While the proposal proved to be the election’s turning point, it was as much a response to long-term necessity as political naivety. Its logic was simple: people who need social care should pay for it themselves until the value of their assets, including their home, reaches a floor of £100,000. While a family would never be forced to sell a property during a patient’s lifetime – with the cost being recouped only after death – for many this was tantamount to introducing a new inheritance tax. That led to widespread anger, particularly among their voter base, because while seemingly progressive, the policy created a lottery in how medical services were paid for. If you had cancer the cost of treatment was socialised through the NHS, whereas if you had dementia you were on your own. The Tories included the policy in their manifesto, framing it as painful but necessary, because they incorrectly believed their lead to be unassailable.
And yet there was more to the Dementia Tax than political myopia. The emphatic changes it proposed, which so outraged long-time Tory voters and activists, at least represented a response to the crisis of ageing. Whoever governs, and whatever their ideological views, increased life expectancy and declining fertility rates – two trends which will ultimately impact every society – call into question the viability of socialised health and social care. June 2017 won’t be the last time a major political upset is caused by the politics of ageing.
Any presumption that the leading causes of death will remain static over the next century ignores just how much has changed over the last hundred years. Where infectious diseases like tuberculosis and influenza were once the biggest killers of all, they have retreated, with age-related illness accounting for around two-thirds of global mortality every year.
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