British Prime Minister Andy Burnham pledged on Wednesday to take difficult decisions to overhaul England’s adult social care system, vowing to end unfair high costs that he compared to US healthcare. Burnham held cross-party talks as he accelerates a review of the system, which has left families paying hundreds of thousands of pounds for care. Successive governments have failed to reform the system after previous proposals were defeated by opposition parties that labeled them a “dementia tax” or “death tax.” Burnham did not rule out tax rises to fund the changes, indicating that difficult financial choices lie ahead. The prime minister emphasized the need for a fairer system, acknowledging that the current one places an excessive burden on users. The cross-party discussions aim to build consensus on a sustainable funding model, with Burnham seeking to avoid the political pitfalls that derailed earlier reform efforts. The review, which was sped up following growing public pressure, is expected to propose a range of options, including potential increases in national insurance or other taxes. Burnham’s commitment marks a significant push to address a long-standing issue in England’s social care sector, which has been underfunded for years. The outcome of the talks could reshape how care is funded and delivered for millions of elderly and disabled people.