Concept of a User Pays System in Aged Care

This article discusses the user pays model in aged care, which is based on the idea that the consumer pays the full cost of services provided. It focuses on the need to promote independence, well-being, and quality life for older people in the most effective way possible. The article outlines the positive and negative aspects of the system and how it impacts the health sector. It also highlights the allocation of resources and the quality of services provided.

Running head; Concept of a user pays system in aged care 1
CONCEPT OF A USER PAYS SYSTEM IN AGED CARE
Student’s name
Institutional affiliation

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The user pays model is an essential feature in the modern world health care systems. It
based on the idea that the most efficient allocation of resources occurs when the consumer pays
the full cost of services provided. Baldwin, et al (2017) explains that this model focuses on the
need to promote independence, well-being and quality life for older people in the most effective
way possible. There are many positive and negative aspects that revolve around this system in
reference to both consumers and service providers.
The aim of this discussion is to demonstrate that proper service provision and resource
allocation is important for older people receiving care. It is generally acknowledged that people
pay for various forms of services and these services vary depending on one’s need. The concept
of user pays system supports the idea of horizontal equity in that someone pays only for the
services that he/she benefits from hence someone does not have to pay services targeting
someone else. Service provision is essential especially in examining cost of aged care services to
consumers. This discussion will be outlining the various aspects of user pays system in aged care
and the effectiveness of this system in health care. It will focus on how services are provided for
the aged and the way resources are allocated to older people receiving health care.
Health is not an absolute factor argues Ravenswood, Douglas, & Haar, (2018) and
therefore is affected by certain factors including age. Since the elderly are part of the vulnerable
population in any society, their health needs to be observed and taken care of. User pays system
provides a way in which their health can be monitored more keenly and in a way that suites the
consumer by the service provider at a certain cost. User pays unlike universal health care or the
principle of ability to pay offers these health services to the elderly in a more effective way since
the consumer pays for a specific health care service.

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Resource allocation usually financial is done with reference to most outstanding medical
needs and the consumer’s preference since he/she pays for the needed service. For example, an
elderly might prefer receiving health care in a nursing home and afford to pay for the service. In
cases where the financial resources are limited the service provider might opt to treat the most
life threatening disorder within an elderly with multiple infections if it falls within the cost paid.
Since most elderly people are no longer working and cannot afford some of this services it is
understandable to have medical covers that cover for these charges at retirement or having family
members who are working pay for them so that they access the services more efficiently as
compares to government subsidies that are not comprehensive to cover for all services (Villarosa,
Wang, & George, 2018).
There are several positive aspects regarding user pay systems in aged care that have
impacted the health sector in the world today. These include a significant decline in mortality
rate of the elderly since the service delivery is more effective. The service provision is done at a
cost that they can afford and at their own convenience. For example they don’t have to travel at
their old age to seek medical attention since medical services can be delivered at their homes.
The introduction of nursing homes has also made services available to the elderly at any time as
long as they pay the required fee.
Medical equipment also become more available to them for those who can afford to
obtain them. User pays system has also decongested public hospitals since the consumers can
access private facilities at their own comfort. The elderly also do not have to depend on
government subsidies so as to access healthcare hence can obtain comprehensive medical care
whenever need arises. According to Greenfield, et al (2016) this system allows the elderly to be
insured for medical covers incases of any emergencies. User pays model has helped improve the

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quality of life of older people by increasing knowledge of prevention of diseases and offering
information on self-management since the healthcare provider becomes closer to the individual
consumer.
Barrie, (2017) holds that the quality of life also improves since the diet can be easily
observed and advised in the user pays model hence preventing diet related diseases that the
elderly are predisposed to such as diabetes, heart failure and stroke. The user pays model in aged
care also helps in preventing emergency related cases that might affect the old since the health
care provider is mostly with the consumer.
The user pays model has also negative aspects despite its positive side. Since the
consumer has to pay a certain amount to receive a particular service it can be considered by some
to be expensive especially when dealing with the old. Since most of the elderly do not have jobs
and have retired they may not able to afford some services that they might be requiring hence
they ought to depend on the working population or government subsidies to cover for them
which might not always be certain.
According to Ratnanesan, et al (2014) the service delivery might not as well live up to the
standards of the consumers. Since they pay for the services, it is expected of the providers to live
up to a certain expectation in delivering the services which might not always be the case as the
service might turn out to be poor or delayed thereby in convincing the consumer. User pays
model in aged care may involve nursing homes where the elderly live together and are taken care
of by non-relatives and this may have an emotional effect on them however minimal since their
relatives are not around especially in cases where the old person care is paid for.

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The care giver may as well not offer enough emotional support since they are just being
paid for the services and not emotional support. The care giver may therefore be deficient in such
areas. There might also be deficiencies in the care giving environment since the elderly are
vulnerable to accidents hence it would cost more to introduce home modifications that allow
easy locomotion and accessibility. It is therefore clear that both positive and negative issues face
the user pays model of care in aged care and that organizations should be keen in minimizing the
negative mistakes that could occur.
According to Blackler, et al (2016) evaluation of the user pays model in aged care in
service provision involves around how the services are provided. Since the old people cannot
properly take care of themselves due to decreased activity and since they cannot move up and
about to seek health care services, the services are mainly brought to them at their residential
homes or nursing homes.
The quality of the services provided is essential and in most cases depends on the cost.
Since the consumer pays a certain amount of money to receive the service, it has to live up to the
expectation of the cost. Therefore in many cases the more expensive a service is the better the
quality of services delivered though it might not always be the case since the cost might be
constant as is the quality of the service provided. However since the service provision is more
direct in this model, the quality of the services provided is good and better than where the
services are more public and free (Nagata, et al 2016).
This model has proven to be more effective as compared to other models since the
service delivery is guaranteed. The aged care service provision is direct and hence there is no
delay since the care giver is payed to look after the elderly. The allocation of health care
resources involves a societal determination of what resources should be devoted to a particular

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program (Williams, 2015). Since it is a unanimous obligation of every society to take care of the
elderly, a considerably good amount of healthcare resources is allocated to the elderly. In the
user pay model, financial resources raised by relatives or individual are targeted to provide care
for the elderly. However, since health care resources are growing scarce rationing is being
directed to the elderly as well by the governments of various countries including the United
States of America.
Sugimoto, Ogata, & Kashiwagi, (2016) have argued that an integral part of a rationing
system is to ration care among the elderly thereby restricting expensive, high technology, life
sustaining care for those who have reached a certain age. Implicit in this argument is the
principle that elderly health care represents an investment of scarce resources with limited
returns.
In conclusion, health care sectors and organizations are working hand in hand to ensure
proper health service delivery is improved for all consumers using the user pays model. There
are several issues both negative and positive raised by this model and organizations look towards
handling them in a more careful manner. The user pays model for aged care is proving to be
quite useful if handled properly. The key focus is seeing the implementation and proper
allocation of resources for aged care. Hence the user pays model needs close attention so as to
minimize the negatives and add on the positives.

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