Free Medicine

This essay's great virtue is that it thinks long, gaining the advantage of depth of field, seeing medicine evolving over decades. The essay's great difficulty is that it thinks long, accumulating predictive error over time, necessarily becoming "a trajectory" rather than "the trajectory" of the endeavors it forecasts. What happens in the meantime is also crucial, because of path-dependence.

I think this is a pretty good guess about the direction of travel in the absence of significant societal distortions from the Big Pharma parties whose involvement you mention but do not analyze. They want the vested-rights system from which they benefit to exist long enough, and to accrue enough apparent normative authority that they can commandeer the "biological engineering" industry that your hypothesized science brings into existence. They want it for themselves on a long-duration individual-monopolies basis secured through the patent system, such as they benefit from now in the closing period of this phase of the industry. Their patent-intensive approach, as we can see around us, allows significant distortion of the societal research investment, comprehensively replacing socially useful research by patentable research (a different and in no way congruent category), with significant second-order effects on the way medicine is practised and the way the information health care accrues is distributed and used.

You also do not take full account of the immense social changes, in health care particularly, that will be brought about by omnipresent intelligent sensor networks. You refer to the streams of genetic and other biological information available. When the environment is comprehensively measured everywhere, inside our bodies and outside, by billions of inexpensive network-attached sensors, the process of maintaining health and preventing injury is modified as fundamentally as the 20th century modified it, first with the automobile and then with the seat belt and the air bag.