{"id":30040,"date":"2026-07-31T04:00:00","date_gmt":"2026-07-31T02:00:00","guid":{"rendered":"https:\/\/www.thebrokernews.ch\/?p=30040"},"modified":"2026-07-27T11:32:36","modified_gmt":"2026-07-27T09:32:36","slug":"longevity-the-sick-span-is-underestimated","status":"publish","type":"post","link":"https:\/\/www.thebrokernews.ch\/en\/longevity-the-sick-span-is-underestimated\/","title":{"rendered":"Longevity: The sick span is underestimated"},"content":{"rendered":"
\"While the grandparents' generation was passive, this generation is actively involved,\" says Nadine Esposito.<\/span><\/div>\n\n\n\n

Ten years between good health and the end of life a period that hardly any insurance company factors into its pricing. Nadine Esposito, founder of Wellthspan Advisory, discusses an industry that still thinks in terms of \u201clifespan,\u201d while its customers have long since been living in \u201chealthspan.\u201d<\/strong><\/p>\n\n\n\n

There are terms in the insurance industry that become outdated faster than the people they\u2019re meant to describe. \u201cLongevity risk\u201d is one such term: technically correct, but blind to what happens in between. Nadine Esposito has coined a distinction for this that is uncomfortably simple. Lifespan is the length of time a person lives. Healthspan is the portion of that time during which they are healthy. And in between lies the sickspan, on average, a decade, during which chronic illnesses, the need for long-term care, and associated costs converge, a reality that hardly any product on the market today addresses.<\/p>\n\n\n\n

Esposito, founder of Wellthspan Advisory<\/a>, has been exploring for years what demographic change means for an industry that traditionally views risk through the lens of mortality tables. Her thesis: Longevity is not just a pension issue, but a systemic risk that is also one of the greatest untapped business opportunities of the coming decades. In this interview, she explains why technical knowledge can be replaced but judgment cannot, why the fastest-growing customer group is largely ignored by product development, and what it means when an industry outlives its own plans. <\/p>\n\n\n\n

Ms. Esposito, you distinguish between lifespan, healthspan, and sickspan. Why is the traditional definition of \u201clongevity risk\u201d no longer sufficient in the insurance industry? <\/strong><\/p>\n\n\n\n

Because it takes only a single number into account: how long someone lives. The classic longevity risk is the risk that people will live longer than the mortality table assumes, in other words, a purely pension-based perspective. It is technically correct, yet it fails to account for what is most costly in economic terms: the quality of those additional years.<\/p>\n\n\n\n

The data is clear. Across 183 WHO member states, the gap between life expectancy and healthy life expectancy averages 9.6 years; in the U.S., it is 12.4 years. I call this decade the \u201cSickspan\u201d: the phase in which chronic illnesses, the need for long-term care, cognitive impairments, and the highest costs all coincide. From an actuarial perspective, the Sickspan is the actual event, and yet hardly any product covers this transitional period. We insure against death, and we finance retirement. In between lies a decade that neither life insurance nor traditional health insurance adequately addresses. <\/p>\n\n\n\n

Anyone who measures longevity solely in terms of lifespan misses the risk precisely where it arises. That is why the industry needs this three-part framework: lifespan as the time horizon, healthspan as the usable time, and sickspan as the phase for which products, reserves, and advice are largely lacking today. <\/p>\n\n\n\n

The average duration of sick leave is ten years, and in the U.S., it is actually continuing to rise. What are the factors driving this trend, and can it be applied to Europe? <\/strong><\/p>\n\n\n\n

Paradoxically, the most important driver is medical success. Today, we survive conditions that killed previous generations, such as heart attacks, many types of cancer, or strokes. Fatal conditions are becoming chronic conditions. Medicine is prolonging life faster than it is prolonging health. Added to this are metabolic diseases and physical inactivity, which cause morbidity to set in earlier, as well as a social gradient: preventive care reaches precisely those who need it most but are least likely to receive it. The fact that the U.S. tops the list at 12.4 years has a lot to do with unequal access to preventive care and primary care. <\/p>\n\n\n\n

The trend is applicable to Europe, but not the extent of it. European systems mitigate the gradient, but they do not eliminate it. And Switzerland should not rest on its laurels: 49 percent of the population has low general health literacy, and the proportion is even higher when it comes to digital health tasks. Prevention is a personal choice, but it is shaped by structural factors. Those who cannot navigate the healthcare system lose healthspan, regardless of their financial means. For insurers, this means that \u201csickspan\u201d is not an American phenomenon to be observed from a safe distance. It is growing here as well, just more slowly and quietly. <\/p>\n\n\n\n

