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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.

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June 28, 2011 Posted by | Carers Strategy, Social Care | , , , , , , | 4 Comments