Rights-Based Approach – Australia’s Aged Care Reform

The Australian government has in recent years aggressively pushed forward aged care reform, including the new Aged Care Act, described as a “once-in-a-generation reform.” Originally scheduled to take effect in July 2025, it was delayed by four months and officially came into force on November 1.

Elderly Rights Enter the Agenda

The scale of the reform is significant, with the government investing an additional AUD 5.6 billion over five years. Australia’s previous aged care system was essentially based on government and service providers allocating resources, leaving older people to passively receive care. Service quality was inconsistent, and at one point residential aged care facilities were exposed for “neglect, abuse, and poor food quality.” The reform rewrites the fundamental philosophy of the system, shifting from a provider-centred model to one in which older people are rights-holders, rather than passive recipients of charity.

The new Act lists, for the first time, the statutory rights of older people, including autonomy in decision-making, dignity, safety, culturally sensitive care, and transparency of information. In other words, older people are no longer merely service recipients, but participants with rights, able to make requests and challenge services.

Many Chinese migrants who moved to Australia before or after retirement arrived through their children who had already migrated, or settled in Australia in their forties or fifties through skilled or business investment visas. Compared with Hong Kong or other regions, Australia’s aged care services are considered relatively good. Regardless of personal assets, the government covers living expenses, medical care, home care and community activities. Compared with their country of origin, many elderly people feel they are living in an ideal place. Of course, cultural and language differences can cause frustration and inconvenience, but this is often seen as part of the cost of migration.

However, this reform requires the Australian government to take cultural needs into account when delivering aged care services, which represents major progress. The Act establishes a Statement of Rights, specifying that older people have the right to receive care appropriate to their cultural background and to communicate in their preferred language. For Chinese-Australian older people, this is a breakthrough.

Therefore, providing linguistically and culturally appropriate care—such as Chinese-style meals—is no longer merely a reasonable request but a right. Similarly, offering activities such as mahjong in residential care for Chinese elders is considered appropriate.

If care facility staff are unable to provide services in Chinese, the government has a responsibility to set standards, ensuring a proportion of care workers can communicate with older people who do not speak English, or provide support in service delivery. When language barriers prevent aged care residents from having normal social interaction, it constitutes a restriction on their rights and clearly affects their physical and mental health.

A New Financial Model: Means Testing and Co-Payment

Another core focus of the reform is responding to future financial and demographic pressures. Australia’s population aged over 85 is expected to double in the next 20 years, driving a surge in aged care demand. To address this, the government introduced the Support at Home program, consolidating previous home care systems to enable older people to remain at home earlier and for longer. All aged care providers are now placed under a stricter registration and regulatory framework, including mandatory quality standards, transparency reporting and stronger accountability mechanisms.

Alongside the reform, the most scrutinised change is the introduction of a co-payment system and means testing. With the rapidly ageing population, the previous model—where the government bore most costs—is no longer financially sustainable. The new system therefore requires older people with the capacity to pay to contribute to the cost of their care based on income and assets.

For home-based and residential care, non-clinical services such as cleaning, meal preparation and daily living support will incur different levels of co-payment according to financial capacity. For example, low-income pensioners will continue to be primarily supported by the government, while middle-income and asset-rich individuals will contribute proportionally under a shared-funding model. To prevent excessive burden, the government has introduced a lifetime expenditure cap, ensuring out-of-pocket costs do not increase without limit.

However, co-payment has generated considerable public debate. First, the majority of older Australians’ assets are tied to their homes—over 76% own their residence. Although this appears as high asset value, limited cash flow may create financial pressure. There are also concerns that co-payment may cause some families to “delay using services,” undermining the reform’s goal of improving care quality.

Industry leaders also worry that wealthier older people who can afford large refundable accommodation deposits (RADs) may be prioritised by facilities, while those with fewer resources and reliant on subsidies may be placed at a disadvantage.

