Inequalities, inheritance and politics of long-term care: The Fair Deal

The paper analyses the politics of long-term care in Ireland with a unique focus on intergenerational obligations. Ireland is among very few countries that had introduced inheritance clawback clauses in their long-term care funding schemes. With the Fair Deal scheme of 2009 the state covers long term care costs for those in need up front and would claim the costs back from the estate after the elderly person deceases. We ask two main questions: First, which inequalities are emerging around income and wealth redistribution? We estimate micro simulations to show the distributional effects based on income and housing wealth. Overall, nursing home residents with above average pension income and housing wealth benefit from the reform and can pass on more relative wealth to their kin. Second, who are the main political actors and ideas shaping the reforms and intergenerational obligations? Based on in-depth document analysis we trace the policy process and ideational battles. We show that in Ireland intensive lobbying by the private long-term care providers facilitated the introduction of deferred payments from the estate. We argue that Christian democratic parties struggle to position themselves on the issue, between more state support, protecting the family home and individual responsibility.