Age-based criteria have paradoxical effects on defining later life, especially in modern times. Years matter in planning retirement decisions, determining Social Security benefits and health care resources, and qualifying for discounts in public transportation, movie tickets, and food stores. Gerontologists meanwhile claim that chronological age per se is a poor predictor of most pertinent bio-medical-psycho-social-spiritual dimensions of aging. In the wake of the Longevity Revolution, policy makers, media experts, and welfare agencies question the utility of chronological age in categorizing the potentials and needs that accompany advancing years. No compelling alternative has yet to replace chronological age as a delineator.¹ Baby boomers are trying to ascribe idioms and expectations they have experienced into fresh responses to the question “How old are you?”

Marking Old Age in the New World during the First 250 Years of European Settlement

In virtually every historical moment and site, old age was said to commence around age sixty-five, give or take fifteen years on either end.² No other stage encapsulates so large a percentage of the human life span (itself perennially fixed at 120 years). Chronological subdivisions demarcate stages within old age. Commentators at all times and in all places have distinguished a “green old” or vigorous “third” age (the onset of which typically marked between sixty-five and seventy-five) from a “fourth” age or “second childhood” (the latter stage that signifies diminishing physical and intellectual faculties with advancing years). (p.302) One additional parameter merits mention: premodern elders, rare in numbers, were deemed “strangers” in the community. Now, ironically, contemporary old persons often fade invisibly despite their growing proportions in the populations of developing and advanced industrial societies.

Ideas about old age in U.S. history range concurrently from notions of worth through contradictory and ambivalent perceptions of decline to fears of ignominy. Demography plays a part in this complex array. Since the beginning of old age customarily has been fixed within wide margins, acknowledging the fact that the old eighty is not the new fifty must be reconciled with two other patterns. First, in the “natural” sequence of events, the coming of old age presages death. Preparing to die shadows most executions of the completion of being. Second, between 1900 and 2000, thirty years were added to life expectancy at birth and in the middle decades. Gains in life expectancy later in life, for boomer males, have been modest; boomer females can expect to live eleven years more than their great-grandmothers.³ Gender differences in later years are not simply cultural constructs.

Like chronological delineators, old age’s iconic manifestations and accessories persist over time and place. Older persons in ancient times were depicted with gray or white hair and bald heads. Artists past and present incorporate canes and walkers in portraying elders, as well as trumpets for hearing and signs of missing teeth or gout. Attempting to disguise or erase the ravages of age long has been a rite of passage; some manage to please themselves or fool others, but most risk contempt. Renewal, not rejuvenation, can occur in late life.

Attaining old age was an achievement worth celebrating and emulating in early North American history. To survive to late life was a feat, particularly since reaching young adulthood required luck and pluck. Trumpeting instances of longevity, moreover, had political value: bills of mortality were thought to affirm the relative healthfulness of conditions in the New World compared to the Old. As John Bristed opined in Resources of the United States of America (1818): “The aggregate salubrity of the United States surpasses that of Europe; the males are, generally, active, robust, muscular, and powerful, capable of great exertion and endurance; the females define a fine symmetry of person, lively and interesting countenances, frank and engaging manners. … The Americans (p.303) average a longer life than the people in Europe, where only three out of every thousand births reach the ages of eighty to ninety years; whereas, in the United States, the proportion is five to every thousand.”⁴

