Nobody yet knows the new pay equity regime’s administrative cost. But we have a pretty good estimate of the costs of the pay equity settlement for the aged care sector: about two billion dollars.

Pay there was going to have to increase to attract more workers to serve an aging population – which perhaps discouraged the government from simply legislating around the TerraNova decision. But there is a better way to improve pay for home-based care workers, to reduce overall cost, and substantially to improve conditions for both carers and clients.

Those needing government-funded home-based care, and their families, have little say in who comes into the home to help: they get who the DHB contractor sends. You have more choice in who will be your plumber than in who will assist with your bathing.

Enter MyCare.

MyCare’s website lets carers post the kinds of jobs they can help with, and clients post about the help they need. Then they find each other. About 3500 care workers already are registered through the MyCare system, posting their credentials and hourly rates.

The system takes a small commission but provides a lot of value in exchange. MyCare helps its self-employed contractors find local jobs to suit their skills and availability.

It also handles service records and invoicing, manages their tax obligations, and provides liability and indemnity insurance for workers paid through its platform. On the client side, family members can easily find and coordinate care for elderly or disabled relatives.

And carers there earn more than they would earn through DHB contractors: because clients and their families manage more of their own care, overheads are lower.

But if your home-based care is government-funded, you are stuck with the local DHB contractor. And that regime is set to become a lot more expensive, both because of an aging population and because of the TerraNova decision. Costs would be lower, clients would be better off, and carers would earn more as contractors through sites like MyCare.

District Health Boards should revisit how they handle home-based care. A self-directed system running in parallel to the traditional model would respect able clients’ agency by allowing them choice and more control over some of their own decisions.

And if it means that the TerraNova decision is a bit less costly, so much the better.