This article shows how age as a category of dependency upends popular consciousness about race and class within postcolonial health systems. White individuals working within South Africa's private health insurance (medical aid) market and allied fields face a conundrum with respect to elder care. Some policies accommodate older adults' needs, but being older is costly and long-term residential care is excluded. Critically, these workers' position as middle- and upper-class enables them to pity older, poorer whites and blacks who more often use a dysfunctional public health sector, yet the elder care gap and other limitations reveal that these workers' own class position is also tenuous.