Dr. Benjamin Rush concurred with Bristed. North America’s first geriatrician “observed many instances of Europeans who have arrived in America in the decline of life who have acquired fresh vigour from the impression of our climate, of new objects upon their bodies and mind, and whose lives in consequence thereof, appeared to have been prolonged for many years.”⁵ In extolling elders as exemplars of rectitude, contemporaries took to heart a verse from Proverbs (16:31)—“Grey hair is a crown of glory, if it is won by a virtuous life.” The aged’s moral faculties, Dr. Rush reported, outdistanced their physical and mental capacities. Yet, as Scripture recognized, the miserly and avaricious, drunken and gluttonous, obstreperous and bitter were not guardians of virtue.⁶ People wanted respected elders to offer advice, to be repositories of tradition, so that all ages together could build a novus ordo seclorum. “What a blessed influence the old exert in cherishing feelings of reverence, affection, and subordination in families, in warning the young against the temptations and allurements of the world,” opined Reverend Cortlandt Van Rensselaer in a sermon on old age in 1841. “How much good of every kind is accomplished by the tranquilizing, wise and conservative influences of age.”⁷

Older people in early American history offered these resources and more. In farming communities aged women and men managed homes and supervised plantings. Engaging in politics, commerce, and the professions typically sustained men of property and standing well into advanced age. Those who prospered in late life were rare, however. Auction prices of unskilled African Americans diminished conversely with advancing years. Owners freed slaves when they no longer could labor in fields. Many widows, regardless of race, ethnicity, region, religion, or class, depended economically and psychologically on children, neighbors, and strangers. Even once powerful men, like Increase Mather, perceived a mounting loss of esteem a decade before leaving his pulpit at eighty-two.⁸

Superannuation occurred more frequently than mandatory retirement. According to Noah Webster’s American Dictionary (1828), “superannuation resulted from infirmity or poor health”; accidents, injuries, (p.304) and illnesses superannuated youngish workers. “Retirement” connoted a “private way of life … withdrawing from company or from public notice or station.” Like superannuation, retirement was a term that could be applied across age groups, not just to the old.⁹ “Though age-related norms and prescriptions were not totally absent—most communities, for example, frowned upon the marriage of a young man and an elderly woman—cultural values associated with age were imprecise,” contends Howard Chudacoff. “Age-graded stages of life, such as Shakespeare’s ‘seven ages of man’ were often more theoretical than experienced.”¹⁰

Being old and becoming older in antebellum America did not connote loss of functionality, however. Only in unusual circumstances did men in antebellum America leave office on account of age. Some jurisdictions adopted a 1780 Massachusetts constitutional precedent that required justices of the peace to renew licenses every seven years; the measure sought to minimize incompetence, not to discriminate against seniors. New York’s legislature reacted to an actual case of a justice who grew senile on the bench. The state’s 1777 constitution permitted its chancellor, Supreme Court judges, and the ranking judge on each county court to “hold their offices during good behavior” until reaching age sixty. New Hampshire (1792), Connecticut (1819), and Maryland (1851) set seventy as retirement age for their judges and justices of the peace. Upon becoming states, Alabama (1819), Missouri (1820), and Maine (1820) also imposed age-based ceilings on service.¹¹ These are the only instances of legislators and voters imposing on the aged chronological restrictions to public service.

Indeed, it is worth recalling that the U.S. Constitution and local jurisdictions curtailed the franchise of youth far more greatly than they discharged age. Men could not vote in presidential elections before they were twenty-one, nor could they serve in the House or the Senate before they reached thirty and thirty-five, respectively. (Women of all ages were disenfranchised on account of sex.) Failing to meet property requirements prevented young men from testifying in court, executing a will, or holding county offices until they were counted mature. In contrast, the influence of older men who controlled assets and/or held sway was praised or feared until death.

No wonder, then, New York’s removal of senior judges at sixty was derided. Alexander Hamilton denounced the provision in Federalist 79. (p.305) Chancellor James Kent, upon vacating the bench, wrote Commentaries on American Law (1826–30). Hale until his eighty-fourth year, Kent became America’s Blackstone. New York deleted the age restriction when it revised its constitution in 1846. Young Americans knew that they could not squander ripe, functional age.

