IMO, two significant things have happened since the 1980's with respect to aged care:
-Aged care has been mostly privatised and run for profit since Australia adopted Neo Liberalism in the late 1980s -mental institutions have been closed down and those with a mental disease such as Alzheimers are lumped in with the normal aged residents in aged care.
There are 3 ways that Aged Care for profit derive their income: (a) a straight daily/monthly rate of $150-$200/day. (The upmarket Aged Care homes can cost up to $500/day.) (b) a $400K-$600K deposit in the Aged care Trust Account of which the interest is used + The Government Contribution + 85% of the Aged pension to cover the fees. (c) A Government fee for those without means + 85% of the Aged Pension (This is the most costly for the taxpayer)
Unlike normal hospitals, Community Volunteers are not allowed . This is very unusual IMO, because Community Volunteers are argueably more needed in Aged care than in your average hospital where the average stay is less than a week! I assume that both the Aged Care and the Aged Care resident's family don't want Community Volunteer's for different reasons -the former might regard it as interference & another source of whistleblowing and the latter a threat to inheritance.
IMO, there is a common practice of declaring Granny "incompetent" and therefore electing a family member as her family as "Power of Attorney" to preserve her current will days before sending her to Aged care. This prevents Granny from changing her will or offering her home to others who would care for her at home.
The only power an old person has to prevent family from sending them into aged care when the aged person does not want to go there is to disinherit the family members and favour others via her will who volunteer to look after her.
IMO, this is where a death tax is necessary. , Its not fair for Granny who owns an average house say worth $600K to have that capital preserved for her inheriting family who wont look after her in her old age but when she dies pocket the $600K when the taxpayer has already paid a sizeable %age of aged care cost.
Let's look at the 85% of aged pension + the interest on say $500K in the Aged Care Trust Ac:
The Aged Pension is about $700 a fortnight with trimmings & the interest on $500K is about $7500 per year (1.5%)# That's a total of $25.700 P/A which falls short by nearly $30K P/A on the daily rate of $150.
This is why it is ridiculous for family to inherit say the $500K deposit when Granny passes way when the taxpayer has been left to pick up the tab.
IMO, If the Aged Person with means (say a $600K home) had to pay the real cost of aged care , then there would be a bigger incentive for the inheriting family to look after Granny at home.
We tend to copy the USA & The UK when it comes to aged care but both have 40% death taxes & we have none.
All IMO only
# These Trust sums held by the Private Aged Care corporations (These are not institutions) can be used to offset buildings' debt which is about 3% P/A, IMO.This would mean that a $500K Trust Deposit is worth about $15K P/A
