Lester del Rey’s 1957 Mars novel Badge of Infamy envisions the future of healthcare

As the United States moves closer to finalizing a decision as to whether or not its healthcare system needs reform, Badge of Infamy (1957), a novel set on Mars and written by SF Grand Master Lester del Rey, provides some interesting speculation about the future of healthcare. A tale about a doctor, Daniel Feldman, who once made the mistake of saving a friend's life in violation of Medical Lobby rules, here’s a lengthy but critical excerpt from Badge of Infamy that explains the worlds in which Feldman operates:

There had been a medical lobby long before, but it had been a conservative group, mostly concerned with protecting medical autonomy and ethics. It also tried to prevent government control of treatment and payment, feeling that it couldn't trust the people to know where to stop. But its history was a long series of retreats.

It fought what it called socialized medicine. But the people wanted their troubles handled free -- which meant by government spending, since that could be added to the national debt, and thus didn't seem to cost anything. It lost, and eventually the government paid most medical costs, with doctors working on a fixed fee. Then quantity of treatment paid, rather than quality. Competence no longer mattered so much. The Lobby lost, but didn't know it -- because the lowered standards of competence in the profession lowered the caliber of men running the political aspects of that profession as exemplified by the Lobby.

It took a world-wide plague to turn the tide. The plague began in old China; anything could start there, with more than a billion people huddled in one area and a few madmen planning to conquer the world. It might have been a laboratory mutation, but nobody could ever prove it.

It wiped out two billion people, depopulated Africa and most of Asia, and wrecked Europe, leaving only America comparatively safe to take over. An obscure scientist in one of the laboratories run by the Medical Lobby found a cure before the first waves of the epidemic hit America. Rutherford Ryan, then head of the Lobby, made sure that Medical Lobby got all the credit.

By the time the world recovered, America ran it and the Medical Lobby was untouchable. Ryan made a deal with Space Lobby, and the two effectively ran the world. None of the smaller lobbies could buck them, and neither could the government.

There was still a president and a congress, as there had been a Senate under the Roman Caesars. But the two Lobbies ran themselves as they chose. The real government had become a kind of oligarchy, as it always did after too much false democracy ruined the ideals of real and practical self-rule. A man belonged to his Lobby, just as a serf had belonged to his feudal landlord.

It was a safe world now. Maybe progress had been halted at about the level of 1980, but so long as the citizens didn't break the rules of their lobbies, they had very little to worry about. For that, for security and the right not to think, most people were willing to leave well enough alone.

You can read Badge of Infamy online or download it from Project Gutenberg or ManyBooks.net. Also, you can listen to a reading of the novel through Librivox.

Pictured: Recent audiobook artwork.