All blogs are the views of the author, and do not necessarily reflect the views of Independent Age.

In public policy, the worthiest of intentions are no match for the hard lines of a budget spreadsheet. We know that investing in prevention is better than dealing with the consequences but one-year budgets and three-year spending reviews are one reason why only 4% of the health budget is spent on prevention, and only 6% of spending across government, according to National Audit Office analysis.

There are exceptions. Where governments can make confident forecasts they do take long-term decisions; the most recent example being the Chancellor’s announcement that the state pension age would in future rise in line with average life expectancy, to prevent the bill ballooning unsustainably. 

But ONS analysis released last month revealed that 80-84 year olds in the richest areas of the country are in better health than people twenty years younger living in the most deprived regions. As the state pension age rises the poorest are hit far harder than the richest.

One – clearly impractical – way to address this unfairness would be to give each individual a ‘bespoke’ state pension age, so that we could all enjoy roughly the same proportion of our lives in retirement.

The only other solution is to dramatically reduce health inequalities, so that the state pension age does not discriminate against the most deprived. Poor health in later life not only renders the pensions system unfair, but puts enormous pressure on the acute health and social care budgets and significantly detracts from wellbeing.

So how do we stimulate the same long-term thinking and decisive action in tackling health inequalities that we have seen in relation to reducing pension liabilities? One solution, which the Early Action Task Force suggests in a report to be launched shortly is to tie the two issues together, by legislating to make rises in the state pension age conditional on falling health inequality. This would have two impacts.

First, it would ensure that raising the state pension age did not disproportionately disadvantage the poorest, since the SPA could only rise if the health gap between rich and poor was closing.

Second it would provide government with a strong fiscal incentive to tackle health inequality, since the sustainability of the state pension system would be riding on its success.

Government would be forced to think long term about health inequality and consider investing now in order to save vastly more in both reduced healthcare costs and unsustainable pension payments. It would transform the experience of ageing, from one where a lifetime’s experience culminates in the diseases of old age, to one where we are all ready to thrive and live healthily for longer.

What do you think needs to happen to make the UK the best country to grow older in?

What concerns you most about growing older and why?

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