There is a special feature of the health and welfare problems of the elderly population that sets them off from the other domestic problems of the developed countries of the world. They combine two difficult elements, complex enough when taken alone but much more so when combined. There is, on the one hand, the economic problem of finding ways to make adequate provision for the needs of the old, barely met with full adequacy in any country and full of greater threats in the future. There is also, on the other hand, the extraordinary delicacy needed to conduct serious public debate on the issues. At a time when many countries still struggle against a pervasive ageism, trying to open up new possibilities for elderly people and to foster new attitudes, it is exceedingly painful to contemplate further economic constraints, even rationing, to meet the impending economic problems.