However, it does allow for insurance and a basis for decision-making, and it does provide more defined rules and sanctions for those caught doing it. As noted by others, the insurance industry is no doubt watching this carefully, and I expect higher rates or more difficulty getting coverage for flying, say, a 36 Bonanza with no medical. We shall see.
That may well be; like you said -- we'll see. It wouldn't surprise me at all.
With or without a medical certificate, though, the responsibility for determining a pilot's fitness for flight rests squarely and solely on the shoulders of the pilot. The medical certificate means the AME didn't find any specific reasons to DQ you on that particular day. Doesn't mean you're fit to fly the next day; only you can make that determination. Have you taken anything that affects your attention, judgment, reaction time or alertness? Too tired? Too sick? Got that nagging little pain in your chest that comes and goes, but you haven't had looked at yet? The AME isn't going to save you, nor is a CFI nor a DPE. Only you, the pilot.
Originally my FAA medical was nothing more than an added expense. My regular annual checkup was far more thorough. Now it's the one thing keeping me from flying -- although my regular doc (a fellow pilot) and my cardiologist agree that there should be no reason I can't fly safely, an FAA policy says otherwise.
So, if that policy changes I'm not going to shed any tears.
So what about all "those other guys" who are irresponsible, in denial, reckless, etc? They're out there now, they're flying now, and they will continue to do so. I know there are guys flying with expired or invalid medicals, just like there are plenty of guys flying planes that are out of annual. I could be wrong, but I don't think the proposed change in certification rules is going to have a significant impact on those numbers. Safe, responsible guys are going to continue to be safe and responsible. Reckless idiots are going to continue to be so. Policy isn't going to change behavior much, and enforcement? You still have the same rules in place. Fly with a known deficiency and get caught, pay the price -- medical in your pocket or no.
But hey, like i said, I could be all wet on this. Maybe we'll see flaming balls of crumpled aluminum tumbling into neighborhood schoolyards on a daily basis. If that's the case I'm sure we'll see some swift regulatory adjustments.