My overall principle is that people who can afford to pay for their nursing home care should do so.
Counter to this: The state asks ALL of its citizens to contribute to the provision of essential care so that coverage will be available to ALL of its citizens, should they need care.
Assumption: Nursing home care is essential care.
Justification: The state funds it for citizens who cannot fund it for themselves.
I don't know if I will need nursing home care, or cancer treatment in a public hospital, or access to expensive prescription medicines for a condition. These are unpredictable, unplanned for events of unpredictable duration and cost. The same applies to all citizens.
As a society we are pooling the risks to disperse the costs of access to essential care among all citizens.
We ask a fair and proportionate contribution from all citizens towards coverage. But we do NOT ask citizens to pay the full costs of these claims where this would be a significant financial burden.
It is reasonable to charge fees to access services to ensure they are not abused.
It is reasonable to seek co-payments (relative to means) where services are accessed in the market, so that citizens can determine for themselves how best to address their needs.
Neither of the above are intended to cover the full cost of the care.
e.g. look at the prescription model which covers all citizens - either you have medical card or your prescription costs are capped. Even if someone could afford to pay €1000 a month towards their medication, we do not ask for this, given the nature of the care they are accessing.
I think that 'all or nothing' structures, such as proposed here, inherently are more likely to lead to povery traps and dependency. Further, it is undermining to society if half the people feel they are carrying the other half and getting no thanks or help in return.
I think such an approach is more likely in the long run to lead to a 'free for all' approach, where everyone must look after their own needs.
If that is the case, let us give fair warning now that the state will not be there for ANY of its citizens, and you should start making provision now for you own coverage.
It is unreasonable and wrong think that people will work hard and help out others if at the end of the day, they are left with nothing for themselves and no help is forthcoming when they need to access care.
When it comes to essential care, either we are all in this together, and the State (republic?) stands with us - or let us know that we all must stand alone.