Late last week, citing anonymous sources, the Australian Financial Review reported the federal government was considering delaying and possibly overhauling its plan to impose a higher tax on superannuation balances above $3 million.

The federal government has not confirmed such a pause, but sources reportedly indicated officials were re-examining the policy amid mounting criticism.

There’s still the opportunity for a compromise. Recent polling suggests more than half of Australians support the government’s proposed changes to the way large super balances are taxed. Yet, many groups remain vocally opposed to the way this policy has been put together, for various reasons.

So, are the government’s plans for reform really in trouble – and what might come next?

How did we get here?

In 2023, the Albanese government announced an additional 15% tax on earnings from super balances above $3 million. This would lift the effective rate from 15% to 30% on the wealthiest accounts.

The government estimated this change would affect a very small group: fewer than 0.5% of super members, or about 80,000 people.

The change was framed as a matter of fairness – superannuation was designed to help Australians save for retirement, not to provide unlimited tax shelter for the very wealthy.

But controversy quickly flared over one unusual policy design choice: taxing unrealised capital gains. This would mean a super member could face a tax bill when the value of their fund’s investments rose — even without selling assets or receiving cash.

It’s a bit like being taxed on the rising value of your house each year, even if you were never going to sell it. Critics argue this breaks with a core principle of Australia’s tax system: gains are normally taxed only when they’re realised.

Behind the backlash

Three major concerns dominate the debate around Labor’s proposed changes.

The first relates to “liquidity” – the ready cash someone can actually use, not just wealth tied up in assets like property or super. Critics say taxing “paper gains” could leave members scrambling for funds to pay their tax bill.

For example, a farmer with valuable land in their super fund might face a large tax bill on rising land values, even if they had no cash from a sale to pay it.

The second is the complexity of compliance. Super funds would need to revalue diverse investments every year, from listed shares to property and private equity. This would add significant cost and compliance burdens for funds and for the Australian Taxation Office.

The third concern relates to “bracket creep”. The $3 million threshold central to this policy is not indexed.

As wages and prices rise over time, more Australians will be caught by the policy, even if their relative wealth hasn’t grown. It’s like a coffee that may have cost $3.50 a decade ago now costing $5.50. The coffee hasn’t changed, only the price tag.

In the same way, someone with a $3 million super balance in 20 years won’t be as wealthy as that figure implies today. Together, these concerns have driven industry pushback, fuelled media backlash, and rattled the government.

Alternative options

Indexing the $3 million threshold to inflation or wages would be one easy way to stop “bracket creep” and restore fairness over time. But indexation doesn’t solve what is arguably this policy’s biggest flaw: taxing gains before they are realised.

If the government does decide to pause and redesign its planned reforms, several alternatives are on the table:

Only taxing ‘realised gains’

Super members would pay the extra tax only when assets are sold and profits “crystallised”. This removes liquidity pressures, but may reduce short-term revenue and encourage investors to delay selling — the so-called “lock-in effect.”

Using ‘deeming rates’

The government could assume a notional rate of return called a “deeming rate” on super balances above $3 million and apply the extra tax to that. Deeming rates are fixed percentages the government uses in certain situations to calculate the assumed income from a person’s financial assets, regardless of what those assets actually earn.

This approach, already used for pension means testing, is simple and predictable. But choosing the right rate is tricky: set it too high and savers are overtaxed; set it too low and the government loses revenue.

Putting hard caps on super balances

Another option would be to set a maximum balance, say $3 million or perhaps $5 million, that could remain in the concessional system. Anything above this amount would need to be withdrawn and invested elsewhere.

This is straightforward in theory but politically sensitive: no government likes telling people they’ve saved “too much” and now have to pull money out of their preferred account.

The bigger picture

This debate is about more than tax mechanics. At stake is the very purpose of superannuation. The superannuation system was designed to provide retirement income, not to serve as a tax-free inheritance vehicle or wealth shelter. Extremely large balances stretch that purpose and risk undermining public trust.

It also raises issues of generational fairness. Younger Australians – already struggling with housing and unlikely to accumulate multimillion-dollar super balances – are effectively subsidising tax breaks for a wealthy few.

Politically, the government also faces a credibility challenge: constant tinkering erodes confidence, but poorly designed reforms do the same.

A combination or hybrid model of the options discussed here could be explored to balance simplicity, fairness and revenue needs. For example, indexing the threshold and also using a deeming rate to calculate returns.

