Universal free personal care for the elderly could become means tested, a report has warned.
The report author, Lord Sutherland, said "there are no sacred cows" for public spending cuts.
The Age Scotland report claimed a "one-size-fits-all" policy for older people's services would become hard to justify as budgets were cut.
Lord Sutherland said the consequences of the looming spending cuts would be "quite awful" for some.
He said: "This means, in my view, there are no sacred cows.
"If you're talking where we have to trim, it's very important that we don't isolate so many things as beyond consideration that everything else gets cut to death."
The report, carried out by the University of Edinburgh on behalf of Age Scotland, looked at the impact of public policy on older people since devolution.
It also questions why even the wealthiest over-60s get concessionary bus travel.
The document stated "universalism versus targeting or means testing is likely to take on a higher profile as public sector resources become squeezed following the recession."
The new UK government has announced £6bn of public sector cuts for this year and is planning more to follow.
Lord Sutherland said blanket cuts were the "wrong way" to approach the issue.
He said: "You do have to look at what the priorities are and where there are important matters. You have to have some sort of protection.
"I don't think the health service should be sacrosanct because I think we can't afford the health service we've got, not in the current position."
He called for greater integration of health and social care budgets and claimed that where this happens locally, the quality of care improves.
David Manion, chief executive of Age Scotland, said: "This thought-provoking report raises issues that, to date, there has not really been a need to address.
"In so doing, it makes an important contribution to the debate surrounding the future of Scotland's groundbreaking older people's policies and seriously questions what the future should hold for the next generation of older Scots."
Free care for older people was implemented in 2002 by the Labour/Lib Dem executive in light of a royal commission chaired by Lord Sutherland.
It is a key policy of the SNP administration.
Two years ago spending watchdog Audit Scotland said it had an annual funding shortfall of £63m.
The SNP Government has agreed to increase funding to councils by £40m after financial concerns were raised in a review by Lord Sutherland.