The Increasing Prevalence of Chronologically Based Criteria for Defining Old Age

Urbanization and industrialization transformed the United States after the Civil War. These forces, modernization theorists hypothesize, diminished the marketplace status of older people.¹² Census data indicate otherwise. In Massachusetts, which was predominantly industrialized by 1885, the percentage of gainfully employed workers over sixty had declined very little.¹³ “In its initial stages, industrial development had little direct effect on the elderly population,” contend Carole Haber and Brian Gratton. “In skilled occupations, age—rather than being a handicap—led to greater mastery, better jobs, and higher income. Older craftsmen owned the tools and resources necessary to the trade, and they bartered knowledge and training for assistance from apprentices, who were often young kin. The craft system allowed skilled workers to avoid menial, physically demanding tasks by exchanging knowledge for labor.”¹⁴

Meanwhile, federal agencies and private industry started discharging workers at a certain age and/or after a specified term of employment. The innovation set precedents that made mandatory retirement a condition for delineating old age. Congress in 1861 required naval officers below the rank of vice admiral to resign at sixty-two. Another provision required sailors to retire at fifty (1899); yet another intended to “promote the efficiency of the Revenue-Cutter service” (1902) by removing those who were incapacitated or over the age of sixty-four. Transportation companies inaugurated the earliest private pension programs. American Express (1875) offered workers over sixty a gratuity for good service, a gesture meant to purge obsolescence. The Baltimore and Ohio Railroad’s retirement scheme (1884) gave pensions to employees over the age of sixty-five who had completed a minimum of ten years of service.¹⁵

The quest for efficiency reworking modes of productivity insinuated chronological age per se into personnel decisions that devalued and (p.306) discriminated against older workers. “The practice of retaining on the pay-roll aged workers who can no longer render a fair equivalent for their wages is wasteful and demoralizing,” opined professor F. Spencer Baldwin in 1911; he argued it hurt overall morale to protect individuals who could not keep up with the pace.¹⁶ Obsolescence arose from circumstances out of elders’ control, declared Corra Harris in a 1926 article in the Ladies Home Journal: “Old people are not so much prisoners of their years and infirmities as they are of their circumstances, after they are no longer able to produce their own circumstances, but are obliged to adjust themselves to conditions made for them by people who belong to a later generation in a new world.”¹⁷

The practice of forcing retirement beyond a certain age gained acceptance in industrializing America. By the eve of the Great Depression there were 140 industrial pension plans, covering nearly a million workers. Stipulated retirement ages ranged from fifty to seventy-five. Meanwhile, the federal government enacted an old-age and disability insurance program (1920) for its half million civil servants; six states followed. Municipalities created programs based on age and service for teachers, police, and firemen.¹⁸

The imposition of chronological-age-based criteria crept downward in market determinations, targeting certain segments of the aging work force negatively and positively. To wit, while captains of industry were designing age-specific criteria for retiring employees, Henry Ford and the Studebaker Corporation inaugurated seniority-based bonuses in order to reduce job turnover. Union officials mainly fought for bread-and-butter issues for younger members, but they also understood that seniority bolstered job security for aging workers. Seniority meanwhile infiltrated elite circles: Congress between 1880 and 1910 instituted rules that restricted the flexibility of the Speaker of the House to make committee appointments; as a consequence, discretionary power accrued to older lawmakers the longer they stayed in office.¹⁹

Discriminatory age-based measures affected workers in their prime. “An age barrier” for those forty and older in heavy manufacturing consigned workers to an industrial scrapheap. Personnel managers in technology-rich industries in the 1920s were deploying psychological tests and other filters to discourage the recruitment and retention of mature and aging job candidates. “There is much evidence to support (p.307) the growing belief that industry is honeycombed with strict hiring limits,” reported contributors to Herbert Hoover’s committee investigating Recent Social Trends (1933).²⁰

Claims that capacities diminished with aging received their most celebrated exposition from William Osler, arguably the preeminent professor of clinical medicine on two continents at the turn of the century. Osler noted “the comparative uselessness of men above the age of forty. … The effective, moving, vitalizing work of the world is done between the ages of twenty-five and forty—these fifteen golden years of plenty, the anabolic or constructive period.” To Osler’s detached gaze men over sixty were utterly useless, so what “incalculable benefit it would be in commercial, political and in professional life, if as a matter of course, men stopped work at this age.”²¹ Osler remarked about “The Fixed Period,” a reference to a novel by Anthony Trollope, which proposed that sexagenarian college professors be chloroformed after being granted a year to compose their last lectures.

