This week, we learned older people in home-based aged care will no longer have to pay out-of-pocket for showering, dressing and continence care.

This backflip will provide relief for those currently receiving services under the Support at Home program and the 100,000 or so people on the waiting list for home care.

For people with continence issues, wounds and other issues that make showering essential, this is welcome news and something both advocates and consumers have been calling for.

This announcement comes as the government grapples with the cost of providing health care in various forms, prompting major changes to the National Disability Insurance Scheme, aged care and private health insurance.

In fact, the government plans to pay for increased funding for aged care, including the Support at Home program, by scrapping the additional private health insurance rebate for the over-65s.

One key issue now is how Australia subsidises this type of aged care without shifting excessive costs onto future generations.

Equitable but at what cost?

A key push of the Support at Home program, which started in November 2025, is that people who can afford it should fund more of their own care. The aim of this so-called “vertical equity” is to ensure the system is sustainable.

In theory, this protects funding for those who need it most. In practice, it has raised questions about whether it has undermined access to necessary care.

There’s a list with three types of services requiring the person receiving care to contribute at different levels:

• Clinical support services require no co-contribution, regardless of means. This includes services such as wound care or podiatry.
• Independence (including personal care) requires a contribution of 5–50% of the fee depending on income and assets. This currently includes services such as showering, social support and respite care.
• Everyday living requires the biggest contribution of 17.5–80%. This includes cleaning, home maintenance and gardening.

Let’s see what this means in dollar terms. Currently, if a shower costs about A$100 an hour (not unreasonable given this hourly rate has to include superannuation, travel, workers compensation, for instance), a person on a full aged pension would have to pay $5 per shower and a person at full rates would pay $50.

You can see how this adds up quickly with payments also required for other services, such as cleaning and gardening eating into a fixed age pension. Getting help to shower every day becomes impossible – particularly with higher rates paid at the weekend.

Some people may be able to get friends and neighbours to help with some tasks, such as mowing the lawn or putting out the bins. But showering is intensely personal. It isn’t something you want to have to ask of a friend.

However, the recent announcement means personal care – showering, dressing, continence care – moves from being classified as “independence” which attracted a co-payment to “clinical support”, which requires the participant to pay nothing out-of-pocket.

This ensures a different type of equity, known as “horizontal equity”. In other words, everyone with similar clinical needs can access the same support.

But there’s a flip side. This change means people who could afford to contribute to personal care will no longer need to do so. This increases the share of costs borne by taxpayers.

Why are there different subsidies?

When people start to have difficulty managing their daily activities, they often turn to requesting help doing the cleaning, cooking and gardening rather than working on improving or regaining their capacity to do those tasks.

The idea behind setting varied prices for the different types of services is to shift this pattern.

It’s to encourage people to get the clinical support they need and promote capacity building – via using services with no out-of-pocket costs – so people can continue to manage daily living at home. This may mean bringing in a physiotherapist to help someone move about, and maintain muscle mass and stability, making it easier for them to manage at home.

This logic makes sense early on, where people are capable of reversing or preventing frailty. We want to encourage people to stay active and well. But this isn’t always possible.

Requiring co-payments for support services – such as support to prepare meals or do the laundry under the everyday living category – when capacity can’t be regained can feel like a punitive measure. It’s this part of the funding equation that the latest announcement doesn’t touch on.

How about the future?

Currently, we don’t know if the Support at Home program is delivering its intended effect of increasing access to clinical and capacity building services while charging more for those who can afford it to pay for their care.

But we have a great opportunity to find out. We can compare the types of services people receive under the previous version of the home aged-care scheme before November 2025 (which some people are still on) with the current scheme.

As the Support at Home program matures, we also need to review the level and type of services that attract co-payments. We need to understand if people are forgoing some types of care due to the co-payments and whether other adjustments to the program are needed.

As people progress and need more care, we may need to consider whether co-payments for certain services are still a good idea, or are creating new inequities. As one example, cleaning may need to be provided without a co-payment for people with greater care needs and less ability to pay.

We also need to consider whether wealthier older people should pay more.

A delicate balance

This announcement addresses a clear and important equity concern by removing financial barriers to essential personal care. But it also highlights the delicate balance governments must strike in designing a sustainable aged-care system – one that protects access for those with the greatest needs, while fairly sharing costs across the community.

As Support at Home matures, equity will need to be monitored and government must be prepared to make changes where needed.

Getting that balance right will be crucial to ensuring older Australians can age with dignity, without causing intergenerational inequity by shifting excessive costs onto future generations.

Tracy Comans, Professor, School of Public Health, The University of Queensland; The University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Every few weeks or months, the media reports on a new study that tantalisingly dangles the possibility of a new drug to give us longer, healthier lives.

The latest study centres around a drug involved in targeting interleukin-11, a protein involved in inflammation. Blocking this protein appeared to help mice stave off disease and extend their life by more than 20%.

If only defying the ravages of time could be achieved through such a simple and effort-free way – by taking a pill. But as is so often the case, the real-world significance of these findings falls a fair way short of the hype.

The role of inflammation in disease and ageing

Chronic inflammation in the body plays a role in causing disease and accelerating ageing. In fact, a relatively new label has been coined to represent this: “inflammaging”.

While acute inflammation is an important response to infection or injury, if inflammation persists in the body, it can be very damaging.

A number of lifestyle, environmental and societal drivers contribute to chronic inflammation in the modern world. These are largely the factors we already know are associated with disease and ageing, including poor diet, lack of exercise, obesity, stress, lack of sleep, lack of social connection and pollution.

While addressing these issues directly is one of the keys to addressing chronic inflammation, disease and ageing, there are a number of research groups also exploring how to treat chronic inflammation with pharmaceuticals. Their goal is to target and modify the molecular and chemical pathways involved in the inflammatory process itself.

What the latest research shows

This new interleukin-11 research was conducted in mice and involved a number of separate components.

In one component of this research, interleukin-11 was genetically knocked out in mice. This means the gene for this chemical mediator was removed from these mice, resulting in the mice no longer being able to produce this mediator at all.

In this part of the study, the mice’s lives were extended by over 20%, on average.

Another component of this research involved treating older mice with a drug that blocks interleukin-11.

Injecting this drug into 75-week old mice (equivalent to 55-year-old humans) was found to extend the life of mice by 22-25%.

These treated mice were less likely to get cancer and had lower cholesterol levels, lower body weight and improved muscle strength and metabolism.

From these combined results, the authors concluded, quite reasonably, that blocking interleukin-11 may potentially be a key to mitigating age-related health effects and improving lifespan in both mice and humans.

Why you shouldn’t be getting excited just yet

There are several reasons to be cautious of these findings.

First and most importantly, this was a study in mice. It may be stating the obvious, but mice are very different to humans. As such, this finding in a mouse model is a long way down the evidence hierarchy in terms of its weight.

Research shows only about 5% of promising findings in animals carry over to humans. Put another way, approximately 95% of promising findings in animals may not be translated to specific therapies for humans.

Second, this is only one study. Ideally, we would be looking to have these findings confirmed by other researchers before even considering moving on to the next stage in the knowledge discovery process and examining whether these findings may be true for humans.

We generally require a larger body of evidence before we get too excited about any new research findings and even consider the possibility of human trials.

Third, even if everything remains positive and follow-up studies support the findings of this current study, it can take decades for a new finding like this to be translated to successful therapies in humans.

Until then, we can focus on doing the things we already know make a huge difference to health and longevity: eating well, exercising, maintaining a healthy weight, reducing stress and nurturing social relationships.

Hassan Vally, Associate Professor, Epidemiology, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.