Comment by DaiPlusPlus | Hacker News Reader

Comment by DaiPlusPlus | Hacker News Reader

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> adult social care crisis, a pension crisis, and in some areas a rundown NHS

I remember about 10 years ago, "the idea" was that retirees would, as their health starts to decline, do equity-release in their homes to pay for their care needs (on the basis that the NHS would start to means-test care based on the value of all assets, including housing, so that if an OAP has £1m locked-up in their house and they probably have less than 5-6 years to live it's only fair that they liquidate some of that wealth instead of expecting the NHS to pay for everything - while those who don't own their own houses, would still benefit from free NHS care).

I left the UK just-over 10 years ago (but I still visit my parents a few times a year and do the WFH-thing-but-abroad) so I'm not as clued-in on subtler points of public policy, but I'm curious if that's still the case? ...or if the Tories reversed that decision in the 8 years they've held power? (after-all, it would be anathema to Daily Mail readers, who give me the impression that they fully expect to enjoy their house-prices even after they're dead).

Theresa May tried to sell this as part of her election campaign. It was a disaster. No one wants to be forced to give up some of their personal wealth to pay more for an NHS they've already paid into.

That may not be fair, but when most voters are property owners you're not going to get a different outcome.

This is an interesting topic because it highlights how the political and economic culture is broken and incapable of effective national strategy. I don't think housing, health, industrial policy, education, or anything else can be fixed without a complete overhaul of the UK's political parties, media, and systems.

> Theresa May tried to sell this as part of her election campaign. It was a disaster. No one wants to be forced to give up some of their personal wealth to pay more for an NHS they've already paid into.

It's not as simple as "give up some of their personal wealth to pay more for an NHS they've already paid into". If you have 20K in your bank account and no property, you have to pay for your care. If you own 2 flats worth 1M each and have 10K in your bank account, you pay nothing. The so-called "dementia tax" would have make this situation fairer. Besides, they wouldn't have to release equity while alive, but the cost of care would be paid by the heirs upon selling or inheriting their parent's property.

Imagine a scenario where you have 20K in your bank account. You child inherits only 10K, because you had to pay for your care. Now imagine you have 2 flats and 10K in your bank account. Your child gets the whole lot. Does this look fair?

Theresa May, that, as far as I'm concerned, should be sent to the Hague for architecting the hostile environment for foreigners, had only one non-demented idea in her entire political career: making social care fairer, and that's what killed her premiership. I can't think of a more emblematic example of what is going on in the UK.

They already paid for NHS during their active period. Why should people have to pay again, once retired? If you request them to pay for healthcare, after they are retired, then you shouldn't ask them for money during their active period.

Because they paid £15k for their house in 1974 and it's gone up to £1.5 million through no special skill of their own. Their life expectancy has also increased 10 years in that time due to NHS advances so they will be living longer and costing much more than before to care for. The calculus as to what they own and what they owe has changed dramatically just during their life span.

Welcome to the beautiful world of empty, overconfident political promises that are smashed against the rocks of reality 30 years later.

This is why I plan to finance my own retirement and consider a minimum social security pension a happy bonus.

This is obtuse; you're ignoring the observation that people with sufficient cash have to pay now, and the contrast with property owners. Sure, you may think it's unfair that anyone has to pay after having paid taxes, that's a legitimate opinion I happen to share. But just stating that and ignoring the rest of the GP post isn't helpful.

> Does this look fair?

No, but because we should end means testing completely. I thought NHS meant you didn't have to do all the things we have to do here in the US.

A few years ago, I had to do an annual wellness exam so I could keep my health insurance "discount" at work. There was some miscommunication within the three parties: 1. Doctor's office 2. Lab 3. Insurance and I had to act like a mediator between them. I thought that was bad enough but NHS sounds worse now.

The Conservative government that's been in power for 13 years has consistently underfunded the NHS. While the current vogue is to blame Covid, it's only been the final crack in a dam that's been bursting for years now.

It seems like maybe they didn’t pay in enough - baby boom demographics meant there were relatively more productive workers paying for relatively few old people, so each worker was paying a fraction of what it would cost to carry themselves through old age.

Also, not enough kids, and of those, not enough who wanted to go into medicine.

It seems like baby booms have a way of making things seem artificially good for a while, and then there’s a hangover.

> It seems like maybe they didn’t pay in enough - baby boom demographics meant there were relatively more productive workers paying for relatively few old people, so each worker was paying a fraction of what it would cost to carry themselves through old age.

Right but manufacturing technology better and more efficient, we produce far more "per worker" now

Yeah, but I don’t think we’ve seen commensurate gains with healthcare workers, except by perhaps reducing visit time per patient.

Perhaps the inference is that the owners of industrial technology should be paying more taxes on their profits, since the proportion of labor as an input is shrinking.

But getting people to pay twice for public services is a core way to increase tax revenue!

The core way that pushes this cost onto the working class.

It’s I my broken because our electoral system favours conservative outcomes. If we had proportional representation then many of the issues that seem impossible would suddenly become easy to solve.

Edit: in before anyone asks for evidence of favouring conservative outcomes: Boris Johnson had a landslide 80 seat majority with only 43.6% of the popular vote. PR would mean more coalition governments, but those would largely be left leaning Labour/Lib/SNP even when the conservatives have higher than historically average vote shares.

So people are expected to pay twice for healthcare, just because they own a house?

No. At the moment it's people who don't own a property and have savings instead who "pay twice". People who couldn't get a mortgage to buy a house so saved instead are expected to pay more towards old age care than those who did get a mortgage to buy a house. The proposed policy change was to rebalance the current rules which greatly benefit property owners over involuntary renters of similar means, to make the rules fairer.

See https://news.ycombinator.com/item?id=36489768

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