Australia has known for decades that the baby boomers were coming. We knew when they were born, when they would retire and roughly when they would need aged care. There was nothing mysterious about any of this.
Yet somehow we've turned one of the most predictable demographic changes in history into an aged-care crisis, with rushed reforms, confused consumers, anxious families and providers struggling to explain policies they didn't design. The changes were necessary. The way we went about them was not.
I recently interviewed Professor Susan Kurrle, one of Australia's leading geriatricians, for my Where to From Here? podcast. After more than 40 years working with older people, Susan is remarkably clear about something governments have struggled to explain.
Those of us who can afford it are going to have to pay more for our aged care.
"I'm in your age group," Susan tells her patients. "We are not gonna get this all funded by the government. We have to pay for it ourselves."
I'm 68, so this is personal. And I agree with her.
We have known this for a very long time
In 2005, the Productivity Commission published a major report on the economic implications of an ageing Australia. In 2011, it produced a comprehensive blueprint for aged-care reform, proposing that older people contribute according to their financial circumstances, with protections for those unable to pay.
That was 15 years ago. Since then we've had reviews, taskforces, inquiries, royal commissions and enough policy papers to fill a library. We had the evidence and the time to explain what ageing would cost and who should pay. But we never really had that conversation.
The conversation we avoided
Susan told me about the son of one of her patients. He couldn't understand why his mother should pay for care when she'd paid taxes all her life.
Susan pointed out that those taxes had paid for roads, police, hospitals, education and countless other services. They weren't sitting in an account waiting to pay for her aged care.
For a generation of Australians, the assumption has been that you work hard, pay taxes, retire and government will look after you. That expectation wasn't unreasonable, our aged-care system encouraged it.
But people are living longer, more need support, and the cost of care keeps rising. Some older Australians have substantial housing wealth and superannuation. Others have very little. We need a system that publicly acknowledges both realities.
Instead, we handed people a new set of rules
When Support at Home began in November 2025, older people entering the new arrangements faced a complicated contribution system based on their financial circumstances and the services they received. There were protections for existing recipients and clinical care remained government-funded. These were important features.
But consider the experience. People who had never understood aged care were expected to navigate assessments, budgets, contribution rates and changing prices. Providers had to explain it all while dealing with late policy decisions and unfinished administrative arrangements.
As we've argued repeatedly at Invox, there were serious problems with the design and implementation of Support at Home itself. The absence of a sustained public conversation made them considerably harder.
Had people understood for years that higher contributions were coming, they could have planned and challenged the arrangements on their merits. Instead, many encountered the changes precisely when they needed care.
We still need the conversation
Some aged-care reforms were overdue and some are genuine improvements. But we've confused passing legislation with preparing people for change.
We should have spent the past two decades explaining what longer lives mean for personal finances, housing, family responsibilities and aged care. People in their 50s and 60s should have been encouraged to think seriously about these things.
And we should have been honest that government would continue providing substantial support, while those with the means would increasingly contribute to their own care.
Susan Kurrle has these conversations with her patients every day. Why couldn't our national leaders have been having them with the rest of us?
We had decades to prepare for ageing. The demographic change was inevitable. The confusion and distress surrounding it were not.
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You can hear the full conversation in the podcast interview here. https://share.descript.com/view/Bn3Xh30Zg1q