There is public support in principle for a funding system in which individuals and the State both contribute to long-term care for older people, writes Carl O'Brien, Social Affairs Correspondent.
If you hear a ticking sound in the background, Government policy-makers are likely to tell you it's a demographic time-bomb waiting to go off.
The number of people aged over 65 is set to double between now and 2031. Numbers in care are projected to rise from 84,000 three years ago to 144,000 in 2031, and 203,300 by 2051.
The murky and ambiguous rules of eligibility and entitlement surrounding long-term care for older people have sufficed until now.
However, in seeking to defuse the problems caused by an aging population, politicians will have to face up to fundamental questions of what clear responsibility the family and the State should have in paying for care into the future.
An unpublished report by the ESRI, Attitudes Towards Long-term Care of the Elderly, will be useful in helping to answer some of these questions.
In general, of the 2,063 people interviewed as part of the research, there was a very strong preference for receiving long-term care in one's own home. Over four in five adults felt it was "very important" to be able to stay at home as long as possible. Just 7 per cent felt they should move to a nursing home or hospital.
When asked who should take responsibility for funding long-term care, very small percentages felt the family should take full responsibility, compared to 42 per cent who indicated that the Government should provide full funding. A majority (54 per cent) said the burden should be shared between individuals and the Government.
In general, the preference for shared funding was more characteristic of younger people, those with higher levels of education and those on higher incomes. In contrast, older people and those on lower incomes supported State responsibility.
On the issue of how it should be paid, private coverage by insurance policy received widespread support, with two-thirds in favour and one-quarter against.
When it came to increases in tax or social insurance contributions, it was clear that in principle VAT increases were approved of by only 38 per cent, PRSI increases approved of by 50 per cent, and one-third in favour of tax increases.
While in principle there is public support for various forms of shared funding options between individuals and the State, the limit to which people are prepared to pay appears to deteriorate quickly when actual values for annual increases are presented.
It found that even with modest weekly increases of €4 a week, or €200 a year, almost two-thirds (64 per cent) were opposed to the measure.
When the weekly contribution was raised to €8 per week, or €400 a year, opposition increased to 83 per cent of the overall adult population.
The ESRI report notes that the ground would have to be prepared in marshalling public support using these measures by informing people about the risk of requiring long-term care and the cost of paying for it privately.
Respondents were also asked about various forms of funding partnerships between the family and the State, including "front-end" cover, which involves the State taking responsibility for funding in the initial period of caring and the family stepping in after a certain period, and back-end cover.
There was a clear preference that funding should be provided as long as it is required, rather than for shorter periods as outlined in the front-loaded alternatives.
There was also widespread opposition to the prospect of older people remortgaging their homes or signing up to equity-release schemes. Sixty per cent of people definitively recorded their opposition to such schemes.
Overall, what emerges is a contradictory set of results in which people accept they may have to pay for long-term care costs, but are not willing to sacrifice even modest weekly payments.
As the report itself notes, much groundwork will need to be done in informing people about the costs of private care if the wider public is to accept any increase in social insurance or tax to fund a system which will come under increasing pressure in the years ahead.