Longer life. Greater well-being. Biohacks that slow aging. All of these advances and more are promised by researchers, health care providers and social media. But what they usually don’t mention is that healthy life expectancy – the average number of years a person can expect to live in "full health" without chronic disease or physical limitations – is headed in the opposite direction.
For example, late baby boomers (1960-1965) reported more chronic health problems (at the same age) than mid baby boomers (1954-1959), who in turn reported more health problems than early baby boomers (1948-1953), who had more problems than those born during and immediately after World War II (1942-1947).
This trend of more chronic diseases at the same age extended back to the beginning of the 20th century. In essence, the average person today has more chronic health problems than their parents did, and the number of health problems is increasing even more in younger people. There is a socioeconomic component to this trend – chronic disease is more common among disadvantaged people – but there are tens of millions of middle- and upper-income adults who are less healthy than their parents.
How can this be, given improvements in medical care? Three reasons.
First, older adults in recent generations are more likely to have conditions that increase the risk of disease, such as obesity, inactivity, unhealthy diets and diabetes. Second, screening tests identify diseases that would not have been detected in the past. Third, better medical care allows people with multiple medical conditions to live when they would have died in the past, thereby increasing the number of chronic conditions among survivors.
Points of engagement
Here’s what this means for financial advisors and their clients.
More people will live longer than their parents, but for many of them, relatively more years will be spent living with and managing multiple chronic conditions.
Some middle-aged people won’t be able to work until the normal retirement age, and working after retirement to supplement income may not be possible for some retirees.
Health care costs will be higher for many people. This alone will increase the strain on retirement nest eggs, but the issue is compounded by underfunding of Medicare. Future retirees should plan on some combination of reduced benefits and greater cost shifting to beneficiaries, higher Medicare copayments, coinsurance and deductibles, an increase in the Medicare payroll tax (for pre-retirees), and Medicare premium surcharges (income-related monthly adjusted amount) that affect more retirees.
Some older retirees will need both family-provided care and paid care at an earlier age because of the cumulative effect of decades of health problems. Much of this care will be paid for out-of-pocket because it will not qualify as “long-term care” since the degree of disability will be less than required by HIPAA criteria.
Robert Pokorski, MD, MBA, is a consultant and public speaker with expertise in longevity, long-term care, and the decline of cognitive and financial ability at older ages. He specializes in educational meetings for financial professionals and consumers. He may be contacted at [email protected].