The Freedom Bulletin

Note: This essay describes what an ideal medical system (in my opinion) would look like. It is not supposed to be realistic or practical at all; I know that a system like this has very little chance of existing anytime in the near future. I simply believe that this is the kind of system that America should strive for.

In a just medical system, people would have the right to do anything they want, as long as it does not violate the rights of anyone else. Neither doctors nor companies nor organizations nor the government would attempt to control or influence what people do. 

People would pay for health services the way that people pay for most products and services. They have a price, and you can either pay the price and get the service or not pay the price and not get it. The government would not pay for anyone’s health services, and charging people different prices for the same thing would be banned. However, because the demand for most health services is inelastic, there would be price ceilings, or upper limits on what doctors and drug companies are allowed to charge. 

When a person needs a medical service, they would go to a doctor’s office or hospital (either after making an appointment or not) and let the doctor or staff know what procedure(s) they would like by filling out a slip of paper. All of the procedures offered would be listed, along with their prices, on a sign, in a pamphlet, or on a website. Services offered may include: 

• Vaccinations
• Tests (taking samples, performing imaging, testing samples in a lab, interpreting the results of imaging, etc.)
• Surgery
• Examinations
• Advice (about what medications to take, what procedures to undergo, how to exercise, what to eat, etc.)
• Diagnosis
• Note-taking (writing down the customer’s medical history, test results, etc. and storing the records if the customer wishes)

 Doctors would perform all and only the procedure(s) that the customer orders.

 There would also be self-service options for people who want to be more self-sufficient and have more dignity. There would be facilities where people can perform imaging tests on themselves, give themselves vaccinations, test their own urine and blood samples, et cetera.

 If a person wants medicine, they would simply go to a store and buy it. No medicines would be outlawedor require a doctor’s permission to obtain.

 If a person wants medical information, they could consult pamphlets, books, and websites created by governmental or medical organizations. These organizations would provide the public with facts, including data about the statistical probability of diseases, instructions on interpreting the results of imaging and tests, figuring out what illnesses one has, and deciding what medicines to take. They would not make normative judgments about what people should do.

 If people want to keep medical records about themselves, they could either write down the information themselves or ask a doctor to do it for them. Doctors would keep no records about their customers beyond what is needed to remember whether the customers have paid or track which procedures are the most popular. Customers would be responsible for creating their own records (or none at all), physically possess those records, own the rights to them, and decide whom, if anyone, to share them with.   

In a just medical system, people would be allowed to perform any of the medical services listed above without assistance from anyone else. If they wished, they could also ask a doctor to do any of these services for them to save time or effort. Doctors could choose which services to offer, just as stores can choose what products to stock, but they would have no say in what services each customer receives. Instead, customers would be in control of what happens to them. People would have dignity, and customers and doctors would interact as equals.