach to assessing the means of older people’
• a new home aged care program
• innovations in the delivery of care.

Its final report made 23 recommendations for change, with a priority on underpinning the Support at Home program, as well as making fees fairer, simpler, and more transparent.
 
Other recommendations included ensuring a strong safety net for low means participants to meet costs, funding for daily living needs to cover the full cost of services, conducting research into best practices, and streamlining financial reporting to Government.
 
Dr Anthony Marinucci, Chair of RACGP Specific Interests Aged Care, told newsGP he supported the recommendations, saying they will help to create a more secure and sustainable aged care system.
 
‘I support the goals of more transparency with the ability for one to choose where they should wish to age – in order to achieve this, changes to the current system are required,’ he said.
 
‘We know there are many gaps in the current system, with current funding arrangements not adequately remunerating most stakeholders in the aged care industry. 
 
‘For example, the current Medicare model of fee-for-service does not adequately capture the ongoing care needs many people living in residential aged care require, and often leads to GPs working without compensation for their time.’
 
The Taskforce said Australia’s ageing population will see the demand for care continue to skyrocket, with future generations having high expectations of what the service will look like in the future.
 
It found extra funding is needed to meet these changing demands and deliver quality care but described the sector’s financial viability as ‘poor’.
 
Total government spending on aged care in 2021–22 was $24.8 billion but is projected to more than double over the next four decades.
 
Dr Marinucci said these shifting demographics, as well as increased demand and requirements for high-quality care, are forcing the overhaul.
 
‘With the call for at-home and residential aged care places continuing to rise, the impact on the primary care workforce will be significant,’ he said.
 
‘The only way to support this is to increase funding and implement funding models more appropriate to addressing the ongoing and complex care requirements of this population. 
 
‘This must be an absolute priority for the State and Federal Governments.’
 
In its report, the Taskforce identified a number of problems with home care programs and said they need to be overhauled to meet future demands.
 
‘The current home care programs are not ready to meet the needs of a rapidly growing cohort of older people,’ the report said.
 
It says this has led to a system where applicant assessments are inconsistent and not well aligned to actual need, access to services is inconsistent, and many older people are not receiving an optimal mix of services.
 
‘Those who can access home care under the current system can leave significant funds unspent, while others can wait for months to access services,’ according to the Taskforce.
 
‘This is due to existing program constraints, limited availability of services and appropriately skilled workers, as well as behavioural and attitudinal factors.’
 
In the Home Care Packages Program, unspent funds as of 30 June 2022 totalled $2.3 billion.
 
In response, the Taskforce recommended establishing a fee-for-service model for Support at Home that ensures participants only pay a co-contribution for services received, and for co-contributions to vary based on the type of service accessed.
 
Dr Marinucci agreed, saying it is a particularly complex area of care delivery.
 
‘There are structural issues which need to be addressed, and funding this service seems a challenge,’ he said.
 
‘I think GPs play the most central role in the care of the aged. We are experts in dealing with and coordinating the care required to manage complex comorbidities, burden of chronic disease and end-of-life care that characterise the ageing process.
 
‘Furthermore, throughout each step of the ageing process, it is crucial the continuity of one’s care is maintained to make the most informed and correct decision about their living arrangements at the time.’
 
The Taskforce also referenced workforce shortages plaguing the sector, saying attraction and retention issues are impacting quality care.
 
‘A skilled workforce will be critical to the ability to deliver high quality and person‑centred care,’ it said.
 
Minister Wells chaired the Taskforce and said the Government will now consider its recommendations.
 
‘There is universal acceptance that something must change in order to ensure all Australians can age with the dignity, safety and high-quality care they deserve,’ she said.
 
‘All of us have a stake in a sustainable, high-quality and dignified aged care sector – whether it’s for our parents, ageing loved ones, or even eventually for ourselves.’
 
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