The principle is clear: very large balances should not enjoy the same concessions as ordinary retirement savings. The challenge is finding a design that is workable as well as fair.

Natalie Peng, Lecturer in Accounting, The University of Queensland

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

You may have lived in Australia for most of your adult life, speaking English every day. But if you acquired the language later in life and then develop dementia – a brain condition that affects thinking, memory and everyday function – you may lose fluency and find the language you spoke as a child takes over again.

For many migrants, this is the confronting reality. Language loss affects not only how they communicate with doctors and carers, but also how they connect with family, friends and the world around them.

More than one in four (28%) people living with dementia in Australia is from a culturally and linguistically diverse background.

This means language changes in dementia aren’t a niche issue – they affect thousands of families. It is estimated that 411,100 Australians were living with dementia in 2023.

How does dementia affect language?

Dementia can cause changes to speech and language, and these are often early symptoms. People may repeat themselves, have trouble finding the right word, switch topics unexpectedly or use words in unusual ways.

But these language changes can affect bi- or multilingual people differently.

Dementia usually affects the parts of the brain that store more recently acquired skills, including languages.

Languages learned during childhood are more deeply embedded in long-term memory than recently acquired skills.

This means someone who moved to Australia in their 20s and then learned English may lose their ability to speak it when they develop dementia later in life. But they may retain the ability to communicate in a first language – such as Italian, Arabic, Greek or Vietnamese – and revert to using only this.

Losing a second language means more than losing a skill. Migrants with dementia may be losing part of the life they’ve built, returning to a version of themselves from decades ago, which family and carers might not recognise.

The language gap in dementia care

While interpreters are widely available in aged care and to assist people with dementia, most lack specialised training.

Without this knowledge of dementia-specific communication, even skilled interpreters can struggle to communicate tone and meaning and recognise dementia symptoms.

Trained health interpreters are scarce outside major cities, and in regional areas family members are often heavily relied on.

But interpreting for a loved one with dementia is no easy task. Research shows family carers from culturally and linguistically diverse backgrounds face added stress thanks to language and cultural barriers. Many provide unpaid care and feel isolated.

For instance, a daughter caring for her mother with dementia might struggle to understand medical terms, while at the same time dealing with her own grief and exhaustion.

Some elderly people may also not want to discuss personal health details in front of their children or other relatives.

Burnout is a huge issue for family members and can sometimes lead to errors in care.

So, what works?

Evidence shows dementia-aware language services and culturally responsive care can help reduce stress for carers and improve quality of life for people living with dementia.

In a 2023 clinical trial, Australian researchers co-designed and evaluated specialist online training for interpreters. These included modules on dementia, aged care and cross-cultural communication.

The study found the training significantly improved the quality of interpreters’ communication during cognitive assessments of people with dementia, which are used to work out what supports someone might need.

This training has since been made available for free to all interpreters in Australia. At least 13% of the active interpreter workforce has completed it so far.

Dementia Support Australia also provides language support for people with dementia and their carers, arranging interpreters, translated materials, and Auslan services when needed.

There are also various initiatives in different states and territories, such as the “language buddies” program in Victoria which help people with dementia reconnect with community.

But we still need to do more

Despite these positive developments, there is still more to do to ensure diagnosis and support for people with dementia are not delayed due to cultural and language barriers.

We need to continue expanding supports, including:

1. Specialist dementia training for interpreters: to handle repetitive speech, non-linear conversation and culturally specific expressions.

2. Language and dementia awareness training for health workers: to understand why language loss happens and how to adapt care to address cognitive decline and also consider overall wellbeing.

3. Better matching of interpreters: including age, dialect and cultural familiarity, especially in dementia-related contexts.

4. Expanding the bilingual workforce: hiring more health-care workers who share the languages and cultures of local communities, particularly in rural, regional and remote areas.

5. Culturally tailored dementia resources: booklets, videos, and support groups in multiple languages, co-designed with community members.

Fahad Hanna, Associate Professor in Public Health, Torrens University Australia

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

A new test could help to diagnose memory issues associated with Alzheimer’s disease in as little as three minutes. According to recently published findings the test, called the Fastball EEG test, may one day help doctors flag people who need further checks for Alzheimer’s disease without the need for unnecessary waits or time-consuming procedures.

Alzheimer’s disease affects millions of people worldwide. It’s a progressive condition, in which brain cells are slowly damaged and die – leading to memory loss, confusion and difficulties with thinking and daily tasks.

