Please question the PC recommendations!
Forget blind faith! It’s time to ask the hard questions about the PC’s proposed market-based approach to aged care, before it’s too late.
Above: Associate Professor Michael Fine presents at the Anglicare/United Voice forum
By Yasmin Noone
The sector needs to ask hard questions about the Productivity Commission’s (PC) recommended market-based approach to aged care while there is still time to make a difference, a leading sociologist said.
The PC’s recommendations should be thoroughly analysed and questioned in terms of sector sustainability and social equity, the deputy director of the Centre for Research on Social Inclusion at Macquarie University, Associate Professor Michael Fine, said yesterday at the Living on a low income and care in later life, Canberra.
The forum, organised by Anglicare Australia and United Voice (formerly LHMU) explored how a new aged care scheme might better serve the interests and needs of people with a low income.
Prof Fine discussed the limits of a pure market system and questioned whether or not it is suited to aged care, given the unique nature, frailty and vulnerability of the consumer.
“Where is the evidence from aged care that it operates as a market system?” Prof Fine asked.
“Where is the evidence that [an open market system] will provide a better aged care system?”
He explained the difference between aged care and other ‘typical’ markets: aged care consumers often lack the information or expertise to make an informed choice; decisions about aged care are often made at a time of crisis; aged care services are not something that consumers commonly look forward to buying; and the elderly and frail are vulnerable and need protection.
Market forces throughout the sector are not even, given that aged care services vary according to location (rural and remote) and type (special needs, homeless services, dementia care).
Prof Fine said that, according to true market theory, it is also likely that there will be also be a temptation for profit-motivated aged care organisations to respond to consumer demand by choosing to provide more services to those with the money to buy more and pay more.
He therefore argued the case for continued public responsibility.
“We’ll be one of the only [developed] countries in the world without a government-based aged care system if we move to a market system.
“The Australian example will be closer to the US example of health care, where aged care services are variable and many consumers do not access community care services.
“They pay than five times more for their community care than Australia and it only reaches 20 per cent of the population.
“…It’s hard to see how adopting a system like the US will help us.
“It’s also important to note that all of the problems in the aged care system may well have complications for the [broader] health system, where people end up using health services [hospitals and acute care], not aged care.”
Prof Fine also criticised the PC’s proposed market-based model of aged care for being based on assumptions and population predictions, which have not yet been proven or realised.
Firstly, he said, the PC assumes that the ageing population makes the current public financing model unsustainable. Predictions also fail to account for improvements in technology and innovative developments, which could improve outcomes.
Prof Fine proposed an alternative “hybrid market system” in place of the suggested pure market-based system of the draft report and replaced the phrase ‘consumer-directed care’ with the “less emotive but more accurate term, cash for care”.
He also acknowledged the need for more investment in technology, research and disease prevention in the future, as well as a “long-term care insurance, tax, death duties and capital financing solutions”.
“Let’s welcome the grey and be optimistic about the ageing population.
“It’s not a disaster. It’s not a problem…but it’s something to celebrate.”
What rot how often is it that the resident makes the decision to move into high aged care? Most of the time it is done by the family; sons and daughters who are engaging in all types of contracts and engagements. And if they do not understand do what they do know seek independent professional advise.
Open the market and let the clients decide what type of accommodation they want and what they are willing to pay for it. Society and Government have to realize that aged care is broken into two very different sections One is the CARE section that should be over seen by the government. The other is the ACCOMODATION section the clients and client’s families have to decide what type of accommodation they want and what they are willing to pay for. Let the clients decide!!!!