Age-based criteria in evaluating worth and allocating benefits slowly pervaded U.S. society. No aspect of America’s urban-industrial-bureaucratic milieu was exempt. Consider how chronological criteria were adopted in two unrelated welfare arenas—old-age pensions and old-age relief.

Although Thomas Paine pled for the creation of nationally funded pensions to prevent old-age dependency after the Revolution, his contemporaries were reluctant to compensate aging veterans. Congress restricted the scope and provisions for survivors of the Revolutionary War, War of 1812, and Mexican-American War until long after peace settlements. (The government during this period underwrote a U.S. Naval Home [1833] and a U.S. Soldiers Home [1851] for disabled and superannuated veterans.) Post–Civil War politics broke this dilatory, stingy pattern. Initially, Yankees (not vanquished Confederates) filed claims on grounds of disability. By 1912, having determined that old age per se was a disability that impeded veterans from gainful employment, Congress granted pensions to any Union soldier over age sixty-two who had served at least ninety days in the Civil War. The cost of military pensions soared to $174.2 million, roughly 18 percent of all federal expenditures.²²

Arguing that U.S. military pensioners fared better than social insurance beneficiaries in Western Europe, Theda Skocpol underscores the (p.308) important role that chronological age played as a criterion for work and retirement:

European contributory old-age insurance and noncontributory pensions were explicitly meant for lower-income elderly people or for certain categories of retired employed workers. … By the turn of the twentieth century, Civil War pensions served for many Americans as an analogue to noncontributory old-age pensions, or to disability and old-age insurance without the contributions. … Civil War pensioners could automatically claim disability for manual labor due to old age by age 62, and in practice many started receiving pensions in their fifties or earlier. … Given that skilled and unskilled manual laborers in the nineteenth century often wore themselves out well before age 65 or 70, the American veterans had a distinct advantage—above all in relation to Britons—in being able to draw benefits earlier, especially since the benefits for those Americans who gained eligibility before age 62 were not necessarily any lower.²³

The introduction of chronological benchmarks for defining military pensions foreshadowed two developments in the bureaucratization of modern America. First, setting age criteria obviated the necessity to define or evaluate a person’s functional capacity. Old age was reconceived as a disabling condition conveniently—albeit arbitrarily—reckoned by calendar years. Second, it seemed fair to grant benefits to veterans who met standardized service and age requirements. Nonetheless, privileging the Union’s aging veterans created a special category of entitlement. The group was overwhelmingly white and male; they had not contributed (as had European wage earners) in youth or middle age to a social insurance scheme from which they would draw in senescence. Older U.S. veterans, counting themselves lucky to have survived battle, now were recipients of a windfall at the very time when lawmakers ignored the claims and pleas made by women and men who were worn-out veterans of the new urban-industrial state.²⁴

Public and private administrators of welfare agencies concurrently started to deploy age-based criteria in determining needy older people’s eligibility for institutional support. Tradition dating back to Elizabethan Poor Laws dictated that upstanding, destitute elders be considered “worthy” poor who should be duly relieved from their vicissitudes. The quality (p.309) of mercy then and now was strained, however. Most Americans in the nineteenth century preferred to invest in schooling native-born white children and caring for orphans. Those charitable funds and religious bodies that built old-age homes for widows and specific groups of urban elders wanted older beneficiaries—mainly “theirs”—to live out their last years in relative comfort. Accommodations varied: ethnic Catholics in the North erected parochial centers; ex-slaves, rarely admitted to public facilities in the South, contributed to private old-age homes. Age mattered. Supervisors set thresholds (sixty, sixty-five, or seventy were common) for admitting residents, and they kept track of lengths of residency. “Benevolent asylums, pension plans, and geriatric medicine all worked to remove the aged from industrialized society; they sought to shelter them in a world consciously devoid of the young.”²⁵

