A lower level medical for CTA and RPL is needed perhaps up to say 6 POB or anything larger than a Bonanza / 182 ish...
This is warranted from several view points
1. to keep costs down for recreational, private and trainee, struggling small CPL operations
2. to allow for the reduced risk - eg a cessna 182 or smaller wont destroy half of westfield and 3 city blocks and wont take out 300 people if it goes down...and as someone already said... passenger cars full of upto 8 people are driving around having accidents all the time with people having no real medical requirements or tests other than age related restrictions.
3. to encourage private, recreational and small CPL operators to see doctors when necessary rather than avoid it in fear of being bankrupted or having a $70-100k aircraft in a hanger they cant use, because of some overly strict ruling that assumes your flying a380's -
This last one is huge... my first thought now, is not I should go see the doctor...its Far out if i see the doctor and he writes this down wrong, or wants an unnecessary test to rule something out, and make his monthly quota of referrals, to get a free trip to Switzerland....i lose my ability to fly...and it shouldnt be like that. Or even if he/she is doing it for great reasons, just to be careful..this can disqualify you and make it almost impossible to get back in the air.
The patient and doctor should be free to talk about what ever they want and get any test done they want to rule out anything...and the pilot should only be grounded when needed or when unsafe...not because a wrong or precautionary test or medication was used as a just in case, or lets see if this helps...
Only when the medication, condition, symptoms affect the persons safety should the be grounded...and as soon as those safety factors are gone, the person should be free to fly again.