Let’s talk about the value of healthcare – not the cost



Over the past few weeks, the UK has been seized with a heated discussion about the subject of social care and who should pay for it, and how – if it is done through taxation – it should be collected. It will be paid by National Insurance, a tax that focuses on younger and less well-off workers.

For several weeks, the discussion seemed to be nothing more than an outrageous argument over who should open their checkbook to cover the costs. This demonstrated a flaw in our approach to the subject: that we consider the care of others, in particular the care of the elderly, as a financial and fiscal issue, and in particular as a burden.

But what the pandemic has really shown is how many people around the world care deeply and selflessly about our elderly and vulnerable. I say “our” rather than “their” because they are part of our village, of our extended families, of our societies. They are us. We are them. To consider them as a handicap is unfortunate.

For me as an unpaid caregiver – like millions of others in the UK and around the world – this approach to care misses the crux of the matter. People seem to focus a lot more on the cost of care, but the question should be: what is its value? And how to maximize it?

There are many studies on the benefits of intergenerational living for young people and for society. Interaction and engagement have benefits for older people. But here’s the problem: It also has tremendous benefits for young people, giving them a sense of identity, culture, history and space. It builds community bonds and adds a sense of grounding.

Caring for people is skilled and difficult work

A vision of welfare also means the benefits of more jobs, with more value. This is something missing from the conversation. The hours and efforts devoted to care have not been sufficiently discussed. Historically, care has always been a “woman’s job” and is free. And like many so-called “women’s jobs”, they are unpaid and considered without stature.

But taking care of people is skilled and difficult work, and it needs to be assessed properly. Thus, by thinking about the value of care rather than the cost, millions of new high added value jobs can be created. It is part of the growing service economy.

Any discussion of care also means recognizing, supporting and funding the millions of unpaid caregivers in the informal care sector who provide the vast majority of care. Unpaid care of loved ones has a huge impact on caregivers. It is said to have an impact like post-traumatic stress disorder. And there is a ripple effect on families and caregivers’ workplaces.

And when caring for the elderly or vulnerable is added to caring for young children, it is the plight of the “sandwich generation” – those in their 30s and 40s, who care for both their elderly parents and their young. children. This is the time when this generation is most productive in the public space and in the workplace, but stuck with heavy responsibilities. With no one to help them, they get exhausted, take care of their parents and children.

All of this is driven by massive economic, demographic and socio-cultural changes. Our populations are older than they have ever been.

Our understanding of the needs and attitudes towards those to be cared for – especially children and early retirement has also changed. Our societies have changed when it comes to women less at home to look after everyone.

When the UK’s National Health Service was launched in 1948, this was a radical proposition. The first of its kind in the world, it was free at the point of service and based on need, not capacity.

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It was part of a larger radical transformation in establishing a welfare state. In the post-war period, there was a consensus that we needed to do things differently to come out of the devastation of previous years, but also to build something worthy of a future where deprivation, suffering and indignity were reduced and where every person had the right to care, health, education and housing.

As we begin to plan beyond the health needs beyond the pandemic, we need a vision that addresses the type of society we are now and creates a model of care and its role in our families, our communities and our nations. It is not an afterthought or a penalty. It is at the very heart of societies because everyone needs it in one way or another.

When the NHS was launched in 1948, it was transformative. The same happened when education was rolled out for children. Today, our societies need to transform again. It should not be seen as a burden but as an opportunity.

Update: September 17, 2021, 9:00 a.m.



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