Tom Miller

I was initially assigned the working title, “Pursuing Equality in Health Care for the Elderly Is Futile.” I prefer to think of that particular dead end of health policy as one of listening to the wrong music for too long. Hence, this article reprises and revises the title song of the early 1980s movie, Urban Cowboy, but with Johnny Lee’s original lyrics adapted as “Looking for better health [rather than either ‘love’ or ‘love of equality’] in all the wrong places.” The better goal is to achieve more progress in improving health for more people, including the elderly. It need not be as futile as the pursuit of the elusive abstraction of “equality” for all — but only if we first move away from a path-dependent approach of recent times that remains too narrowly focused on statistical disparities in health care services received by particular groups.