For the most part, elderly men and women relied on kin and/or applied for funds for outdoor relief or the poorhouse. Courts in four states (Colorado, Indiana, Kentucky, and Ohio) punished adult children who abandoned their parents; thirty-two states (of forty-eight) by 1914 enacted measures to reduce the threat of dependency among family members of all ages but seldom acknowledged the elderly’s vulnerability. Whereas social reformers like I. M. Rubinow condemned poorhouses as “concentration camps for the aged,”²⁶ legislatures concluded that there were more pressing issues to attend. A 1910 survey of the extent of old-age poverty in Massachusetts presaged a conclusion reached by other jurisdictions: the “problem” of pauperism among elders was not acute. Fiscal conservatives feared that initiatives to assist aged indigents might destroy thriftiness, lower wages, and eviscerate family bonds. Measures to relieve old-age poverty passed in Arizona and Pennsylvania were quickly ruled unconstitutional.²⁷

The Great Depression had a devastating impact on older workers and their kin. The aged’s unemployment rates exceeded the national average. The economic crisis exhausted resources that corporations, unions, and private charities might have extended to elders in need. Providing food and shelter for children left little for aging parents. Hard times required fresh approaches to the challenges of late life.²⁸ “I am looking for a sound means which I can recommend against several of the great disturbing factors in life—especially those which relate to unemployment and old age,” declared Franklin D. Roosevelt to a cabinet-level Committee (p.310) on Economic Security and to experts from academia, business, government, and labor whom he charged to draft an omnibus bill. “These three objectives—the security of home, the security of livelihood, and the security of social insurance—are it seems to me, a minimum of the promise that we can offer to the American people.”²⁹

The Social Security Act (1935) mounted a two-pronged attack on the problem of old-age dependency. Title I, Old-Age Assistance, required applicants to meet the age, residency, and needs requirements established by the several states and then approved by a federal board. Benefits up to fifteen dollars per month, an amount set by the state and matched by Washington, varied from place to place; some southern states did not establish programs. To reduce future reliance on relief, Title II (Old-Age Insurance) established a pension program wherein employees (in designated sectors of the economy) and their employers contributed to an account from which workers eligible for Social Security could draw at the age of sixty-five.³⁰

Setting age sixty-five as an eligibility criterion in both Title I and Title II was a compromise. Half the states wanted to select age seventy as a criterion for old-age assistance under Title I in the hope that aged citizens in their jurisdictions would not live long enough to benefit from the program. At the other extreme was the Townsend social movement, which proposed awarding two hundred dollars a month to people aged sixty and over who agreed to quit working and to spend their pension within a month.³¹ (Despite mass appeal, the Townsend plan floundered on its dubious cost projections.) In prioritizing social insurance over social welfare, lawmakers designed a plan that “amounts to having each generation pay for the support of the people then living who are old.”³² Through intergenerational transfers, the needy aged would receive assistance under Title I. Aging workers who had contributed to Title II earned future protection that policy makers anticipated. Caring for the old would empower middle-aged couples to devote more of their time and money to raising their children.

Social Security transformed retirement thinking. It popularized life insurance plans and galvanized interest in corporate and labor pensions throughout the private sector. As coverage widened, Social Security increasingly made “retirement” an option for the middle class (instead of a perquisite of wealth, as it had been). Above all, it legitimated the practice (p.311) of delineating old age chronologically in establishing and implementing retirement plans in the public and private sectors.

