Alan E. Nourse’s 1974 The Bladerunner is a standalone near-future medical SF novel. It is not the novel on which the 1982 Ridley Scott film Blade Runner is based. It is the novel on which the title of the film Blade Runner is based. More on that later.
In this novel’s 1994, America faced the perfect storm of population pressure, an aging population, soaring universal health care costs, and studies blaming the increased incidence of antibiotic-resistant diseases and the spread of genetic disorders like diabetes on modern medicine itself. Following the Health Riots the United States hastily adopted the Heinz-Lafferty Eugenics Control program.
Medical treatment is still available to all, but any individual who requires health care services for any reason is sterilized. Children under five are exempt, save for children who have known hereditary disease; the latter are routinely sterilized or euthanized.
Unsurprisingly, a considerable fraction of Americans want medical treatment without mandatory sterilization. Many physicians do not agree that the Heinz-Lafferty program is good public policy. The resistant Americans have provided demand, The resistant physicians have provided supply. The twenty years since the Riots have seen a black market in medical care firmly establish itself in the US. Such a vast black market needs its middlemen and that’s where Billy Gimp comes in.
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