If longevity is a systemic risk, who in an insurance company should really be addressing it today: the actuarial department, product development, HR, or senior management?<\/strong><\/p>\n\n\n\n

The honest answer: all four, and that\u2019s exactly the problem. What belongs a little bit to everyone ultimately belongs to no one.<\/p>\n\n\n\n

“Systemic” means that the risk manifests itself in different forms across every function. In actuarial work, this raises the question of whether models take morbidity as seriously as mortality, in other words, whether we can price sick leave, not just death. In product development, it\u2019s the gap between what the 50-plus generation needs and what\u2019s actually on the shelf. In HR, this issue is twofold: the company\u2019s own workforce is aging, experienced specialists are retiring, and their knowledge often goes with them. And in executive management, it\u2019s a strategic question of whether to manage demographic change as a cost issue or shape it as a growth opportunity.<\/p>\n\n\n\n

My recommendation is therefore clear: Responsibility belongs with senior management, with an explicit mandate that cuts across silos. Not because the functional departments aren\u2019t capable of handling it, but because longevity happens precisely at the intersections: between health and finance, between human resources and product. Silos can solve silo problems. Sick leave is not one of them. <\/p>\n\n\n\n

You founded your own consulting firm, Wellthspan Advisory, to address this topic. What was missing that led you to want to fill this gap, and how does your approach differ from traditional actuarial or strategy consulting? <\/strong><\/p>\n\n\n\n

What was missing was consulting that considers financial and health issues together. Actuarial consulting does an excellent job of optimizing within existing models, but the models themselves address the issue of pensions, not the issue of health insurance. Strategy consulting presents the \u201cdemographics\u201d megatrend in a slide deck, but rarely translates it into products, advisory sessions, and personnel decisions. That was the gap. <\/p>\n\n\n\n

Wellthspan Advisory works with a framework I call Longevity Literacy 2.0: four forms of capital: financial, health, social, and structural, and two mechanisms that connect them. First, these forms of capital shift with age and in response to shocks: diagnosis, the need for long-term care, and death. Second, they convert into one another: financial resources are replaced by health, and care provided by family members replaces money but comes at the cost of earned income. Traditional financial planning treats each of these dimensions in isolation. However, the decisions with far-reaching consequences over the course of a long life occur precisely at these transition points.<\/p>\n\n\n\n

The second difference is the target audience within the company. I work not only with the actuarial department, but also with the people who interact directly with customers, such as advisors and relationship managers. That\u2019s where it\u2019s decided whether longevity remains just a concept or becomes a topic of conversation. <\/p>\n\n\n\n

They say that technical expertise can be replaced by AI, but judgment cannot. Where exactly does that line lie in practice? <\/strong><\/p>\n\n\n\n

The line is drawn where knowledge ceases to be codifiable. Mortality tables, product rules, regulations, tax logic: all of these are documented knowledge, and today, AI can retrieve documented knowledge faster and more consistently than any human. Anyone who bases their professional value solely on this has a problem. <\/p>\n\n\n\n

Good judgment is revealed in what I call \u201cmoments of shock\u201d: a diagnosis, a family member requiring care, or a death. In these moments, decisions regarding various forms of capital, such as money, health, relationships, and legal structures, are compressed into short periods of time under intense stress. That\u2019s when you need someone who listens to what the client isn\u2019t asking.<\/p>\n\n\n\n

A real-world example: An AI accurately calculates a retirement gap. What it fails to recognize is that behind a customer\u2019s seemingly technical product inquiry lies his wife\u2019s emerging cognitive decline, and that the truly urgent issues are power of attorney, full access to bank accounts, and long-term care financing. Recognizing this requires not computational power, but experience with people in exceptional situations. In short: knowledge scales, but judgment does not. For companies, this leads to an uncomfortable reality: the value of experienced employees increases as AI takes over the technical tasks. Yet many are currently planning in the opposite direction.<\/p>\n\n\n\n

What exactly happens in a company when experienced professionals retire without a succession plan in place? Can you describe an example from your consulting experience? <\/strong><\/p>\n\n\n\n

The tricky part is that none of this appears on a balance sheet. There is no line item labeled \u201clost experiential knowledge.\u201d The costs show up in scattered ways, in the form of longer lead times, lost bids, or legal risks, and are rarely traced back to their common cause.<\/p>\n\n\n\n