Multiplying Chronologically Based Measures of Old Age since Social Security

Rather than track the proliferation of age-based criteria for delineating late life, it suffices to document bureaucratic amendments grafted into Social Security’s original chronological baseline. Age sixty-five remained for decades the best known benchmark in both the public and private sectors as Social Security coverage and eligibility expanded. Negotiations between General Motors and the United Auto Workers after World War II fostered a pension boom, which reinforced the significance of sixty-five as the “formal” age of retirement. In addition, Congress introduced other triggers. Under the 1956 amendments women could fully retire at age sixty-two, and workers of both sexes could take “early” retirement, with actuarially reduced Social Security benefits.³³

Disability provisions, introduced in the 1950s, treated incapacitated workers between the ages of forty and sixty-five as if they were retiring early. Disability insurance subsumed health risks under age-based bureaucratic protocols. Sometimes existing criteria generated new chronological thresholds. Earnings tests under Social Security were complex. Basically by rewarding workers who postponed withdrawal from the marketplace, the provision enhanced “flexible retirement.” The 1983 amendments raised the “normal” eligibility age for full Social Security benefits to age sixty-six for boomers and to age sixty-seven for younger workers.³⁴

Policy makers enacted around the original 1935 Social Security Act a variety of other postwar federal initiatives.³⁵ Hence, Medicare (Title XVIII of the Social Security Act, enacted in 1965) provided hospital insurance for Title II beneficiaries and workers not yet drawing Social Security benefits. In 1972, consonant with bureaucratic liberalizations of Title II, federal health coverage was extended to 1.7 million people under age sixty-five who had been receiving disability benefits for two years as well as to 10,000 people who suffered from acute kidney disease. “As an insurance plan, Medicare does not create the environment needed for the practice of high-quality modern geriatric medicine,” contends (p.312) Christine K. Cassel. “On the other hand, Medicare is much better health insurance than a large majority of Americans now enjoy.”³⁶

In addition to Medicare and Medicaid, Congress enacted the Older Americans Act (OAA) in 1965. OAA established a new contract with elders, promising an extraordinary commitment to ensuring “(1) an adequate income in retirement … , (2) the best possible physical and mental health …, (3) suitable housing …, (4) full restorative services …, (5) pursuit of meaningful activity …, (8) efficient community services, including access to low-cost transportation …, (9) immediate benefit from proven research knowledge …, (10) freedom, independence, and the free exercise of individual initiative in planning and managing their own lives”³⁷ A vast network of Area Agencies on Aging (AAA) initially addressed the needs only of citizens over sixty-five; over time AAA launched initiatives for frail elders and adults at risk (and, in 1992, provided for caregivers of the elderly) and coordinated planning and delivery services at the local and state levels.

Institutions whose founding predated Social Security expanded its age-based eligibility criterion. Since its establishment in 1930, when it was assigned oversight of 54 hospitals, the Veterans Administration (VA) has grown to include 152 hospitals, 100 community-based outpatient clinics, 126 nursing homes, and 35 domiciliary units. The VA health care system provides the fullest continuum of elder care and currently determines services on the basis of (old) age as well as extent of survivors’ service-connected disabilities, length of active duty, and current income.³⁸

One other initiative is worth noting. In 1967, Congress enacted the Age Discrimination in Employment Act, which applied only to workers between the ages of forty and sixty-five. The upper age was raised to seventy in 1978 and eliminated altogether in 1987. This measure effectively ended a century-long era of age-based mandatory retirement.

In all these instances, lawmakers and agents determined that defining coverage on the basis of age-based criteria had certain bureaucratic advantages. Doing so was administratively straightforward. It avoided the stigma of welfare associated with means testing. Nor did this approach require tests of income or capacity as had been required when age was a proxy for functional status. To the extent that people perceived older Americans as a group that was vulnerable financially and medically, age-based criteria seemed fair and nondiscriminatory.

