From Rationing to Rights: Creating a Universal Entitlement to Aged Care

• Published date: 01 June 2021
• Author: Stephen Duckett,Anika Stobart
• Date: 01 June 2021
• DOI: http://doi.org/10.1111/1467-8462.12424

The Australian Economic Review, vol. 54, no. 2, pp. 257–265 DOI: 10.1111/1467-8462.12424

From Rationing to Rights: Creating a Universal Entitlement to

Aged Care

Stephen Duckett and Anika Stobart*

Abstract

This article presents an argument for creating

a universal entitlement to aged care.

Following the Royal Commission into Aged

Care Quality and Safety, significant reform of

Australia's aged care system is needed. The

current policy of rationing care must end,

because it leaves too many older Australians

without the level of care they need. It should

be replaced with an aged care system that is

underpinned by an objective to support the

rights of older Australians, including their

right to independently assessed, government

funded, reasonable and necessary needs‐

based care. This more equitable approach

will require a massive boost in government

spending to ensure all older Australians get

the care and support they need, when they

need it.

1. Introduction

Australia's aged care system is an important

part of the country's health and social infra-

structure. It supports 1.3 million people over

65 years of age with daily living and nursing

care (Aged Care Funding Authority 2020). It

is the responsibility of the Commonwealth

Government to manage and fund the system

under the Aged Care Act 1997. Three main

programs provide a spectrum of support, from

home support through to residential care,

costing the Commonwealth Government

$19.9 billion in 2018–19 (Aged Care

Funding Authority 2020).

Despite this significant cost, the recent

Royal Commission into Aged Care Quality

and Safety found it was nowhere near enough

(Royal Commission into Aged Care Quality

and Safety 2021a). The Commonwealth

Government has for decades pursued a

stringent austerity policy of rationing the

number of residential aged care and home

care places it is willing to support, leading to

the underfunding of care and contributing to

the significant problems in access and quality

we see today.

This article will explore the consequences

of rationing and argue that it needs to be

thrown out in order to achieve real change.

Rather than add another band‐aid, the

Government must turn the system upside

down by making the rights of older

Australians paramount (Duckett, Swerissen

and Stobart 2020a, 2020b). Funding must not

be rationed at the system level but, rather,

* Health and Aged Care Program, Grattan Institute,

Victoria 3053, Australia; email <anika.stobart@gratta-

n.edu.au>

© 2021 The University of Melbourne, Melbourne Institute: Applied Economic & Social Research,

Faculty of Business and Economics

Published by John Wiley & Sons Australia, Ltd