Health care: a science fiction story

We spend fifty percent of gdp on health care.

We spend most of the rest of gdp monitoring the quality of health care institutions, let’s call them clubs.

At birth your parents buy you membership in a highly capitalized health care club.  It takes very good care of you.  Some of them are set up as mutuals.

Your club monitors what you put in the toilet, feeds you drugs through your drinking water, and manipulates your DNA to counter incipient health care problems.

At some point the club refuses to spend any more money and it lets you die (kills you?), depending how costly it is to treat your ailments.  At some cost it could keep you alive forever, though not in a very happy state.  It won’t.

Society has two main issues: discovering new medical advances, and monitoring the performance of health care clubs.  For each individual a computer record is kept of his health, his ailments, and when and how he is killed.  Specialists judge the performance of the clubs in deciding when to kill people (oops, let them die), and in turn those specialists are judged by other specialists who in turn are judged by specialists as well.

Some dissidents won’t participate in this system at all.  They die natural deaths, and for a while are much wealthier than they otherwise would be. 

There is a lot of spying on health care clubs.  Some brave club members accept huge sums to be given fatal diseases, so that intermediaries may measure whether they are killed at the proper time and in the proper manner.  These voluntary victims often use the money to save hundreds of lives in India, where the standard of living is no higher than that of contemporary America.


Would the clubs be engaged in espionage and other war-time
activities against tobacco and processed food companies?
Do they force memebers to exercise?
Are they largely responsible for much improved safety in
vehicles, practically eliminating car crashes and other
Are guns outlawed, and not even in the hands of outlaws?
Do they abort fetuses with bad DNA, or those with expensive
health problems?
Do they force sterilization of those with offending traits?
Are all immigrants allowed in only after health exams?
Does the country actively recruit immigrants with desirable
Is the military then only filled with the expendables, the ones
that should not procreate, or the elderly, or the infirm?

And you're selling the movie rights...

Scary but plausible...

I wonder how it will look like for the individual, the moment when his club decides he should better die? Will he receive a notice, with the possiblity to object/invest more money/whatever? Will there be a right of every individual to monitor his live expectancy? Will the club have the right to low that threshold if the individual does not obey certain rules (smoking/drinking/having sex more/less than prescribed/allowed, etc)? Will there also be selective breeding?

I would advise you to review what you consumed in the last few days, and not to repeat it!

(It was not really possible for me to suspend disbelief in this little story, because it conflicts with my vision of human nature (and of the evolution of science), at so many levels. I think we will have a continuing tension between "fun" and dangerous behaviors and "repairs" that might save us at the last minute. That is just the way we are. I mean, any species that would "monitor what you put in the toilet, feed you drugs through your drinking water, and manipulate your DNA to counter incipient health care problems" would have banned alcohol, tobacco, and maybe caffeine, centuries ago. We are left with a very "constructed" sci-fi world, from which it is impossible to draw any meaningful lessons.)

Sorry if that's too harsh, but unless you change the species too, it doesn't work.

Sounds like the British NHS, except at a much higher percentage of GDP. Hope the waiting times are less.

wasn't there a movie about this... Gattaca, I think it was? Or maybe Code 46? Or the aforementioned Logan's Run? or perhaps Brave New World? gee...

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