Michael Cook

Michael Cook is the editor in chief of Mercator. He lives in Sydney, Australia.


The Titanic sank after it collided with an unseen iceberg. Western societies with low birthrates are steaming straight towards an iceberg in broad daylight. But they refuse to change course.

The problem is this. As birthrates drop, there are fewer and fewer productive workers and more and more unproductive elderly. The tax burden on the workers grows heavier and heavier. Pension funds will begin to run out of their reserves and benefits will shrink. The iceberg of a pensions crisis looms on the horizon in many countries. And there aren’t enough lifeboats.

Every economist knows this. Every politician should know this. But the Titanic steams ahead towards the iceberg.

Finally someone has proposed a way to avert disaster.

The president of Belgium’s biggest health care fund, Christian Mutualities (CM), wants to throw the elderly overboard.

Luc Van Gorp told Belgian media earlier this week that people who are tired of life should be allowed to end it through euthanasia.

Like all other European countries and, indeed, the rest of the world apart from sub-Saharan Africa, Belgium faces a huge increase in its elderly. Over-80s will double by 2050, from around 640,000 today to 1.2 million. Financial pressure on healthcare, medication and nursing homes will increase.

More money is not the solution, says Van Gorp. “No matter how much you end up investing, it will still not be enough. There are simply not enough health workers to do the job,” he said. “Do we really need all those extra residential care centres? Just building up rooms without doing anything about the staff shortage is not a sustainable model. I miss the why-question in elderly care. Why do we do business the way we do them now? There is often no answer to this.”

He is in favour of “a radically different approach” – not asking “how long can I live?”, but “how long can I live a quality life?”. He wants euthanasia to be an option for Belgians who believe that their lives are complete, not just for those who are terminally ill or suffering unbearably.

“Suicide is too negative a term,” says Van Gorp. “I would rather call it: giving life back. I know it is sensitive, but we really have to dare to have that debate.”

In an interview with the Flemish newspaper Nieuwsblad, Van Gorp declared:

Everyone wants their parents and grandparents to stay as long as possible, right? But do those people want that themselves? And what do they need for that? These questions are asked too little. Some people over 80 will not need anything at all to age well. They will even be able to support others, for example by keeping them company. Others need a lot of care, and – just to be clear – we must continue to provide it.

But what about the category of elderly people who receive maximum care, but who still do not have the quality of life they desire? That question is asked far too little.

Although some Belgian politicians supported Van Gorp, Christian Democrat leader Sammy Mahdi said that Belgium was becoming a “throwaway society”. “This makes me angry,” he wrote on X. “If someone is tired of life and feels they are in the way or don’t get visitors anymore, aren’t we just failing as a society?”

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