The irony is hard to miss: An industry whose business is assessing risks leaves one of its biggest risks uninsured within its own ranks. Knowledge loss is more predictable than almost any other risk, since the retirement date is set years in advance. It\u2019s not a lack of predictability, but a lack of priority. <\/p>\n\n\n\n

Companies are looking for a 35-year-old with the knowledge of a 55-year-old. How have you encountered this line of reasoning in your clients\u2019 cases? <\/strong><\/p>\n\n\n\n

The fallacy behind this is more serious than the smile might suggest: experience is treated as a personal trait rather than as a function of time. Experience cannot be compressed. You can\u2019t \u201cbuy\u201d it when you\u2019re younger; you can only make it transferable. <\/p>\n\n\n\n

That\u2019s exactly where I start in my consulting engagements. Instead of looking for the \u201cimpossible\u201d person, we seek out the \u201cpossible\u201d structure: tandems in which an experienced professional and a younger colleague share responsibility. Roles that are divided into those requiring experience and those requiring technical skills. And experiential knowledge that is recorded as documented decision-making cases, not as a process manual that no one reads, but as a collection of real-world edge cases with justifications. There\u2019s no such thing as a 35-year-old with the knowledge of a 55-year-old. Any organization can build a team that combines both, and it can do so today.<\/p>\n\n\n\n

They are calling for a shift in thinking about succession planning, away from linear career paths. What does a succession model look like that anticipates career breaks and fresh starts, rather than treating them as exceptions? <\/strong><\/p>\n\n\n\n

The classic succession model is a ladder: training, promotion, handover, retirement: a linear career followed by a cutoff date. This model assumes a career path that is becoming increasingly rare. With a working life spanning nearly fifty years, disruptions, such as a break to care for a family member, an illness, or a career change at fifty, are not the exception; they are the norm. Incidentally, this is the same logic as in my framework: shocks are not disruptions to the plan; they are part of one\u2019s career path. Anyone who plans for the average is planning wrong.<\/p>\n\n\n\n

A succession model that accounts for this has four components. First, pipelines instead of \u201ccrown princes\u201d: multiple candidates of different ages for key roles, so that a single absence doesn\u2019t derail the model. Second, genuine return pathways: Anyone who steps away for two years to provide care returns to the main track, not a siding. Otherwise, we systematically lose the women of the sandwich generation. Third, gradual transitions instead of a cut-off date: partial retirement with an explicit mandate for knowledge transfer, in which the final years are devoted to passing on expertise, not to winding down. Fourth, \u201cencore\u201d roles: retirees who return for leadership positions, projects, or training. <\/p>\n\n\n\n

None of this is exotic. What’s exotic is just how rarely it’s built systematically. <\/p>\n\n\n\n

Today, four or five generations work at the same company. Where does this actually lead to friction, and where is it more a matter of prejudice? <\/strong><\/p>\n\n\n\n

Let\u2019s draw a clear line. Real friction arises in communication standards, whether synchronous or asynchronous, phone calls or chat, meetings or documents. In the choice of tools. In the pace of decision-making. And in differing expectations regarding loyalty and tenure: Someone who plans to stay with a company for forty years will find it hard to understand someone who thinks in three-year increments, and vice versa. These are real coordination costs, and they\u2019re resolved through explicit agreements rather than appeals.<\/p>\n\n\n\n

In contrast, almost everything related to performance is considered a prejudice: that older people don\u2019t want to learn, can\u2019t handle technology, or resist change. The evidence for this is thin; the differences within an age group are consistently greater than those between groups. Age is a weak predictor of almost everything that matters in everyday work life. <\/p>\n\n\n\n

The real issue runs deeper: Most so-called \u201cgenerational friction\u201d isn\u2019t friction at all. It\u2019s friction between structures designed for a three-stage \u201cnormal\u201d life course (training, working, retirement) and workforces that have long since been living differently. When career logic, continuing education budgets, and performance evaluation systems recognize only linear advancement, the system creates conflicts that are then conveniently attributed to generational differences. Prejudice is easier than structural reform, but only in the short term.<\/p>\n\n\n\n

In your experience, what organizational structures are most often missing that would allow the experience and knowledge of older employees to truly combine with the technological expertise of younger employees, rather than just existing side by side?<\/strong><\/p>\n\n\n\n

