What does NRC think | People in their forties: think about how you will pay for your care later

Seventy may be the new sixty, but sooner or later everyone gets ramshackle. And in 2040, the Netherlands will have 4.7 million over-65s. A quarter of the population. Some families care for an elderly mother, father or brother full-time. But those ‘informal carers’ eventually become overloaded and the children often live too far away to really care. If there are any children.

The Netherlands will therefore need two million healthcare providers by 2040, according to the SER, who visit the elderly to help them dress, wash or take medicine. But also nurses who work in the hospital or at the GP. At the same time, fewer and fewer people want to work in healthcare – see the current staff shortages. The costs will rise colossally. Policy makers have known this for a long time and that is why the care homes have largely been closed after 2015. The fact that the elderly live at home with the help of district nurses is more beneficial for the community than in a home. Only the very oldest elderly are now in a nursing home. And even for them there isn’t always room – at least not in the vicinity.

The new ‘integrated care agreement’, between the government and care parties, is once again trying to limit costs with a view to that future: reimburse less ‘nonsensical’ care (some medical interventions). That’s very sensible. Let the patient pay more himself if he necessarily wants help from someone who is not contracted by his health insurer. This is understandable, but also difficult because waiting lists, especially in mental health care, force patients to turn to uncontracted, expensive care providers. Helping patients more via the computer. This can work out well for small questions, but not for complex ones. And traveling further for medical treatment – ​​annoying when you’re old but also doable in a small country.

The general practitioners and the district nurses, it turns out, do not agree. Because they have had to do a lot more for patients who live independently in their neighborhood since the closure of care homes and mental health institutions. They are often understaffed, so they have to hire more expensive staff or overwork themselves or set a patient stop.

And since the chronic care for sugar and heart patients is no longer provided in the hospital but at the (cheaper) GP, GP and district nurses are also busier. Not to mention all the accountability administration they have to keep. They also do not trust that health insurers will pay the agreed reimbursements.

This conflict cannot be viewed separately from the plans that the government unfolded in July for the future of care for the elderly. ‘Even if possible, at home if possible and digital if possible’ – that’s how it summed up that ‘transformation’. There is talk of robots that remind you to take medicines or a sensor that alerts the district nurse if you have fallen. Provided your WiFi works well.

According to the cabinet, the current elderly care must be phased out because society is aging. “If we keep elderly care as it is, some people will not get the care they need.” So less worry for everyone.

Advice to all those in their forties and fifties to think about how you will purchase private care in your old age. In the worst-case scenario, meager provisions remain – for the most deprived elderly. The rest will have to pay for itself.