At work today I got to listen to the ways in which the health care system is failing, not that I did not already know that. It does not matter, which side of the issue you are on I think everyone can agree that where it currently is does not work. Some of it is not necessarily about the level of care, but more about how much it costs and the hoops that you have to jump through in order to be covered by your insurance at times. The other part is who decides what something is actually worth versus the actual cost and who decides what medically necessary means? Some of these seem like very subjective reasoning. So instead of trying to talk about what the current situation I want to examine what science fiction mentions about health care.
The bad side of science fiction and health care are the stories that show a class divide. Most of the dystopias lean towards part of the problem being that health care is only available to the elite or that they get better health care. It seems that in these scenarios insurance is not even a thing that exists anymore. The rich are just so wealthy that money is no object and just pay for anything they can. The poor on the other hand are stuck with second hand medicine that one can just hope will actually work. The thing about most of these situations is that there is no such thing as a middle class. Health care is not the reason for the separation, but health care seems to be one of the indicators of class separation. It makes sense because health care can mean the difference between life and death.
The other side of the coin for health care in science fiction tends towards really, really good. Often in many of these situations health care is fully accessible and easy to get. Some of them do not even need to have physical doctors, because a computer can run a complete diagnostic to figure out what is wrong. The interesting thing about most societies where this health care shows up is that they tend to have no real economy. Some how money has not even become an issue anymore and everyone has access to practically everything. Again, health care is so important because it can be the difference between life and death. When money does not matter then it is amazing what becomes available. At the same time these scenarios seem to be more unrealistic because the materials and everything have to come form somewhere. The thought that we could really invent with abandon is amazing.
Most science fiction seems to be tending toward the extremes or not mention it at all. It is difficult to think of what could be a good middle ground. Money seems so crucial to how the world works and it has been that way for a while. The movie In Time does show another side to health care that could be interesting, and that is: what happens if our health care kept us from dying? Suddenly time has no meaning when we do not run out of it. You can still starve to death and die other ways, but if time is not an issue people could do anything. Loans do not mean too much because you have all the time in the world to pay them off. Thus to keep an economy status quo the time left in your life becomes the economy.
I don’t know that this provides any easy answers, but does show how much health care affects our lives and how important it is. Health care is usually not the focus of science fiction, but it can usually be used to show the status of a society.