The health costs nobody warns you about once you turn 60

Brought to you by Australian Unity.

As a society, we plan remarkably well for the health events of the first half of life. We take out cover for pregnancy, we insure against accidents and sports injuries, and we prepare for the unexpected.

What we don’t plan for, and almost nobody warns us about, is the entirely predictable pattern of health costs that arrives in the second half of life. The wear and tear on our bodies and the slow accumulation of decades of use. It’s like our body is sending invoices for things we did, and didn’t do, in our 40s and 50s. And no one explains that it’s coming or how to prepare.

Think about it. In the first half of life, the money we spend on our health tends to be driven by life events. Some are planned, such as childbirth. And many are unplanned, such as when we break a bone in a fall, play footy and tear an ACL or fall off a bike and get injured. But each of these things is acute, and usually resolved relatively quickly with the right medical treatment.

In the second half, the pattern changes entirely. Health costs become chronic, cumulative and increasingly predictable. The question stops being “what might happen?” and starts being “what is almost certainly going to need attention, and when?”

The answer, for most Australians, follows a fairly consistent pattern. Joints start to ache or weaken, eyes start to deteriorate, ears stop hearing as well, teeth start to crumble. And then there’s the slow management of internal conditions that build up over years until they can no longer be ignored, such as heart disease, diabetes or kidney disease.

Joints: the bills arrive slowly – then all at once

Joint problems are among the most common and most expensive health costs of later life. Osteoarthritis affects about 2.1 million Australians, and the numbers climb steeply with age. Hip and knee replacements are now among the most frequently performed elective surgeries in the country.

The costs are not small. A knee replacement in a private hospital can run to $20,000 or more out of pocket without appropriate cover.

And the demand is only growing as the population ages and as active mid-lifers put more stress on joints that were never designed for decades of running, skiing and high-impact sport later in life.

What’s worth understanding is that joint deterioration rarely happens overnight. It builds over years, often with early warning signs that get managed but not addressed.

The people who do best are those who take those warning signs seriously in their 50s, with physiotherapy, weight management, strength training and early specialist review, rather than waiting until a replacement is the only option.

Eyes and ears: the costs with huge consequences

Vision and hearing changes are so gradual that most people don’t notice them until they’ve already had a significant impact. Financial costs, for glasses, hearing aids, specialist appointments and procedures add up considerably over a decade.

Hearing aids can cost between $2000 and $10,000 a pair, and most Australians need to replace them every four to six years. Cataract surgery, one of the most common procedures performed on Australians over 65, costs several thousand dollars per eye in a private setting. And glasses can cost the average person in the hundreds per year too.

But the costs that don’t show up on invoices are much larger. Untreated hearing loss is now one of the most significant modifiable risk factors for dementia.

Untreated vision loss, which was recently added to the Lancet Commission’s list of modifiable dementia risk factors, can affect your independence, mobility and quality of life in ways that generate an awful lot of other household costs over time.

Investing in your eyes and your hearing is important. Early detection means early intervention, and maintaining your quality of life for longer. Most people don’t see hearing that way. I wish they did.

Dental: the cost that compounds over time

Dental health is one of the most underestimated financial concerns of later life, partly because it sits largely outside the Medicare system and partly because the costs tend to creep up gradually before arriving later in a rush.

Root canals, crowns, implants and extractions are expensive. A single dental implant can cost $4000 to $6000. And dental health in later life is influenced heavily by the habits and treatments of what was done in earlier decades.

That means neglecting your teeth in your 30s, 40s and 50s tends to arrive as a big bill in your 60s and 70s.

There is also a broader health connection that most people don’t know about: poor dental health has been linked to increased risk of heart disease, diabetes complications and cognitive decline. Your teeth are not a vanity item, so please don’t treat them like they are. They are fundamental infrastructure for a long healthy life.

Chronic conditions: the long tail of health costs

Heart disease, type 2 diabetes and kidney disease share common characteristics: they are expensive to manage, they don’t go away, and they are significantly influenced by the lifestyle choices you made decades before.

The financial burden of managing a chronic health condition throughout retirement is substantial. You need to think about this in the cost of medications, specialist appointments, monitoring equipment and, eventually, higher levels of care that you will need in life, potentially for longer.

And note the personal cost, in the form of potentially losing your independence earlier, and grappling with a shorter health span.

The important thing to understand about chronic health conditions like these is that they are rarely inevitable. They develop at your obvious risks points – where you can logically see your genetics and your lifestyle choices combine. And, for most people, lifestyle is the bigger lever they can pull to impact things.

If you make investments into your cardiovascular health, focus on your blood sugar management and try to decrease your weight in your 50s, you will directly reduce the probability of having to manage these conditions in your 70s.

Planning for what’s predictable

I hope I haven’t frightened you. And yet, in some ways I’m hoping I do. Because the health costs we might have to bear in the second half of life are, to a significant degree, quite foreseeable.

That means they can be planned for, financially, through appropriate health cover and by putting aside some savings. And you can plan physically too, by building the habits that reduce both the likelihood and severity of what’s coming.

The Australians who fare best in their 70s and 80s are rarely the ones who were lucky. They are the ones who understood what was likely to happen and started preparing early enough to make a difference.

Bec Wilson is author of the bestseller How To Have an Epic Retirement and the newly released Prime Time: 27 Lessons for the New Midlife. She writes a weekly newsletter at epicretirement.net and hosts the Prime Time podcast.

• Advice given in this article is general in nature and is not intended to influence readers’ decisions about investing or financial products. They should always seek their own professional advice that takes into account their own personal circumstances before making any financial decisions.

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