Still Playing: Summer, Highland Falls

Sadness or Euphoria

My good friend, Jane Barratt’s piece on the global aged care shortage is something that I haven’t been able to shake. She looked at Australia’s aged care numbers — capacity at 97-98 percent, a shortfall of 10,000 beds a year for the next two decades, frail people parked in hospital beds because there’s nowhere else to send them — and instead of stopping at the crisis, she looked sideways. To Denmark, which quietly stopped building nursing homes in the 1980s and bet everything on home care. To Japan, which turned long-term care into a social contract everyone pays into starting at 40. To Canada, where nobody disputes the bed count but nobody is rethinking the model either.

Four countries, four different bets about what security in old age requires. None of them wrong, she argued. Just different.

I kept coming back to one line in particular: *how much of our aged care panic is really a beds panic, and how much is a failure of imagination about what care could look like?*

That’s when Billy Joel showed up in my head, the way he always does when I’m circling something I can’t quite name. This time it’s his song “Summer, Highland Falls,” a song that spent its life as the B-side to “James” rather than a hit in its own right, but one I keep returning to for a single line: the idea that we’re shaped entirely by the circumstances we’re handed, and that what we feel about them can tip either way — grief or joy — sadness or euphoria - depending on how the light hits.

That line is the whole aged care debate, if you squint.

Read Denmark’s numbers one way, and it’s a story about decline — nursing home places falling from 49,000 to 15,400 in under twenty years, a country walking away from institutional care because it had to. Read the same numbers another way, and it’s a story about liberation — a government deciding, deliberately, that your home and your care don’t have to be the same negotiation. Same data. Different key.

Read Japan’s mandatory insurance scheme one way, and it’s a burden — every citizen paying into a system for decades before they’ll ever need it, costs that have roughly doubled since 2000. Read it another way, and it’s the most honest thing a country can do: admit early that aging is not a private emergency but a shared and predictable one, and price it accordingly.

That’s the trick of “Summer, Highland Falls.” It never resolves the tension between sadness and euphoria because it isn’t a tension to resolve — it’s just what it feels like to look honestly at something big. Most of us want our aging-policy conversations to land somewhere tidy: crisis or solution, failure or fix. But the countries actually doing something interesting aren’t choosing one key over the other. They’re playing in both at once. Denmark’s forty-year home-care experiment wasn’t a triumph that ended the story — in 2024 they passed reform legislation to bring back a new form of local nursing home, because the pendulum had swung further than even they wanted. That’s not backpedaling. That’s what it looks like when a country is willing to feel the sadness *and* the euphoria of its own policy, decades apart, and adjust.

I think about this professionally more than personally, most days — the beds, the funding envelopes, the capital risk nobody wants to carry. But I also think about it as someone who was a caregiver and I remember exactly how it felt to sit in that ambiguity myself. Sadness that the person I loved needed more than I could give her at home. Something closer to relief, even joy, at finding a place where she was cared for well. Both were true in the same week. Sometimes in the same afternoon.

Jane ended her piece with a question: where would you hold the meeting, and who needs to be at the table? I don’t have a tidy answer, but I have a suspicion — the table needs people who can sit with both halves of that Billy Joel line at once. The finance people who see the beds panic. And the people who’ve lived inside a family’s care decision, who know that panic is never the whole song.

Some crises get louder the more you try to solve them with a single note. This one might just need a fuller chord.