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On Wednesday, I wrote a story for TDA’s Instagram about a new Government taskforce which will consider ideas for aged care, including whether taxpayers should be asked to pay an aged care levy.

It prompted quite the response. “Can’t boomers just sell an investment property and fund their own care?” asked one reader. “Other than my grandparents I don’t really care about any of them,” admitted another. Others had a different view. “Absolutely I would pay a tax for this,” one said. “We will all need care as we age.”

I thought this deserved a closer look, so I’ve gone a little deeper for this weekend’s column.

In 2018, the ABC’s Four Corners aired gut-wrenching stories of abuse and neglect in Australian aged care homes.

Then-Prime Minister Scott Morrison moved quickly to set up a Royal Commission, a public inquiry to examine the system from top to bottom and recommend a way forward.

In their preliminary report in 2019, the Royal Commissioners did not mince words: all across the system they saw a “shocking tale of neglect”:

“This cruel and harmful system must be changed. We owe it to our parents, our grandparents, our partners, our friends. We owe it to strangers. We owe it to future generations. Older people deserve so much more… [The system] is unkind and uncaring towards them. In too many instances, it simply neglects them.”

By the time the Royal Commission delivered its final recommendations in 2021, this neglect had been put into even sharper focus as COVID-19 ripped through poorly-prepared aged care homes, first in Victoria but eventually across the country.

The recommendations of Royal Commissions, even when they are not adopted, can provide an authoritative perspective on the way forward on issues of national significance.

Unfortunately, the Aged Care Royal Commission did not deliver that. Its Commissioners were divided, and gave separate, conflicting recommendations on most key questions.

Two years on, the Morrison and Albanese governments have taken steps forward to improve quality for care recipients and conditions for aged care workers, who were also recently awarded a 15% pay increase by the Fair Work Commission. Those tasks are not finished, but progress has at least begun. On another question, how to fund the standard of care we expect, the path is less clear.

The resources the government requires to deliver aged care are substantial and growing.

One reason for this is the changing dynamics of Australia’s population – we are living longer and having fewer children. Over time, that will mean there are more old people requiring care and fewer working-age people to pay the taxes to fund that care.

To see just how stark this change will be, here’s the age breakdown of our population in the 1990s compared to what the Australian Bureau of Statistics expects in the 2060s, when millennials will be starting to need aged care.

There are other reasons, too. One is that we simply desire a higher standard of care than has been the norm before.. When Aged Care Minister Anika Wells talks about the need to get more money into the system, she points to the potential to fund innovative, more personalised models of care like the ones pioneered overseas – like villages designed to allow people with dementia to be out and about without the risk of getting lost.

That prospect is enticing, but the politics of finding the money to fund this will be much more difficult. Two options the government has flagged it may consider include higher taxes for everyone and higher personal contributions from care recipients.

Neither is a straightforward proposition. Young taxpayers, especially those who hold older generations responsible for the climate and housing problems they now face, may be reluctant to fork out more to fund aged care.

At the same time, few would be likely to accept a system where any older Australian had to forgo care in their final years because they couldn’t afford it. Yet whenever the conversation turns to asking participants to pay more, this is the inevitable fear.

Still, there may be some middle ground options. For example, the current system places strict limits on how much care recipients can be asked to pay, regardless of their means. The maximum allowable amount an aged care resident can be asked to pay in fees is $75,000 (although they can also pay a ‘bond’ for their accommodation which is returned to their estate when they die). This means someone with a large house worth millions of dollars and a super balance also in the millions can pay a tiny fraction of their wealth towards their care.

Wells suggests some older Australians have told her they would be willing to pay more if the result is higher-quality care. The Opposition, which was quick to oppose the idea of an aged care tax last week, was more open to considering changes to what recipients were asked to pay. Could there be a bipartisan way forward? We will know more when the new taskforce finishes its work in December.

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I’m sticking with the theme this time! As it happens, I was a public servant working on aged care policy in the year the Royal Commission was announced. At the time, I read this article in the New Yorker which explored the challenges of designing humane aged care for people with dementia. It’s a difficult piece to read at times, but it has stayed with me.