A Golden or Gilded Age for Healthcare?

Gold has always symbolized something precious, extraordinary, and enduring. The word “golden” brings to mind brilliance and rarity. What comes to mind when you hear it? Maybe it’s Harry Styles singing “Golden,” Tina Turner’s sultry “GoldenEye” from the James Bond classic, or the beloved Golden Girls sitcom. Perhaps it’s a nostalgic scene from On Golden Pond, or even a hearty meal at Golden Corral.

But “golden” isn’t just about pop culture or restaurant chains. It’s often used to describe remarkable periods in life — like the “golden years” of retirement — or in society, as in a “golden age.” But what truly defines a golden age?

Golden Age: From Mythology to Modern Times

The concept of a golden age comes from Greek mythology. It describes an idyllic time when humanity lived in harmony with the gods, free from work, aging, or conflict. Food was plentiful, peace was constant, and death came gently.

Fast-forward to today, and we use “golden age” to describe times of extraordinary progress or prosperity. Was America’s golden age the Roaring Twenties, with its jazz, cultural innovation, and booming economy?

Or was it the 1950s, marked by post-war optimism, a thriving middle class, and booming consumerism?

The Gilded Side of Golden Times

Not everything that glitters is gold. Even America’s so-called golden ages often had a gilded glow — bright on the surface but hiding cracks underneath.

The 1920s sparkled with jazz and rapid economic growth, but inequality loomed large. By 1929, the top 1% controlled nearly 24% of all income, while over 60% of families lived below the poverty line. The glittering prosperity of the decade turned out to be a gilded illusion.

The 1950s, often hailed as the “Golden Age of American Capitalism,” brought economic growth and widespread consumerism. Yet it was also a time of stark racial and gender inequality. Black Americans faced systemic discrimination, and women had limited opportunities outside the home Still, this era planted seeds of progress, with landmark legislation like the Equal Pay Act of 1963 and Title VII of the Civil Rights Act of 1964 beginning to address inequities. However, inequities continue to this day.

Healthcare’s Golden Days

Defining a golden age in healthcare is equally complex. Was it the mid-20th century, with groundbreaking advancements like antibiotics, surgical innovations, and the polio vaccine? Or is it today, with gene-based therapies and cutting-edge technology transforming medicine?

But a golden age is about more than medical breakthroughs — access to affordable care is essential. Even as Affordable Care Act enrollment reached a record-breaking 24.2 million in 2025, 26 million Americans remain uninsured. Rising costs add to the strain, with the average family health insurance premium exceeding $25,500 in 2024, up 6% from the year before.

Challenges go beyond access and costs. Health disparities persist, with Black, American Indian and Alaska Native individuals facing worse outcomes in areas like infant mortality and chronic disease. These inequities underscore the reality: among high-income nations, the U.S. spends the most on healthcare but consistently ranks last in health outcomes. The true golden age of healthcare has not arrived.

Golden Promises or Gilded Realities?

This week, President Trump declared in his inaugural address, “The golden age of America begins right now.” It’s a bold promise—but will it hold true?

Many healthcare leaders are skeptical. The President’s Executive Orders eliminating DEI initiatives, halting expanded ACA enrollment periods, and withdrawing from the World Health Organization have raised concerns. Additional actions — such as ending some efforts to control Medicare and Medicaid drug spending and ordering the Department of Health and Human Services to halt public communications — further cloud the future.

While the allure of gold may dazzle, are we entering a true golden age marked by equity and lasting progress for all? Or are we facing a gilded age, where prosperity and progress benefit only a select few? Time will tell.

Happy reading,

Enjoy the weekend!

Best,
Suzanne
Suzanne Daniels, Ph.D.
AEPC President
P.O. Box 1416
Birmingham, MI 48012
Office: (248) 792-2187
Email: [email protected]