Column: Will increasing longevity change the way you live?

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If you knew you were going to live to 100, how would it affect the way you live your life? Today, very few people have such certitude. But according to a provocative new book, “The 100-Year Life,” more and more will, as sustained longevity gains continue adding years to our lives.

More significantly, British academics Lynda Gratton and Andrew Scott argue, the prospect of such long lives will become part of younger people’s life view. It’s one thing if an 85-year-old concludes she will live to 100. But if a 25-year-old is convinced she still has 75 years of life in front of her, the implications are likely far more substantial.

We already are seeing a sustained deferral of marriage and childbearing decisions until later ages. The movement of people into full-time careers in their 20s likewise seems more and more to be delayed until their 30s. More research needs to be done about the extent to which people are changing behaviors because they believe they will live longer.

For example, it is easy to chalk up some trends to economic upheaval and related pressures. People with attractive career paths, especially women, are swayed by the logic of spending additional years cementing their professional futures before having families. Those without such appealing paths — of which there are far too many these days — may be forced to bunk in  at their parents’ homes.

As a result, a snapshot of people in their mid-30s today can look a lot like a picture taken 30 years ago of people in their mid-20s. There is, of course, no single image that can capture the diversity of ways people choose or are forced to live their lives. And who would want to travel along such a narrow proscribed path anyway?

The point here, and the point of the book, is that such changes have occurred and will more and more become the new normal. Yes, technology and shifting economic realities certainly play a role here. But, Gratton and Scott argue, so does the inexorable conclusion that longer and longer lives are in store for us.

I have some quibbles with this book, which has been shortlisted by the Financial Times as a candidate for the best business book of the year. Trying to suss out the ways that longevity will change our lives requires a better crystal ball than they (or, certainly, I) possess.

It’s also very hard to separate the effects of longevity from the impact of technological change. In an email exchange, Stone agreed with this, but said longevity gains deserve more of a marquee placement than they’ve received.

“Every generation tends to benefit from better technology and longer longevity. However, the technological change seems disruptive and discrete and so is much discussed, whereas the longevity is slow and constant and tends not to be of much focus.”

Quibbles aside, I have no argument with the growing likelihood that living to 100 someday will be a ho-hum milestone or that people and institutions should be spending more time thinking about how they need to prepare for these added years.

I also think the authors are on sound ground when they argue that the basic units of modern life must change. These units, which they describe as a “three-stage life,” include education, work and retirement. I think you could toss childhood into that first stage if you like and look at it as a period of development and preparation that younger people must complete before they’re ready to be on their own.

Likewise, there are broader models available in the second and third stages. For many people, the work stage of their lives also includes raising families — hardly an inconsequential afterthought. The broader point is that people spend their first 20 years or so in stage one, their next 40-plus years in stage two and the rest of their lives in stage three.

In a 100-year life, however, retiring at 65 is not feasible for most people. They simply do not have the financial resources to afford retirements lasting 35 years. They also may not have the patience to spend so many years on the sidelines of a life where they had long been active. We’ve already begun seeing responses to these pressures.

More people in their late 60s and 70s have remained in the workforce. Investment and job losses caused by the Great Recession are often cited as a powerful driver of this change. But looked at through the lens of “The 100-Year Life,” the possibilities of longer retirements also emerge as a factor.

The three-stage life increasingly will not be a workable model for people who must anticipate longer lives. Instead, the authors argue, people will be developing multi-stage lives. They will feel increasingly comfortable, but also practically driven to break their careers into more pieces, moving in and out of the workforce and going back to school to maintain and sharpen job skills. Parents will adopt patterns of shifting domestic duties among partners to spend more time with their younger children.

As people approach their mid-60s and 70s, they too will need to develop additional stages of life. We’re already seeing this in today’s “encore careers” movements. It will need to expand further in a world of longer life spans. Here, the risk-taking and entrepreneurial mindsets now associated with younger people could be adopted by people in their 70s and 80s.

“Imagine you will have two or three different careers,” the authors write, “one perhaps when you maximize your finances and work long hours and long weeks; at another stage you balance work with family, or want to position your life around jobs that make a strong social contribution. The gift of living for longer means you don’t have to be forced into either/or choices.”

This liberating longer-life view is, of course, much more feasible for highly educated and better-compensated people. For those on the lower rungs, choice is not so much the word that comes to mind. Without economic resources and options, the prospect of living to 100 is not so much fun. Worries about running out of money or of illness-plagued decades can predominate. Touting multi-stage lives to such folks can be a cruel form of humor.

“The danger is that the gift of a long life will only be open to those with the income and education to construct the changes and transitions required,” the book notes. “It is therefore crucial that governments begin now to construct a package of measures to support those less fortunate.… It is unacceptable that a good long life should only be an option for a privileged minority.”

In practice, of course, that seems exactly what will happen in the near term. If government does step up, such actions are not likely to occur until long after that better-enabled minority has been playing and winning the longevity game for some time.


“Why Forcing People to Text to Log Onto Their Social Security Account Was a Mistake”

Social Security changed its mind last week and withdrew a hastily launched requirement that people needed to use their smartphones to access their online Social Security accounts. The Social Security Administration seems to have a tin ear when it comes to evaluating public needs and preferences and certainly did so here. Millions of people were unable to comply with the new rules nor fathom why it was needed. The agency’s motives were commendable. Increasing the security of personal wage and benefits information is important. But this effort was not well conceived. (Source: Mark Miller for Reuters via Money.)

“Private Equity Pursues Profits in Keeping the Elderly at Home”

Can the profit motive succeed where good intentions have fallen short? A potentially marvelous Medicaid program to help frail and mostly older people stay in their homes is about to find out. It’s called the PACE program, an acronym that stands for Program of All-Inclusive Care for the Elderly. Medicare does not pay for nonmedical long-term care services, but Medicaid does. However, the government’s tab for nursing-home care can be very steep. Rather than putting people into nursing homes, PACE provides them with at-home support services and provides transportation for them to a PACE center, where they can receive medical care, counseling and a daytime program of activities. All of these services, it turns out, can be provided for less money than a nursing home would cost. Not only does the government save money, but the quality of life enjoyed by PACE participants can be superior. Historically, PACE programs have been run by nonprofits, and not many people are enrolled in them. Recent regulatory changes have allowed for-profit companies to create PACE programs. Now, attention will be focused on how these companies balance the prospect of making money off of PACE participants with the quality of services they provide. (Source: Sarah Varney for The New York Times in collaboration with Kaiser Health News.)

“Are insurance policies saving patients money, or keeping them from the treatment they need?”

In an effort to save money, Medicare and other health insurers have the right to require doctors and patients to try less expensive drugs and procedures. If these efforts do not produce good results, people are then free to try progressively more expensive therapies until they find one that works for them. In a world of costlier medicine, these “step therapy” programs are likely to become more widespread. So, too, will be concerns that patient welfare is being sacrificed in the interest of corporate profits. (Source: Bob Tedeschi for STAT.)