The disease process begins long before symptoms manifest. Proteins called amyloid and tau gradually build up in the brain, forming plaques and tangles that interfere with communication between nerve cells. By the time memory problems are significant enough for diagnosis, much of the damage has already been done.

It’s important to note that the signs of Alzheimer’s disease and symptoms don’t develop similarly in all patients. This means the amount of amyloid plaques and tau tangles a person has in their brain doesn’t always match the severity of the disease.

In addition, the amount of plaques and tangles can only be estimated via imaging or blood tests. These factors make Alzheimer’s disease difficult to diagnose and predict how it will progress. This is why researchers are keen to develop tests that can spot signs of the disease earlier.

Traditionally, diagnosis has relied on cognitive screening tests, where a doctor asks a patient to remember words, copy drawings or complete problem-solving tasks. These tools are effective, but take time and require trained staff. They may also be stressful for the patients and can be influenced by factors such as a person’s education level, their language skills or test-related performance anxiety.

More advanced diagnostic options, including brain scans and laboratory analysis of cerebrospinal fluid (a fluid which protects the brain and spinal cord), can indicate the presence of Alzheimer’s disease in the brain. But these tests are expensive and invasive.

But the Fastball EEG test uses a different approach.

Instead of asking patients to actively recall or solve problems, it measures how the brain responds to images flashed on a screen. Participants first see a set of eight pictures, which they’re asked to name but not memorise.

Then, during the test, hundreds of images are shown in quick succession – around three per second. Every fifth image is one of the eight previously shown. The EEG headset records the brain’s electrical activity, picking up tiny signals that reveal whether the brain recognises these familiar images.

In healthy people, the recognition response is clear. But in people with mild cognitive impairment (problems with thinking, memory or problem-solving which often precedes Alzheimer’s disease) and especially those with memory issues, the response is weaker.

To understand the test’s suitability, researchers recruited 106 participants to their study. This included 54 healthy adults and 52 people with mild cognitive impairment (MCI). Among the latter group, some had memory-specific problems (amnestic MCI), while others had difficulties unrelated to memory – such as problems with attention (non-amnestic MCI).

The researchers found that the Fastball test was sensitive enough to distinguish between these groups. Those with amnestic MCI showed significantly reduced brain responses to the familiar images compared to healthy adults and those with non-amnestic MCI. In other words, the test quickly identified the kind of memory impairment most closely linked to early Alzheimer’s.

They then repeated the test a year later. Some of the participants who’d only had mild cognitive impairment in the first test had progressed to either Alzheimer’s disease dementia or another type of dementia, called vascular dementia, which manifests in symptoms similar to Alzheimer’s.

The researchers also asked the participants who developed dementia to perform the standard cognitive tests currently used to diagnose Alzheimer’s. These participants showed no or little difference in this test, which means the test wasn’t sensitive enough to detect the transition from mild cognitive impairment to dementia. But with the Fastball test, the participants performed marginally worse than they had previously.

However, of the 42 participants with mild cognitive impairment who repeated the Fastball test a year later, only eight had transitioned to dementia. So, although the results are very promising in illustrating the test’s accuracy, they should be interpreted with caution as they’re based on a small number of people.

The future of diagnosis

Crucially, the test is fast – lasting only three minutes. It also doesn’t rely on the participant’s effort, mood or test-taking ability, which can influence cognitive test results. It can also be done at home or in a GP’s office, which might reduce anxiety for patients and make it easier to reach a larger group of people.

However, the study did not include other conditions where memory impairment is also present – such as depression or thyroid problems – so it cannot be used as a standalone diagnostic tool for Alzheimer’s disease. Future studies in more diverse populations which take these other conditions into account will be needed to better understand the test’s strengths, limitations and potential.

Other tests, which are currently in development, may be better for diagnosing Alzheimer’s disease specifically. For example, blood tests could transform Alzheimer’s diagnosis once they’re more widely rolled out.

These measure proteins linked to Alzheimer’s and can give a snapshot of disease processes happening in the brain. Some tests currently being studied would only require a finger-prick of blood. If they prove to be accurate, this could mean patients could do these tests at home and mail them in for analysis.

Tools such as the Fastball test and blood tests could help shift the focus of Alzheimer’s care from late diagnosis to early intervention. By identifying people at risk of the disease years earlier, doctors could recommend lifestyle changes, monitor patients more closely or provide them with appropriate therapies earlier, while they can still make the most difference.

Eleftheria Kodosaki, Research Fellow in Neuroimmunology, UCL

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