Two films recently have been very similar (and this afternoon I saw the second, even though it’s been out for some time). Elysium and In Time are very similar. Both feature a totalitarian control on magically efficient health care. In both access to this is highly restricted. In both of them health (or immortality) access is highly restricted. Why? Population pressure is explicitly mentioned on one, but it is not clear that this is the problem they might pretend. As an extreme, Michael Moorcock’s Dancers at the End of Time are all immortal by a technology long lost and long forgotten. Our hero in that story is unusual, he’s the only person alive who was “born”.
In the second film, In Time, basically immortality is a consequence of solvency and the consequences of bankruptcy are instantaneous and fatal. When you reach 25, bang, you stop aging, your “clock” (wealth) is set to 1 year. If your clock ever reaches 0, boom. You are dead. The second economic stricture is that there is no post-mortem inheritance. If you die with “wealth” (time) then access to those funds are lost forever. No reason is given for the second issue, which is somewhat odd, because protection of inheritance is a feature that is held today as a feature in place which in-trenches the wealthy (so you’d think the wealthy would have implemented a mechanism for that). The “reason” for the first (bankruptcy kills) is that this is necessary for a Darwinian culling, selection of the fittest (and fitness is measured by wealth alone).
In both of these dystopian communities our hero is drawn from the bottom of the economic slice, from the slums. In both of these, there is little evidence of any positive governmental organs, no social services, no welfare, nothing. Killers and crooks are used in clumsy efforts to keep the order.
The wealthy in the In Time movie suffer from a lack of purpose and ennui. They are eternally 25. They have nothing to do but protect their wealth and avoid any sort of physical risk. The main character is spurred to action after a humanitarian effort saves the life of one of the wealthy, who decides to gift his wealth and die because he’s lived too long and he has no reason to continue.
In Elysium medicine is all automated and there is no indication that the medical resources required to heal people is limited for any actual reason. Our hero liberates access to super-medicine to everyone and the film ends. In In Time, the film ends with market (currency) disruption and a sense that the instability may signal change.
Somewhere, or someday, a fictional dystopian (or utopian?) future story will investigate immortality and almost perfect medical technology, without Malthusian fears and/or the mistaken notion that monetary exchange is zero-sum.