(p.313) As chronologically determined social, economic, and medical initiatives for elders proved to be more effective for bureaucrats, this approach ironically became a victim of its own success. By the late 1970s, thanks to Social Security, the incidence of old-age poverty declined sharply. Similarly, the introduction of Medicare clearly reduced the aged’s medical costs. Friends and foes saw an ominous consequence to these positive developments. “Public policy based on advanced age has undergone a serious transformation over the last few decades, from ‘We can’t do enough’ to ‘Have we done too much?,’” argued political scientist Robert B. Hudson, a Social Security advocate who was one of the first gerontologists to recognize that the “graying of the Federal budget” invited backlash. “Addressing the needs of old people will inevitably be an expensive proposition; the key question will be how to allocate costs among older individuals, their families, community agencies, the proprietary sector, and government.”³⁹

Fears went deeper. Far from being celebrated as a felicitous consequence of the Longevity Revolution, the rising numbers of older people fanned ageism—especially among those who felt that caring for the aged should be secondary to investing in youth. While neoconservative pundits and politicians demanded limits to how much could and should be given to “Greedy Geezers,” editors portrayed images of intergenerational warfare on the covers of the New Republic and the National Journal in the 1980s. And the message stuck: in a zero-sum game, economists insisted, young people with mounting debts and insufficient resources to buy homes should not be expected to subsidize the new old, who, by most accounts, no longer seemed as impecunious and frail as did their great-grandparents. This neoconservative line of reasoning was part of a larger campaign to undercut New Deal liberal principles that had been at the core of the U.S. postwar political economy. The tack regrettably ignored the plight of vulnerable elders, such as poor older women, who had not gained from Social Security entitlement formulae based on steadily covered employment or long-lasting marriages.

Cuts were first evident in federal age-based programs. Jimmy Carter angered Democrats by tightening eligibility criteria under Disability Insurance in 1977. Unexpected shortfalls in Social Security trust funds forced Ronald Reagan to appoint a bipartisan commission to shore up financing. The 1983 amendments in fact stabilized the funds in the (p.314) short run and generated enough revenues to honor commitments to baby boomers. But these accomplishments were not enough to allay subsequent fears of bankruptcy. Conservatives continued to claim that boomers, by dint of their numbers, were going to deplete anticipated surpluses, and that the existing programs could not fulfill promises to younger cohorts of Americans. Seizing on anxieties, George W. Bush sought but failed to privatize Social Security in 2005. Barack Obama seems inclined to reduce the future costs of Social Security’s age-based formulae in order to control the rate of growth of projected federal budgets.

The recent history of Medicare unfolds in similar ways: Reformers want to eliminate chronological age as an eligibility criterion. “We need to start from the bottom up, with a different vision of the future of aging, medicine, and health care than the one bequeathed us by the reform movement of the 1960s and 1970s,” declared medical ethicist Daniel Callahan. In Setting Limits (1987), he proposed “a different way of understanding the problems of providing that care than is commonly considered: that of using age as a specific criterion for the allocation and limitation of health care.”⁴⁰ George H. W. Bush, who greatly expanded coverage for disabled Americans, sought to fill a gap in elder care through the Medicare Catastrophic Care Act (MCCA, 1988). The president wanted to expand Medicare’s scope only if the extra costs remained budget-neutral. Bush’s advisors recommended an intragenerational transfer, a formula strategy that replaced age with class as a trigger. The designers of MCCA wanted affluent Social Security beneficiaries to underwrite the cost of covering less fortunate persons eligible for Medicare. The wealthy revolted because they generally had coverage for catastrophic emergencies through private insurance; MCCA was repealed in 1989.