The Philosophy and Transformation of Australia’s Aged Care

Australia’s aged care policy has not always been centred on older people. Historically, with a young population and high migration, the demand for elder services was minimal, and government support remained supplementary. However, as the baby-boomer generation entered old age and medical advances extended life expectancy, older people became Australia’s fastest-growing demographic. This shift forced the government to reconsider the purpose of aged care.

For decades, the core policy principle has been to avoid a system where “those with resources do better, and those without fall further behind.” The essence of aged care has been to reduce inequality and ensure basic living standards—whether through pensions, public healthcare or government-funded long-term care. This philosophy remains, but rising financial pressure has led to increased emphasis on shared responsibility and sustainability.

Ageing Population Leads to Surging Demand and Stalled Supply

Beyond philosophy, Australia’s aged care system faces a reality: demand is rising rapidly while supply lags far behind. More than 87,000 approved older people are currently waiting for home-care packages, with some waiting up to 15 months. More than 100,000 additional applications are still pending approval. Clearly, the government lacks sufficient staffing to manage the increased workload created by reform. Many older people rely on family support while waiting, or are forced into residential care prematurely. Although wait times have shortened for some, the overall imbalance between supply and demand remains unresolved.

At the same time, longer life expectancy means residential aged care stays are longer, reducing bed turnover. Even with increased funding and new facilities, bed availability remains limited, failing to meet rising demand. This also increases pressure on family carers and drives demand for home-based services.

Differences Between Chinese and Australian Views on Ageing

In Australia, conversations about ageing often reflect cultural contrast. For many older migrants from Chinese backgrounds, the aged care system is unfamiliar and even contradictory to their upbringing. These differences have become more evident under the latest reform, shaping how migrant families interpret means testing and plan for later life.

In traditional Chinese thinking, ageing is primarily a personal responsibility, followed by family responsibility. In places like Hong Kong, older people generally rely on their savings, with a light tax system and limited government role. Support comes mainly in the form of small allowances, such as the Old Age Allowance, which is more of a consumption incentive than part of a care system. Those with serious needs are cared for by children; if children are unable, they may rely on social assistance or move somewhere with lower living costs. In short, the logic is: government supplements but does not lead; families care for themselves.

Australia’s thinking is entirely different. As a high-tax society, trust in welfare is based on a “social contract”: people pay high taxes in exchange for support when disabled, elderly or in hardship. This applies not only to older people but also to the NDIS, carer payments and childcare subsidies. Caring for vulnerable people is not viewed as solely a family obligation but a shared social responsibility. Australians discussing aged care rarely frame it around “filial duty,” but instead focus on service options, needs-based care and cost-sharing between the government and individuals.

Migrants Lack Understanding of the System

These cultural differences are especially evident among migrant families. Many elderly migrants have financial arrangements completely different from local Australians. Chinese parents often invested heavily in their children when young, expecting support later in life. However, upon arriving in Australia, they are often already elderly, lacking pension savings and unfamiliar with the system, and must rely on government pensions and aged care applications. In contrast, local Australians accumulate superannuation throughout their careers and, upon retirement, move into retirement villages or assisted living, investing in their own quality of life rather than relying on children.

Cultural misunderstanding can also lead migrant families to misinterpret the system. Some transfer assets to children early, assuming it will reduce assessable wealth and increase subsidies. However, in Australia, asset transfers are subject to a look-back period, and deeming rules count potential earnings even if money has been transferred. These arrangements may not provide benefits and may instead reduce financial security and complicate applications—what was thought to be a “smart move” becomes disadvantageous.

Conclusion

In facing the new aged care system, the government has a responsibility to communicate widely with migrant communities. Currently, reporting on the reform mainly appears in mainstream media, which many older migrants do not consume. As a result, many only have superficial awareness of the changes, without proper understanding. Without adequate community education, elderly migrants who do not speak English cannot possibly know what rights the law now grants them. If people are unaware of their rights, they naturally cannot assert them. With limited resources, failure to advocate results in neglect and greater inequality. It is time to make greater effort to understand how this era of reform will affect our older people.