Urgent need: new policy on elderly; America's Old Age Crisis: Public Policy and the Two Worlds of Aging, by Stephen Crystal. New York: Basic Books Inc. 300 pp. $16.50.

''Our nation is moving toward two worlds of aging, one poor, one comfortable - separate and unequal,'' warns Stephen Crystal in an advance copy of a book being published in November.

On this carefully documented premise, Crystal sharply scores US policy for supporting the elderly as inadequate, misguided, and basically unsound.

What most bothers Crystal, who serves as director of the Department of Family and Adult Services at New York City's Human Resources Administration, is that present programs constitute a type of lottery in which the not-so-needy aged are the big beneficiaries and the badly-in-need (women and blacks, in particular) are lost in the shuffle.

Why is this so? Primarily because programs like social security and Medicare are aimed at the broad population and not focused on have-nots.

What would Crystal do? Among other things, he would recarve government policies to extend pension plans to a greater number of the poor; bolster social security benefits to widows and others who most need them; and encourage those capable of working after retirement to continue to do so, if only through part-time employment or shared jobs.

If you haven't guessed, the big culprit is costs. The figures are devastating. Now $191 billion - over 27 percent of the total federal budget - is spent on the elderly. Government estimates indicate an annual outlay of $7,600 per aged person, $15,200 per aged couple. Health expenditures alone average $3, 900 a couple.

With inflation and a rapidly increasing older population, these costs will continue to skyrocket. So the only real answer, says Crystal, is to develop ''priorities'' and an integrated federal old age policy to replace the many fragmented ones that now exist.

All this, of course, sounds good. It is even in line with current Reagan administration thinking involving cost-cutting which, ostensibly, would increase benefits for the most needy and prod the less needy to find ways to better help themselves.

As we have seen, social security reform is not easy to come by - despite opinion polls that the majority of citizens favor an overhaul of the pay-in and benefits systems. Pension plans are big business and run by big businesses. They are not likely to seek a change in clientele from the elderly well-off to the elderly poor.

Stephen Crystal is among a growing band of credible people articulately sounding the alarm. His book is important. We should pay some attention.

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