I wouldn't really say this is a great work of fiction nor was it meant to be. I believe that the story is an allegory for the direction that the author saw the country turning.
He envisioned an America where everyone has universal healthcare and no one suffers from the ravages of Tay Sachs, hemophilia, or sickle cell anemia but where those who have these conditions and other congenital deformities are aborted or live Brain Dead in Body Banks ready to 'donate' a body part to those in need.
No one worries about having to live on social security into old age as once you turn 75, the government has you report to a euthanasia center(shades of Edgar G. Robinson in "Soylent Green").
The future he paints is not bright and the ending of the story is not pleasant, but with recent cases in the news and the ascendancy of the culture of abortion and euthanasia the late author may have painted a picture of where we are headed as a society