Tier 0: No Care (The Invisible)
Who: Unregistered individuals, deep Waste residents, those in debt default Annual Cost: ¢0 (services unavailable) Life Expectancy: 35-45 years
Reality: For an estimated 200-400 million people in the Sprawl, formal healthcare simply doesn't exist. Without identity registration, you can't access even basic corporate clinics. Without credits, you can't pay for anything else. These are the invisible—dying in shanties, succumbing to infections that could be cured with a ¢5 antibiotic, if they could afford it.
Options:
- Folk remedies and traditional medicine (variable effectiveness)
- Collective-run mutual aid (limited availability)
- Religious charity (strings attached)
- Dying quietly
The Cascade Legacy: Before ORACLE fell, even the poorest had access to basic automated healthcare. The Cascade didn't just kill billions directly—it destroyed the infrastructure that kept billions more alive. Many Tier 0 residents are descendants of those who never recovered their place in the system.
Tier 1: Street Medicine
Who: Dregs residents, uninsured workers, those avoiding records Annual Cost: ¢500-5,000 (pay-per-service) Life Expectancy: 50-60 years
Service Providers:
Kira "Patch" Vasquez represents the best of street medicine—former Nexus engineer turned Dregs healer, treating everything from neural feedback to emergency trauma. Her expertise rivals corporate doctors; her discretion is absolute. But most street docs aren't Patch. Most are half-trained, working with expired supplies, doing their best in impossible conditions.
What You Can Get:
- Emergency trauma care (bullet wounds, blunt force, burns)
- Basic cybernetic maintenance and repair
- Common illness treatment (infections, minor diseases)
- Unlicensed augmentation installation
- Medication (often expired, sometimes counterfeit)
What You Can't Get:
- Preventive care
- Chronic disease management
- Complex surgical procedures
- Genetic treatments
- Guaranteed outcomes
The Helix Paradox: Helix Biotech operates thousands of subsidized street-level clinics throughout the Sprawl. The care is genuine—they actually help people. But every visit generates data, builds dependency, and ensures that when patients can finally afford better care, they'll turn to Helix. Corporate charity is still corporate strategy.
Tier 2: Basic Corporate Healthcare
Who: Registered workers, entry-level corporate employees, small business operators Annual Cost: ¢10,000-50,000 (or employer-subsidized) Life Expectancy: 65-75 years
What It Looks Like: Corporate clinics with clean waiting rooms, actual diagnostic equipment, and trained (if overworked) medical staff. Treatment protocols optimized for cost-effectiveness rather than patient outcomes. Pre-authorization requirements for anything beyond basics. Long wait times for non-emergency care.
Coverage Includes:
- Annual physicals
- Basic vaccinations
- Common illness treatment
- Minor surgical procedures
- Neural interface maintenance (basic)
- Generic pharmaceuticals
Coverage Excludes:
- Experimental treatments
- Most augmentation
- Genetic optimization
- Life extension
- Chronic condition management beyond basics
- Mental healthcare
The Corporate Trade: Basic healthcare often comes as part of employment packages. This sounds beneficial until you realize it creates dependency—lose your job, lose your healthcare, lose your life if you have a chronic condition. Corporate workers with families often stay in terrible positions because leaving means losing coverage.
Dr. Tzu Yu's Market: This is where unlicensed practitioners like Dr. Tzu Yu find their niche. When your corporate coverage doesn't include augmentation, when you need something done without records, when the wait time for approved treatment is longer than you have—that's when you call the veterinarian who happens to be the best cybernetic surgeon in the Lower Sprawl.
Tier 3: Professional-Class Healthcare
Who: Senior corporate employees, successful independents, mid-tier professionals Annual Cost: ¢100,000-500,000 Life Expectancy: 80-100 years
What Changes: Actual choice of providers. Access to newer treatments before they become generic. Preventive care that prevents things. Real mental health services. The ability to see a specialist without waiting months. Healthcare that feels like healthcare rather than damage control.
Services Available:
Augmentation at This Tier: Professional-class citizens can afford corporate-approved augmentations—neural interfaces, sensory enhancements, physical optimizations. These are regulated, monitored, and require ongoing maintenance (conveniently provided by the corporation that sold them). Nothing too exotic, nothing that might make you better than your betters, but genuine improvements over baseline human capabilities.
The Optimization Pressure: At this tier, augmentation shifts from optional to expected. Senior employees without neural interfaces are viewed as unambitious. Colleagues with enhanced focus and processing speed get promoted faster. The pressure to upgrade is constant, and each upgrade creates more dependency on corporate medical systems.
Tier 4: Executive Healthcare
Who: Corporate executives, wealthy independents, successful criminals Annual Cost: ¢1-10 million Life Expectancy: 120-150 years
The Transformation: At executive tier, healthcare stops being about treating illness and starts being about optimization. Why fix problems when you can prevent them entirely? Why accept normal aging when you can slow it to a crawl? Why remain baseline human when enhancement is available?
Standard Executive Package:
- Quarterly full-body diagnostic scans
- Personalized genetic screening
- Predictive health modeling
- Priority access to new treatments
- Personal physician (on-call 24/7)
- Regenerative therapies
- Anti-aging treatments
- Premium augmentation services
- Mental performance optimization
- Medical concierge services
Life Extension: Executive healthcare includes genuine anti-aging interventions. Telomere management, senescent cell clearance, organ regeneration, neural preservation. A 94-year-old executive like Dr. Amara Osei can appear 40, function like 35, and expect another century of life if nothing violent intervenes.
The Executive Body: At this tier, augmentation becomes an arms race. Your neural processing needs to keep up with your peers. Your physical appearance needs to project success. Your biological systems need to sustain 80-hour work weeks indefinitely. Executives aren't just enhanced—they're rebuilt for competition.
Helix Optimize Service Tiers:
Tier 5: Elite/Experimental Healthcare
Who: Corporate royalty, faction leaders, the obscenely wealthy Annual Cost: ¢50-500 million Life Expectancy: 200+ years (theoretical)
Beyond Normal Medicine: At the elite tier, healthcare merges with research and development. You're not just receiving treatments—you're often the first to receive treatments. Experimental therapies, prototype augmentations, technologies that won't reach the general market for decades (if ever).
What Becomes Possible:
- Complete organ replacement (grown from your cells)
- Consciousness backup (limited, experimental)
- Full-body rejuvenation
- Military-grade augmentation
- Neural architecture modifications
- Genetic reconstruction
- ORACLE fragment integration (extremely rare)
Project Genesis: Helix Biotech's most secretive program operates at this tier. True human enhancement—not optimization within human parameters, but expansion beyond them. Engineered immune systems, sleep elimination, 200+ year lifespans, neural tissue that interfaces directly with electronics. Success rate: 23%. Those who survive become something more than human. Those who don't become research data.
The Invested (Nexus): At Nexus Dynamics, elite executives have begun integrating ORACLE fragments directly into their neural architecture. They gain processing power, pattern recognition, predictive capability. They also lose something harder to define—the executives who've undergone this procedure speak of "gaining clarity" while their colleagues notice a certain coldness in their eyes.
The Mystery Court: Somewhere on The Mountain, the Mystery Court offers treatments that make even Helix's experiments look conservative. What The Keeper provides, no one discusses publicly. Those who return seem... different. More capable. Less certain they're entirely themselves anymore.