More often than not, shared responsibility is lacking. Most companies have mentoring programs, and most of these programs are mere rituals: people meet, they talk, they go their separate ways, but the knowledge stays right where it was. Knowledge doesn\u2019t flow through conversations about work, but through working on the same problems with shared risk. The most effective structure is therefore a mixed team with shared accountability for results: it\u2019s not the older person advising and the younger person doing the work, but both taking responsibility for the same outcome. <\/p>\n\n\n\n

According to this, three unspectacular things are missing. First, time: Knowledge transfer, which is supposed to take place alongside the full workload of daily business, simply doesn\u2019t happen. Transfer requires a time budget just like any other project. Second, incentives: As long as performance evaluations focus only on what an individual produces on their own, sharing knowledge is individually irrational. Those who make their knowledge transferable must be rewarded for it, not just commended. Third, a record: There needs to be a documented archive of decisions that is, real borderline cases with explanations of why those decisions were made. Processes can be written down; sound judgment can only be demonstrated through specific cases.<\/p>\n\n\n\n

None of this is expensive. What is expensive is the alternative: two workforces working politely side by side until one of them retires. <\/p>\n\n\n\n

How should continuing education or knowledge transfer be structured so that it works in both directions, rather than just thinking in terms of \u201cfrom young to old\u201d?<\/strong><\/p>\n\n\n\n

First, regarding perspective: Remarkably, most programs think in only one direction, whichever is most convenient, depending on the topic. When it comes to digital skills, the \u201cyoung\u201d are supposed to train the \u201cold,\u201d and when it comes to technical skills, the \u201cold\u201d are supposed to train the \u201cyoung.\u201d In both cases, one side is treated as the group with deficiencies. That is the fundamental flaw.<\/p>\n\n\n\n

Effective knowledge transfer is an exchange between equals: technological expertise in exchange for judgment, with both sides serving as both teachers and learners. This works best not in the classroom, but through real-world cases: a tandem team working together to resolve a complex claim conveys more knowledge in both directions in three weeks than two separate training programs do in a year. Practical knowledge cannot be passed on through a manual; it can only be acquired through collaborative case work. And digital competence doesn\u2019t stick when it\u2019s presented as tutoring, but rather when it solves a concrete problem encountered in real life. <\/p>\n\n\n\n

Behind this lies an economic calculation: Many companies hardly invest in continuing education for employees over fifty because it \u201cno longer pays off.\u201d This calculation stems from a time when retirement began at 62. Someone who works until age 70 still has fifteen working years ahead of them at age 55, more than some young employees will even stay with the company. The logic behind the payback calculation isn\u2019t wrong. It just\u2019s based on the wrong career trajectory.<\/p>\n\n\n\n

You mention one of the biggest untapped business opportunities of the coming decades. What specific product gaps do you see today among insurers for the 50-plus or 60-plus generation? <\/strong><\/p>\n\n\n\n

The biggest gap is the \u201cSickspan\u201d itself: the transition period between \u201chealthy\u201d and \u201cin need of care,\u201d which lasts an average of a decade. There are hardly any products available today to address this: health insurance covers treatment, long-term care insurance kicks in late, and in the meantime, families bear the costs themselves. Specifically, there is a lack of: bridging products for the early care phase, hybrid products that reward prevention rather than just paying for damages, and solutions for chronic disease management. <\/p>\n\n\n\n

Second gap: cognitive impairment. This is a major financial issue: decision-making capacity, powers of attorney, access to bank accounts, investment decisions, and yet, from a product perspective, this area is virtually untapped. \u201cSupported banking\u201d and insurable retirement planning structures for cases of cognitive impairment could constitute a separate business segment.<\/p>\n\n\n\n

Third gap: the sandwich generation. Anyone caring for their parents at age 52 is converting earned income into unpaid care work. There is virtually no system in place to provide financial security during care breaks that bridges gaps in income and retirement savings. <\/p>\n\n\n\n

And fourth, the wealth side: The largest transfer of wealth in history is, to a significant extent, an intra-generational transfer: in the U.S., of the estimated 124 trillion dollars by 2048, about 54 trillion will first go to spouses, mostly women. Products and advice tailored specifically for this moment, when someone is widowed, wealthy, and often making major decisions on their own for the first time, are surprisingly rare.<\/p>\n\n\n\n

This customer group holds the lion’s share of private wealth, but according to you, it is largely ignored by product development. Why is that? Is it due to the data available, a focus on target groups, or a lack of internal demand? <\/strong><\/p>\n\n\n\n

