The service system at the crossroad of demography and policy making--implications for the elderly

In many countries today, there is an ongoing debate regarding health in 'crisis'. Each country seems to experience a crisis regardless of the level of expenditures in the field of social and health services. This article discusses different influences that affect social and health service systems in relation to the elderly, and brings up the controversy concerning the elderly as a threat to available resources in society. Most examples are based on Swedish sources, but some American and British sources are used as well. Borrowing from the age stratification model, the concepts role and cohort are used as analytical concepts. The role concept is discussed in relation to the development of organizations for retired people. The analysis offered little support for the thesis that the elderly would attain a power position. Thus, a demand for societal resources by means of political strength is less feasible. When looking at the elderly from the cohort perspective, the article includes a discussion of the interdependent forms of care for the elderly; self-care, informal care and formal care. Although great challenges await social and health services systems in this respect, the article concludes that any possible crisis in health and social service systems is socially constructed and not a deterministic effect of demography as such.