This is good, really good and it is I hope , going to be read by those who control the spending on welfare in this country.
Adult social care in the UK is under real pressure — underfunded, means-tested, fragmented. There’s no clear or predictable way for people to prepare for the costs of care in later life. As a result, too many are left exposed:
- Families (often women) shoulder rising unpaid care responsibilities
- People with healthy pensions and savings are reluctant to spend them
- Private insurance is niche, expensive, and largely unpopular
We need a better solution, one that supports personal responsibility, public sustainability, and family dignity.
💡 A New Idea: Portable Care Savings Accounts
Imagine a “CareSaver” — a personal, portable savings scheme dedicated to funding long-term care needs. Much like a pension, but focused on social and personal care rather than income.
These accounts could follow you through life, accumulating funds to be drawn down when care is needed. For those on lower incomes, contributions could be matched or topped up by the state. Individuals could also choose how and when to use their CareSaver funds, for home-based care, family support, or residential services.
It’s not a new idea globally. In fact, Germany and Japan have shown what’s possible when countries take long-term care planning seriously.
Germany: Long-Term Care as a Shared Responsibility
Since 1995, Germany has run Pflegeversicherung, a mandatory long-term care insurance scheme:
- Funded through payroll taxes, split equally between employers and employees (~3.4%)
- Covers 90%+ of the population
- Benefits are portable, and users can choose between home, institutional, or informal care
- Has helped reduce reliance on means-tested systems and family burden
Japan: Universal, Needs-Based, Community-Oriented
Japan launched its Long-Term Care Insurance (LTCI) scheme in 2000:
- Publicly run, funded through taxes and premiums from people aged 40+
- Universally accessible, with entitlements based on assessed need
- A clear, transparent system that has expanded access while easing pressure on hospitals and family carers
- Designed to support care at home and in the community
What Could a UK “CareSaver” Look Like?
A UK portable care savings scheme could sit alongside the current 8% auto-enrolment pension contribution, forming part of a broader, modernised social protection package.
Key features could include:
✅ A parallel workplace care fund, with opt-out enrolment and employer contributions
✅ Drawdown linked to verified care needs, not retirement age
✅ A “partnership model”: personal savings cover moderate care costs, and the state covers catastrophic ones — as proposed by the Dilnot Commission
✅ Transferable funds within families to support spousal or parental care
✅ Care credits for unpaid carers — boosting CareSaver pots for years spent caregiving, similar to a “Carer’s Pension Boost”
This approach would better reflect how people actually age, work, and care, and shift the narrative from care as a private risk to be feared, to one of shared responsibility and dignity.
Looking to the Future: Community-Based, Person-Centred Care
Any care funding reform must also align with service reform. That means:
- Shifting from institutional to home- and community-based care
- Integrating long-term care with health and housing services
- Investing in digital tools, prevention, and reablement
- Supporting informal carers with training, respite, and financial recognition
From Cost to Contribution: A New Social Contract on Ageing
The UK has an opportunity, and a need, to rethink long-term care not as a looming liability, but as a shared, planned-for responsibility.
By introducing a portable care savings scheme like CareSaver, the UK could build a fairer, more transparent, and more sustainable system that (1) encourages early preparation, (2) supports informal carers, (3) reduces fear and financial insecurity and (4) promotes dignity, independence, and choice.
We don’t need to start from scratch. We can learn from Germany and Japan, and adapt their lessons to the UK context. The moment for bold, practical innovation in how we fund ageing is now.
Who is the care service provided by in Germany and Japan? If it is private provision, in UK that would be yet more money to Tory donors to take maximum profit for minimum service – like assylum hotels, school meals, etc. Tax payers sre verh poorly served by private businsses with shareholders
Care services are provided by a mix of public, private and not-for-profit organisations.
Germany and Japan both have mandatory, social long-term care insurance systems, established in 1995 and 2000 respectively, to address their aging populations.
Key differences, however, exist in how their care services are structured and accessed.
Germany’s system is a universal and equitable funding model based on need, with care provided by a mix of public and private providers, while Japan’s system provides benefits to everyone over 65 or those aged 40 and over with age-related disabilities, regardless of income, with user contributions being capped.
Social care in Japan is provided by a hybrid system that includes both the public sector and private companies, as well as non-profit organisations. The public sector, particularly local municipalities and the national government, plays a large role in administration, funding, and direct service provision, while private companies and non-profits are the actual service providers in the communities.
An Independent Expert Panel commissioned by MPs on the House of Commons Health and Social Care Committee have reported palliative cares services remain inconsistent across the country due to a lack of a national commissioning framework, inadequate funding, and a workforce that is not equipped to meet growing demand.
“Funding was often limited, and patients were rarely supported to plan ahead. Many were not identified early enough for appropriate advice or advance care planning. Although many people prefer to die at home, this occurred in only just over one quarter of cases.”
I can personally attest to this, although in my case the availability of personal funding was not a restricting factor. Even the wealthy need a consistent and supportive system in place at the most challenging time of their life.
Back in the States, we have a comparable mix of public and private, means tested, etc. One development, is to note that the purpose of a purchase of Long Term Care Insurance, typically as an add on to life insurance or an annuity, is to serve as legacy insurance.
Other options exist in the states. Health Savings Accounts (HSAs) already serve as “CareSaver” accounts. Unfortunately, too many Americans live paycheck to paycheck, and as a result, even those who have HSAs, tend not to fund more than what they anticipate spending in the next year or so.
Just as important, although the Democrats tend to believe in mandatory auto enrollment in Roth Individual Retirement Accounts in a number of states, they have no interest/nor plan on support for individual funding of medical accounts, such as HSAs.
Today, the HSA is not only the one benefit that offers the most valuable tax preference, but it is also the one benefit that offers the greatest utility.
https://www.koehler.law/wp-content/uploads/sites/57/2021/05/Towarnicky-Maximum-Utility-Your-HSA-Can-Do-Quadruple-Duty-2nd-Qtr-Benefits-Quarterly-2021.pdf
I am working on an innovative solution to raise up both retiree medical and long term care to the “first tier” of benefits in America. So far, no takers.
Best to you.