Over Christmas and New Year, families gather, take stock and compare notes. One family’s grandfather died after just retiring, but an elderly aunt, who has never taken any exercise, is living well into her 90s and racking up enormous care bills. It is never more obvious that life expectancy, even allowing for the inequalities of class, is still a roll of the dice. The healthy die of the unexpected, while the unhealthy can live well beyond their expected span.

Figures confirm the reality. You could be among the one in four people who, after they reach 65, will spend very little or nothing on their care before they die. Alternatively, you could be among the one in 10 with some endemic ailment who will spend more than £100,000 and, on current rules, be forced to sell your house to pay for the care. In an ageing society, this is beginning to become a politically hot issue.

Nor have the consequences of age and infirmity much to do with virtue, “striving” or your due deserts. If you have been dealt the wrong genes – dementia, say, or some crippling disability – you will be hit however virtuously you have lived, and the care costs could be explosive and long lasting. This is one of the brute hazards of life.

For the pure conservative mind this is just too bad. Life is unfair. There is no such thing as natural justice. We are born into a world of devil take the hindmost: life deals unfair cards and that is that. It is a struggle in which only the fittest survive and any social initiative to soften that struggle diminishes us morally and promotes inefficiency. If you are unlucky enough to have to sell your house to pay for care in old age, too bad – better that than the risk of socialised care.

It is a philosophical divide, with the Anglo-Saxon right on one side and Europeans across the political spectrum on the other. Anti-state, anti-collective action is pitched against the recognition of the reciprocal obligations of society to mitigate the effects of how nature deals her good and bad DNA. But the right should beware. Darwinism is much more subtle than just a hymn to simple individualism: species collaborate as much as compete to survive.

When it comes to care for the elderly, it looks as though early in the new year the coalition is about to shed its fealty to low tax individualism and make a big concession to social reality and Britain’s European roots. After 18 months of dithering, Messrs Cameron and Clegg are set to announce that they want social justice to enter the calculus of how we pay for care in old age.

Economist Andrew Dilnot, now warden of Nuffield College, Oxford, was asked by the government to investigate the issue and delivered an unapologetically rational report, one steeped in the European tradition that emphasised that brute bad luck must be countered by what he called risk pooling. We do not live nor should we in a sauve qui peut society. The state must set a cap and pay any care costs above it, a conclusion that had not found favour with George Osborne.

Nobody should have to pay more than £35,000 for adult social care, Dilnot recommended. Once they have paid that, everyone should be eligible for full support from the state. Only those with assets above £100,000 should have to pay on their own account; below that threshold, people should be given means-tested support. Thus the risk of high care costs would be fairly shared between the state and the citizen and, in particular, the least well off would be protected. It would be a standard system for the entire country.

The difficulty is the cost – an estimated extra £1.7bn rising to more than £3.6bn by 2025/6. The Dilnot report unhelpfully, if logically, offered three unpalatable options – to raise the funds from general taxation, problematic for those apostles of low tax, Cameron and Osborne; to divert spending from other programmes, which is never easy even in good times; or to raise a hypothecated tax from the over-65s – his least favoured option.

We don’t know for sure what the coalition will commit to in the new year, but the steer is that to lower the cost to an acceptable half a billion pounds the government will raise the cap on an individual’s contribution to as high as £75,000, protecting far fewer of the old from catastrophic costs. The well-meaning aims of Dilnot will be somewhat undermined.

For Dilnot must know – does know – that the best way of delivering risk pooling is social insurance and this should have been a fourth option. General taxation is far too clumsy a mechanism through which to pool risk in a way that’s both transparent and legitimate.

Taxation is used to pay for policing, for infrastructure, for defence, for education, for research and development and by default – because we have allowed the national insurance system to wither – social security. To say that part of our taxes – we know not what – is for care in old age is to dodge the political question. You end up with what we have: politicians not daring to do what they must, culminating in a fudge.

It would have been far more radical – and more astute for the future of Britain’s social settlement – if Dilnot had recommended, along with his cap, the creation of an insurance system to pay for care in old age, with everyone paying an insurance premium.

It would have been legitimate, fair and easy for politicians to justify and for the public to acquaint itself with what social insurance means, allowing the principle to be extended as it showed its worth in providing care in old age.

It could have brought together, could still I hope, a handsome coalition of, say, the Observer and the Daily Mail (which on the issue of care for the elderly has abandoned its habitual attacks on welfare in the name of a fair deal for the middle class) and helped relieve growing pressure on the NHS; 70% of bed days are allocated to old people when they should be in local care.

The Labour party, if it dared, still has time to float the insurance idea before the government claims to be taking tough decisions from which Labour has shrunk. There’s still time to make Britain a more acceptable country in which to grow old.

http://www.guardian.co.uk/commentisfree/