Someone mentioned annual flight reviews as an alternative to the medical. I believe this lacks supporting data, same as ALPA's play but in the other direction.
I'm not saying that an annual review wouldn't improve safety, but it could also be said that a quarterly review would improve safety even more so.
And... It could be argued that an annual (or quarterly) drivers test would increase highway safety. But that isn't going to happen for the same reason there are no helmet laws for automobile passengers - Political suicide.
But GA, without political clout, is an easy target. When AOPA goes forward with a concept of "online course every year and one pax max", etc., or we think an offer of an annual BFR will call the dogs off, we are kowtowing and we have already lost the fight.