In a non-POM society, basic medical care will be available to everyone and they won’t have to pay for it. After all, medical care is a necessity for most people. In fact, medical care in the form of public health keeps most of us from being killed by plagues. But medicine in today’s economy is very expensive. How can a non-POM society just give it away for free?
There are a lot of things to consider here and we will take up a few of the more important. First, basic medical care such as checkups does not require those specialists who today demand and receive high fees for their services. It is true that there will probably always be medical services which are so expensive in resources that they literally cannot be made available to everyone. There will also come times when the number of people who need treatment will exceed the capacity of the available medical resources, as when flu season comes and there is not enough vaccine for everyone. But basic medical care is all that most people need most of the time.
Second, a lot of the expense of modern medicine in the U.S. comes from regulations, insurance, and lawsuits. Since there is a lot of money involved in medicine, insurance companies go to great lengths to be sure that they pay a minimum of claims and pay as little as possible in each case. But these expenses simply don’t exist in a non-POM economy. Doctors will not be regulated since it will not be necessary. There is no insurance and there are no lawsuits in a non-POM economy. The receptionist who greets you at the doctor’s office will only need to know who you are and what your complaint is. Medical records will be readily available. Therefore, a very large component of the cost of medical treatment will be avoided.
Third, since treatment doesn’t depend on how much money the patient has, there is no need for the poor to use the emergency room for primary care, there is no need to wait until a condition is severe before seeking treatment, and preventive medicine can be practiced.
Fourth, many maladies of today are made worse by poor diet, lack of exercise, and dangerous work and home environments. The food industry provides many foods that are bad for our health (like corn syrup). In a non-POM economy, the nutrition one gets from food is what gets the pay, not the flavor. Therefore, the food provided would have little of the junk calories now found there. Offering people entertaining ways of getting good exercise would earn people money. Creating a workplace or a home which contributes to accidents would greatly reduce a builder’s income. Thus, there should be far fewer industrial accidents and other injuries in proportion to the products produced.
As for the role of the medical personnel, they would be neither restricted nor regulated. They would not be required to provide treatment to anyone, and they could withhold treatment if they chose to do so. But they wouldn’t get paid if they did nothing. Also, it would be the consequences of their actions that would determine the level of their pay, if any. Therefore, if they wanted more money, they would have to treat more people, or treat them better. Mistakes would cost them all money; from the suppliers of drugs and equipment to the janitors who keep the halls in the clinic clean… so everyone would have a motive to minimize errors, whether their own or others. Those who provide medical supplies such as drugs and equipment would also be paid for the consequences of their actions. Drugs’ adverse side effects reduce the pay of those who provide and prescribe them.
Therefore, drugs would only be prescribed when the doctor really thought they would actually help the patient and they would be very careful about such things as drug interactions since those could cost the whole establishment lots of money. No longer would those who market drugs attempt to get them prescribed as much as possible since that would actually reduce their pay. No longer would hospitals buy expensive equipment they didn’t need for status. This would also reduce costs.
Regarding medical procedures which are not at all necessary including cosmetic surgery. Sometimes reconstructive surgery is a necessity, but in other cases, cosmetic surgery is purely for vanity: a luxury in every meaningful sense of the word. In those cases, treatment would have to be paid for in full by the patient at the time the services were rendered.
When there is a shortage of available medical resources (such as after a disaster or other catastrophic event), those who provide the services will decide whom they will choose to treat and whom to ignore. Triaging would be affected, depending on the availability of resources – including personnel. Since one would be paid based on the net benefit generated, individuals who could survive best and go on to provide the most benefit to society would be treated first. Those whose possible contributions would be minimal or are all in the past would be treated last, but usually, there would be treatment for any who needed it. This includes end-of-life care, and doing everything possible to ensure that suffering is minimized.
So to summarize, there is no payment required for most medical care. There is no medical insurance and there are no malpractice lawsuits. There is no regulation of, nor restrictions upon those who provide medical services.