This was sort of an amalgam of a few different jokes: originally, the entire comic was going to be about the technocratic future, as I thought the idea of watching ads to subsidize your ambulance was pretty darkly funny; however, I couldn't find the perfect advertisement to depict visually to make the beats of the joke work. However, in this format the bulk of the joke is text-based, and I had an easier time describing with words a type of advertisement I thought would be darkly funny to see before you die. This is probably the case with most jokes; they emerge in my head as concepts first, and are adapted to imagery later. The text usually is the core of the joke, with imagery adding support and keeping it easy on the eyes to read. Not always though!
There was another idea originally of making this about the four futures from the original 'four futures' essay [https://jacobinmag.com/2011/12/four-futures]
but I couldn't quite make the joke work because there aren't enough pre-existing notions about these hypothetical societies to satirize; maybe I'll do a different type of comic about it someday!