All three, but not in equal measure. The strongest factor is target-group thinking. The industry\u2019s acquisition strategy is optimized for younger segments: that\u2019s where long-term contracts are signed, and where customer value pays off over decades. A 60-year-old woman is considered \u201cfully insured\u201d, an existing client to be managed, not a market to be developed. The fact that this very customer is facing the most expensive and complex decisions of her life, long-term care, estate planning, housing arrangements, and cognitive health planning, is not factored into this logic.<\/p>\n\n\n\n

The data situation plays a role: For the transition zone of the Sickspan, morbidity data are scarcer than mortality data, and insurers are reluctant to price what is difficult to model. This is a reality, but it can be resolved. The data gap is more of an excuse than a cause. <\/p>\n\n\n\n

What\u2019s most interesting is the lack of internal demand. Product success is measured by new business from younger cohorts; anyone who proposes a product for people 60 and older internally is working against their own success metrics. And there is simply a lack of longevity expertise on the committees: Only about one in four adults is \u201clongevity literate,\u201d and there is no reason to assume that product committees are an exception. You don\u2019t develop products for a risk that you yourself don\u2019t understand. <\/p>\n\n\n\n

What distinguishes this generation\u2019s expectations from those of their parents or grandparents at the same age, particularly with regard to health, travel, and lifestyle?<\/strong><\/p>\n\n\n\n

The key difference: This generation expects to shape their later years, not just manage them. For their parents, retirement was a time of rest: they withdrew from active life, and their expectations for the years ahead were modest. Today\u2019s 60-year-olds plan for twenty to thirty active years: travel, not as a one-time reward but as an integral part of life; working beyond retirement age, often in new ways; second careers, continuing education, and entrepreneurial projects. <\/p>\n\n\n\n

The shift is most evident in the area of health. The grandparents\u2019 generation was made up of patients. Health was something the doctor managed. This generation is actively involved: prevention, wearables, health data, targeted information. At the same time, the demand for self-determination is growing in areas where things get serious: housing in old age, care, and end-of-life decisions. People want to decide for themselves, not have decisions made for them. <\/p>\n\n\n\n

For insurers, this has two uncomfortable consequences. First, this customer doesn\u2019t compare her experiences with insurance from 1995, but rather with the best digital services she uses every day. Second, this group is more heterogeneous than any target group before it: 60 is no longer a life stage, but simply an age. There\u2019s a world of difference between the marathon runner and someone in the early stages of needing long-term care: from an analytical perspective, maintaining a \u201cseniors\u201d segment is about as precise as a \u201cadults\u201d segment. <\/p>\n\n\n\n

When you look back in five years: How would you determine whether an insurance company has embraced demographic change as a strategic transformation or continues to treat it as an HR issue?<\/strong><\/p>\n\n\n\n

Four things, all of which can be observed. First, its integration: Is longevity embedded in senior management with its own responsibilities and budget, or does it appear once a year in HR reporting under \u201cage structure\u201d? Second, look at the product lineup: Are there offerings that address healthspan – not just lifespan – as well as bridging sick leave, prevention, and cognitive wellness, as measured by new business with people over 50? Third, in the workforce strategy: Does it account for transitions, such as return-to-work programs, phased retirements with knowledge transfer mandates, and documented experiential knowledge, or does it continue to quietly let its most valuable capital slip away each year? And fourth, regarding the advisory process itself: Do client meetings address all four forms of capital\u2014money, health, relationships, and structures, or do they continue to focus solely on the portfolio?<\/p>\n\n\n\n

If you want a quicker test, you need only ask one question: How many sick leave years do you project for your own customer base, and which of your products cover them? An insurance company that has an answer to that question has understood the shift as a transformation. One that first has to figure out who\u2019s responsible for it will also answer the question, just not in the way it intends.<\/p>\n\n\n\n

Binci Heeb asked the questions.<\/em><\/p>\n\n\n\n

Nadine Esposito<\/strong> is the founder of Wellthspan Advisory, a consulting firm based in Switzerland and Australia that advises insurers, financial institutions, and other companies on longevity and demographic change. She developed the framework, which integrates financial, health-related, social, and structural resources across the entire life course, and is the author of a scientific publication on the subject. By distinguishing between lifespan, healthspan, and sickspan, she has coined a terminology that places the gap between life expectancy and healthy life expectancy at the center of product and strategy discussions.<\/p>\n\n\n\n

See also: Live Longer, Plan for a Shorter Life?<\/a><\/p>\n\n\n\n

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