9 Science Fiction Novels That Imagine the Future of Healthcare

Autonomous, by Annalee Newitz
Newitz, co-founder of io9, delivers seriously plausible—if chilling—future medicine in her debut, imagining a world where pharma pirates reverse-engineer drugs in order to distribute their own versions the way people jailbreak software today. Judith “Jack” Chen hacks a drug called Zacuity, which supposedly makes people feel good about working long hours for their jobs—but when people start dying, Jack discovers the truth: Zacuity makes people addicted to working, to the point of insanity and even death. A thrilling pursuit and race against time ensues as Jack flees agents while trying to get the truth out. In this terrifyingly plausible post-climate change future, pharma hackers—both blackhat and white—are a vital part of the healthcare system in which  “better living through chemistry” is taken to terrifying extremes.

The Heechee Saga, by Frederick Pohl
Pohl’s classic series of novels is set in a future in which humanity has spread into space even as it has become yet more stratified into the have-it-alls and the have-nothings. Healthcare as a transaction is taken to its logical extreme, as the super-rich can afford near-immortality, with almost any medical problem solvable, while the poor must literally risk their lives on insane gambits involving mysterious alien technology for a chance at prosperity. Along the way, Pohl also imagines sophisticated AIs that replace psychiatrists and therapists, often appearing in the physical guide of famous intellectuals as they help the super-rich feel better about everything.

Star Trek, by James Blish
You can’t talk about the “future” and “medicine” without bringing up Star Trek, but what most people don’t consider is how Gene Roddenberry’s imagined utopia seems to offer a future in which just about anyone cn be a healer. How hard is it be to point a tricorder at someone, receive a diagnosis, then replicate the indicated medicine and apply it? Not hard at all, one would assume—meaning Star Trek has basically posited a future where medical treatment is automated and ubiquitous, which falls in line with the overall post-scarcity society the Federation is imagined to be. In other words, in that future we’d all probably have tricorder apps on our communicators.

Never Let Me Go, by Kazuo Ishiguro
Conceptual spoilers for a decade-old novel to follow: Ishiguro’s somber, thoughtful novel centers on a messy future where clones are raised in special school where they are trained to accept their fates as organ farms for the “real” citizens they were bred to serve. The idea of growing replacement organs seems to be creeping closer and closer to a reality, but Ishiguro’s conception of a future where we treat human beings—clones, yes, but obviously sentient and capable of emotional connections and self-awareness—like cattle becomes more chilling and sinister every time you return to it. The book forces you to ask yourself—if you needed a heart and someone had been grown in a vat specifically to provide it, would you hesitate?

The Unit, by Ninni Holmqvist
Homlqvist takes the same basic premise as Ishiguro—patients submit to having their organs harvested for the benefit of others—but where he zigs into contemplative coming-of-age drama, she zags into sci-fi thriller territory. In the future, women over 50 and men over 60—those without children or beneficial careers, anyway— check into the Unit, where they will be pampered and well-cared for up until such a time their organs are harvested one-by-one. All they have to do in the meantime is enjoy life—and submit to the occasional experimental drug and psychological testing regimen. Dorrit Weger is a new resident at the Second Reserve Bank Unit, where she intends to live out her days, at peace in the notion that, at least, her death will serve a greater good. But then she has the misfortune of meeting her soulmate, and sudden;y, a life with an expiration date doesn’t seem quite as appealing. As we debate the merits of who “deserves” health care—are you more deserving of life just because you can pay to extend it?—it’s fascinating, and horrifying, to consider a system in which humanity is treated with such ruthless egalitarianism.

The Andromeda Strain, by Michael Crichton
Crichton’s 1969 novel is a classic of realistic sci-fi still hailed as a master class in problem-solving under pressure. Every time the characters—trained, intelligent scientists—make a decision out of panic, things go haywire, but when they move deliberately, they tend to make progress. At the center of a fascinating story based on logic is the “universal antibiotic” Kalocin, one of the few truly sci-fi concepts in the book. When one of the scientists believes he’s trapped in a lab where the titular infectious agent has broken free, he demands that he be given a dose of Kalocin as his only chance to survive—but this is refused, because such an antibiotic would kill off everything in his system, rendering him lethally susceptible to an infinite number of infections—a future we might be heading towards anyway, with the overuse of antibiotics creating resistant strains every day.

Alien: Covenant, by Alan Dean Foster
While you were distracted by the horrifying chain of events that leads to the origins of the classic Alien xenomorph, you might have overlooked the absolutely bonkers fact that in the Alien universe’s future, you’ll be able to slip into a medical pod and have just about any medical procedure performed. The implications for this are infinite—you can imagine people having plastic surgery done on a whim, or doing real harm as they attempt to cure imagined ailments. The fact that these pods are also apparently easily hacked (if one scientist’s ability to do so one the fly to cut an alien out of her own body) makes you wonder if there is such a thing as litigation in the future. Still, the idea that someday we’ll all have capable robot doctors in our living rooms? Not bad, future, not bad.

General Practice, by James White
If you’re into space operas, White’s fantastic Sector General series is a nice twist on the genre: instead of being set on a spaceship that routinely gets involved in massive space battles, it’s set in a huge space hospital where the medical staff struggles to deal with patients from various genetic backgrounds—in other words, aliens. For some reason, the challenges of providing healthcare to non-humans doesn’t come up often, so White’s engagement with the idea is unique, and in some ways inspiring. We’d love to think that the Hippocratic Oath will extend not just into the future, but to other races as well.

The Culture, by Iain M. Banks
And to leave you on an inspiring note (since we could certainly use one), we have Iain M. Banks Culture universe, where humanity has long since abandoned its fate to the hands of benevolent, all-powerful artificial minds in order to live out their lives in blissful self-indulgence. Want to live hundreds of years while changing your gender and biology on a whim, and never have to worry about how you’re going to pay for any of it, because who needs money in a (fairly) utopian society so post-scarcity its citizens barely know the meaning of the phrase? We, for one, welcome our new AI overlords.
Take heart: the post on healthcare of the past was even more depressing.