How other nations pay for care
Germany and Australia among the nations who could offer inspiration for bolstering England’s ‘threadbare’ care system
At present, England’s adult care system is “one of the most threadbare in the developed world”, according to Thea Stein of the Nuffield Trust, which has analysed the arrangements of 11 comparable nations and regions. England is an “outlier” in that eligibility for any public funding at all is strictly means-tested.
The most generous system is in Denmark, where the state pays 100% of care costs, with no means test. Those in residential care do get billed for bed and board, but means-tested housing benefit is available.
Australia has a similar system, also funded by general taxation. In most cases, bed and board have to be paid for, but there are a series of daily spending caps on different elements, such as food and hotel costs.
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Japan, with the oldest population in the world, introduced a tax on all over-40s in 2000, ring-fenced for care. Everyone who needs it is given a monthly care allowance. They contribute 10%-30% of costs, depending on income; total contributions are capped.
A similar insurance system operates in Germany, but with no cap. Individuals usually pay half of costs. Unusually, adult children can (in rare cases) be liable to pay for parents’ care if the parents run out of money.
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