Should Dilnot recommend compulsory care insurance?

The Dilnot Commission will report next week on how social care in England should be funded. Currently, if you have assets, including property, worth over £23,500 you will likely pay for social services or residential care. This means a lot of people pay for all of their care whilst some pay for none of their care.

Dilnot is charged with finding a system that will create a “fairer” system that will also encourage people to save for care that they may need. The focus will be on encouraging people to purchase insurance to cover future care costs.

The choice comes down to a voluntary insurance scheme or one where everybody has to purchase care insurance – just like all car drivers must purchase car insurance. Or there could be a voluntary scheme where people are automatically enrolled into it but can opt out.

Politicians will then be left to choose, if they choose to do anything. But what hasn’t appeared in the debate so far, is the role of genetics.

Having a certain genetic profile can make it more likely (but not certain) that you suffer conditions such as Huntingdon’s disease or Alzheimer’s. However, your behaviour can also reduce the likelihood of these so knowing your genetic profile could encourage you to change behaviour and reduce the chance of having various conditions.

Knowing can also help you and your family prepare, which is what one person felt when faced with this experience who I was talking to recently. And genetic profiling will become much more common in the future as costs rapidly decrease.

The impact of this on a care insurance market are obvious. In a voluntary insurance scheme, if you don’t have to share your genetic profile with insurance companies, those most at risk of ill health will take insurance but companies won’t know who has the greater risk so all prices will go up, fewer people will take insurance and insurance companies will leave the market. And in a voluntary system where you do have to tell the insurance company, there could be lots of people who will be refused insurance. They will be discriminated against because of their genetic profile.

However, in a compulsory insurance model where you don’t have to tell insurance companies, people will still be able to know their genetic profile and plan for the future but without fear of discrimination, and insurance companies could spread the risk and costs amongst a greater number of people.

Interestingly in 2003, the Department of Health declared: “As our understanding of genetics advances, the case for private health insurance as an alternative to our universal tax financed NHS diminishes”. It may be the same should apply to social care as well.


June 28, 2011 - Posted by | Carers Strategy, Social Care | , , , , , ,


  1. As soon as any form of ” Care ” is let loose to the private sector , the profit element kicks in to the detriment of all end users.

    Many of us witness this first hand with our carees , both LAs and Charities alike are now pricing far too many out of the market, leaving carers to pick up the shattered pieces.

    Interestingly , social care inside the NHS ( eg. When our caree is admitted to hospital ) remains free at the point of delivery.

    Universal Social Care needs to be put on the same footing as the NHS … FREE … as I consider it an essential for existing in today’s Sad New World.

    Again , like the NHS , those who can afford it ( eg. BUPA ) can always look to the private sector.

    Lastly , if left to market forces , how many more unrecorded abuses similar to the those recently highlighted by Panorama will there be ?

    The Government’s number one priority is to protect it;s citizens …. and yet , we are witnessing an explosion in health \ food \ housing \ transport \ energy costs hardly any of us can afford in our caring roles.

    Government of the people , by the people , for the people …. one out of three ?

    Comment by Paul | June 28, 2011 | Reply

  2. If you look at the example of the USA in terms of healthcare insurance, then you’ll wait a long time for a payout. There has to be a simple system (if insurance is the right way forward) that happens also to be guaranteed to pay out. Or those most at risk will get the least support.

    Comment by charles47 | June 29, 2011 | Reply

  3. Knowing what your GENETIC PROFILE may sound like a great idea but it has hidden pitfalls and dangers. For parents who thinking about a family may be put off from having children. those who are pregnant and have a GENETIC test done may decide to abort a child because of percieved problems,THIS IS TOTALLY WRONG AND IS A FORM OF EUTHANISIA AND DISCRIMINATES AGAINST THE THE UNBORN FOETUS IN THE WOMB.
    As for the insurance companies they will probably decide to deny insurance to certain people they deem to be to much of an INSURANCE RISK.
    As things stand most CARERS of DISABLED FAMILY MEMBERS may find and usually find insurance costs to be very prohibitive and often beyond there means.

    All of the technical detail in the blog is reality an excuse to once again DISCRIMINATE against DISABLED people and CARERS,it is also wrong and evil to deny life to as yet unborn child.
    To proceed down the road the insurance companies want to really go is both MORALLY AND ETHICALLY WRONG.

    MY thoughts and feelings stem from my FAITH IN JESUS CHRIST – my SAVIOUR – my KING

    Comment by Taras Kurylak | June 29, 2011 | Reply

  4. Hi Taras
    The genetic profiling that I am describing above is not genetic screening of foetus. However, you are right to say that there is a risk that people at higher risk of certain conditions could be discriminated against. This is a key point of the blog and why some people say mandatory insurance schemes where you do not have to tell insurance companies your genetic profile if you have had it done is the most workable solution.


    Comment by Gordon Conochie | June 30, 2011 | Reply

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