'User pays' and other approaches to the funding of long-term care for older people in Australia

It has been argued that without some system in which future generations of users are able to pay for their care the cost of services for an increasingly large group of older people will be borne by a declining base of economically active younger people. Is the answer a user pays approach to the financing of aged care, as promoted by recent changes to aged care financing? This paper reviews this concept and its recent history in Australia. On the basis of a brief review of alternative funding systems, it also considers the potential of public and private insurance schemes to increase funding by potential service users and underwrite the long-term viability of funding for aged care services.