Funding long term care for elderly people.

Asset testing of elderly people in long term care discriminates unfairly on grounds of age in two ways: only elderly people are charged for public hospital inpatient care and only for elderly people are public health system charges determined by assets not income. In this paper it is argued that the essential requirement for a public health system is that it is universally and promptly available to every person, irrespective of a person's ability to pay. This does not preclude direct charges. The costs for long term care should be met by charges for living and accommodation expenses and any charge for medical and nursing costs should be determined by income and not asset testing. There is no justification for charging for medical and nursing inpatient costs in long term care and not in other areas of public hospital care. If direct charges have to be made for inpatient care, then in the interests of equity, and to achieve adequate funding for the public health system, direct charges for such care should be for acute as well as long term care and for the young and middle aged as well as for the elderly, providing these charges do not preclude any person receiving necessary care.