This article was originally published in Futuribles in 1988. The author then issued a warning to readers about the serious risks connected with the ageing of the population of the United States. Mahoney emphasizes in particular the problems of financing health care expenditures that might arise, which might lead later to rationing care and raise the question of the right to life of very old sick people. He also stresses the possibility of serious intergenerational conflicts in the event that public spending were to become too heavily biased towards funding pensions and the health care needs of the elderly at the expense of the working population and their children. In this regard, the ability of elderly people to organize pressure groups and their greater propensity to vote relative to younger age-groups means that politicians tend to court them and listen closely to their demands; as their numbers rise, the imbalance favouring them at the expense of young people might increase significantly, according to Thomas Mahoney.
The article remains as interesting now as in 1988, to judge from the pattern of demographic change in the United States and its likely consequences (see also the article by Charles du Granrut on "Crunch time for the pension system in the United States?" in this issue, p. 21). It remains just as relevant, too, for the other industrialized countries experiencing an ageing population, in particular France and the "old" countries of Europe.