Earlier quoted context omitted.
Or, worse, the young will never get any power because the old will not relinquish control. Then you have the "surfeit of princes" problem. This isn't just grand political power: imagine being unable to progress in your career because geriatrics above you aren't retiring. That's just one possible secondary effect. We could enumerate many others.
Oh yes. That's a very clear concern. I'm reacting to the "people who decline will he like antivaxers" comment. But it seems far more likely people will be priced out as opposed to voluntarily refuse treatment.
Just to be clear: I'm not from the US, we do have not a very good but nevertheless somewhat working public health system over here.