The States are paying for aged care - whether or not they like it
For decades, the arrangement was simple.
The Federal Government funded aged care. States funded hospitals.
Everyone knew where responsibility began and ended.
Today, that distinction is becoming increasingly difficult to defend.
Across Australia, more than 3,000 older people are occupying hospital beds despite being medically fit for discharge. They don't need acute care. They need an aged care bed, transitional care, a Support at Home package or support to return home safely.
Yet every day they remain in hospital, State Governments pay the bill.
At an estimated cost of around $3,300 per hospital bed per day, that equates to almost $10 million every day, or $3.6 billion every year, spent caring for people who should be receiving support elsewhere.
Suddenly, the actions of State Governments begin to make sense.
In New South Wales, 1,300 older people are waiting in hospital for aged care. This week, the State Government committed $35.3 million towards interim care pathways, aged care placements and at-home support to help medically cleared patients leave hospital.
Queensland has more than 1,000 older people waiting and has invested $581 million over two years to fund 515 interim care beds.
Western Australia has established 146 "Time to Think" beds for older people transitioning from hospital, expanded transition care programs and launched a $100 million zero-interest loan scheme to stimulate aged care development.
In South Australia, more than 400 people are waiting in hospital for aged care. The Government has expanded transition care services, proposed a $250 million no-interest loan scheme for new aged care beds and moved to classify aged care and co-located retirement villages as essential infrastructure.
A pattern emerges
States are funding interim care, transition services, Hospital in the Home programs, virtual wards and aged care development incentives.
Each initiative serves a purpose. Each is designed to improve flow through the system and relieve pressure on hospitals.
The States are spending billions managing the consequences of Australia's aged care capacity challenge.
Very little of that expenditure creates permanent aged care capacity. It does not deliver new Support at Home packages. It does not materially reduce the waiting list of more than 100,000 older Australians seeking care and support.
A transition bed is not an aged care bed. Hospital in the Home is not an aged care bed. An interim placement is not an aged care bed.
They are all designed to keep people moving through a system that lacks the capacity to meet demand.
The uncomfortable reality is that, in the absence of a long-term plan, Australia is becoming better at managing the queue than reducing it.
And for the first time, the States now have skin in the game.