In the 1980s, the prospect of injustice between age groups became an issue galvanizing commentators across the political spectrum. Social Security, once a sacred cow, had become a golden calf. Those who wanted to reduce the size of government denounced old-age entitlements as unnecessary. Columnists across the political spectrum urged elders to sacrifice claims to windfall entitlements for the sake of the commonweal. Scapegoating the aged proved a powerful strategy for reducing present and future burdens associated with population aging. Pitting old against (p.315) young was ageist, but it seemed persuasive to many audiences—despite efforts by demographers, economists, and centrist policy analysts to undercut the message of growing age-based injustice sounded by Americans for Generational Equity and prominent conservatives such as Peter Peterson.⁴¹ Antagonisms between young and old abated, but they nonetheless linger. Individuals under forty want to contribute to Social Security today, although few expect to collect benefits when they reach their “normal” retirement age of sixty-seven. Gerontologists increasingly follow Bernice Neugarten’s lead in distinguishing between the young-old and the old-old.⁴²

Another motif demands attention. U.S. society has been loath to address the needs of persons in the fourth age—men and women whose frailty and impaired functionality diminish their quality of life. Seizing on any chronological age (such as seventy-five or eighty) in targeting the old-old seems as arbitrary and wrongheaded as is maintaining sixty-five as a benchmark for senescence. There are too many exceptions, physical and otherwise, around age norms; gender, ethnicity, and resilience yield diverse capacities in late life. Many are independent at eighty; others are totally disabled at forty. For this reason Neugarten was a trailblazer in juxtaposing future policy choices in terms of Age versus Need (1982); she advocated that old-age social policies deploy income-based criteria for meting benefits.⁴³

“In the contemporary postmodern life course chronological age has lost its potency in determining social roles. As life expectancies increase, the heralded value of youth has been extended to age groups that had once been considered old,” observes Anne Basting. “Definitions of who is considered ‘old’ have shifted without significant changes in the status of those condemned to what remains a devalued category.”⁴⁴ Age-based criteria, which once shaped and drove policies for the aged, have proven too imperfect to sustain as policy makers confront a new set of ideological and budgetary challenges.

Neoconservatism and globalization (among other trends) have transmogrified cultural values and political priorities. By concentrating on the demographic contours of the Longevity Revolution, we too often lose sight of the variegated, often contested, meanings of work, community, (p.316) and love in late life. Radical changes in age-based expectations, not to mention compelling evidence that chronology per se has little bearing on cherished rights and contested responsibilities, pose a double-edged sword for all generations. The boomer vanguard, now the age at which their parents retired, may try to ignore (at considerable risk) the enormous social, cultural, economic, and political developments altering postmodern society. If this cohort defends its entitlements in an unreflecting manner, critics will seize on this response as an instance of boomer selfishness. The cohort born between 1946 and 1964 will be accused of letting down future generations. On the other hand, should boomers join others in redesigning the life course, especially the third and fourth ages, they can rightly claim a stake in the commonweal. This tack, too, poses difficulties, for it is not clear how to proceed without deploying age-based criteria. Age, like race and gender, carries historical baggage into the present moment.

One way to transcend the age conundrum may be for Americans to embrace expanded, transgenerational definitions of social citizenship. To achieve a full measure of citizenship entails reaching out to America’s underclass, including the nation’s frail elders. Resetting the prerogatives and boundaries of citizenship might consolidate and universalize existing work and welfare initiatives. We need policies that correct measures that accentuate disparities by income and health. Present-day age-based entitlements did not eliminate the stigmatizing modes of assistance, as bureaucrats had hoped.

Melding public responsibilities and private needs requires putting age, race, gender, and poverty into context. The postmodern Longevity Revolution has rendered obsolete traditional concepts of the three boxes of life—school, jobs, and leisure. Loosening the chronological links across a variety of federal (and/or state) programs must accommodate disparities in educational and employment opportunities. For example, a new map of (late) life should chart ways to make room for older women and men who want to “repot” in classrooms or community centers in order to extend jobs. It would offer fresh opportunities for those who have contributed to others all their lives to seek meaningful activities as volunteers.⁴⁵ Rethinking chronological delineators probably means returning to where we began: taking a functional view of old age, acknowledging its wide-ranging capacities and vicissitudes.