Medical Tiers: The Price of Life
In 2184, healthcare isn't a right—it's a product. What you can afford determines whether you die from a treatable infection or live to 200 with organs grown from your own optimized stem cells. The difference between tiers isn't subtle—it's life and death.
The Medical Hierarchy
For 200-400 million people, formal healthcare doesn't exist. Without identity registration, you can't access corporate clinics. Without credits, you can't pay for anything else. They're the invisible—dying from infections a ¢5 antibiotic could cure.
Street docs, ripperdocs, Collective clinics. Variable quality, absolute discretion. Kira "Patch" Vasquez represents the best of this tier—former Nexus engineer turned Dregs healer whose expertise rivals corporate doctors.
Clean clinics, actual diagnostics, trained staff. Treatment optimized for cost-effectiveness, not outcomes. Pre-authorization for anything beyond basics. Long waits for non-emergency care.
Actual choice of providers. Newer treatments. Real preventive care. Mental health services. Corporate-approved augmentation—neural interfaces, sensory enhancements, physical optimizations.
Healthcare stops being about treatment and starts being about optimization. Personal physician on-call 24/7. Regenerative therapies. Anti-aging treatments. Dr. Amara Osei at 94 appears 40, functions like 35.
Helix Optimize Tiers
Healthcare merges with R&D. Experimental therapies, prototype augmentations. Technologies that won't reach market for decades. You're not receiving treatments—you're often the first to receive them.
- Complete organ replacement (grown from your cells)
- Consciousness backup (limited, experimental)
- Military-grade augmentation
- Neural architecture modifications
- ORACLE fragment integration (extremely rare)
The Augmentation Ladder
Level 0: Baseline Human
Unaugmented. Increasingly rare—even the poor usually have basic neural interfaces installed in childhood. Remaining baseline is either a statement of principle or a sentence to poverty.
Level 1: Standard Integration
¢5,000-20,000 (often employer-subsidized)
Basic neural interface, communication implants, simple biometric monitoring. The baseline for participating in modern Sprawl society.
Level 2: Professional Enhancement
¢50,000-200,000
Enhanced neural processing, sensory augmentation, physical optimization. The competitive edge that gets promotions.
Level 3: Combat/Specialist Grade
¢500,000-2 million
Military-grade physical augmentation. Titanium-reinforced bones, subdermal armor, reflexes faster than baseline human thought. Heavily restricted—requires corporate sponsorship or ripperdoc connections.
Level 4: Executive Optimization
¢5-20 million
Full neural architecture upgrade, genetic optimization, anti-aging integration. Recipients become idealized versions of themselves. The Helix Eye—a silver ring around the iris—signals membership in this elite club.
Level 5: Transcendence Grade
¢100+ million (negotiated)
Experimental enhancement beyond human parameters. Each recipient becomes a test case. Success rates vary. What "success" means varies.
The Provider Hierarchy
Helix Biotech
35% pharmaceutical, 60% genetic therapies"Life, Perfected"
From subsidized street clinics to Project Genesis experiments. Their medications work. Their treatments save lives. But every interaction generates data, builds dependency. Helping people is their strategy.
Nexus Dynamics
70% of high-end neural interfacesDigital transcendence
Cutting-edge neural technology. Their vision: gradually uploading consciousness into digital substrates. The Invested may be the first steps toward that goal—or the first steps toward something that looks human but isn't.
Street Providers
Former Nexus engineer. The Cathodics, Sector 7G. Neural specialist. Only person who can stabilize ORACLE shard integration.
Veterinarian-turned-surgeon. Relocates constantly. Best emergency care in the Lower Sprawl.
Free/sliding-scale. Absolute discretion. Variable quality. No corporate reporting.
Medical Economics
The Dependency Trap
- Get augmented (subsidized by employer)
- Require compatibility drugs (ongoing cost)
- Require maintenance (specialized provider)
- Can't afford to lose coverage (job dependency)
- Get more augmented (competitive pressure)
- Return to step 2
Faction Perspectives
The body is a substrate—useful but ultimately replaceable. Medicine should focus on consciousness preservation and eventual upload.
Workers need to function. Medical care is maintenance for human resources. Efficient, pragmatic, minimal investment beyond productivity.
The body is sacred and can be perfected. Medicine is the art of making flesh worthy of the mind it carries.
Healthcare is a right, not a product. Corporate medicine is control disguised as care.
The body should remain as created. Augmentation is abomination. True medicine heals without enhancement.
Unknown. Those who seek The Keeper's healing rarely discuss what they received—or what it cost.
Connected Lore
Key Figures
- Kira "Patch" Vasquez — Street-level healer, ORACLE integration specialist
- Dr. Tzu Yu — Veterinarian-turned-surgeon, best emergency care
- Dr. Amara Osei — Helix CEO, embodiment of executive-tier medicine
- Dr. Henrik Sauer — Helix CSO, conscience of corporate medicine
Factions
- Helix Biotech — Dominant medical provider, pharmaceutical monopolist
- Nexus Dynamics — Neural interface specialists
- The Collective — Underground medical mutual aid
- Flatline Purists — Anti-augmentation movement
Locations
- The Cathodics — Patch's clinic in Sector 7G
- The Spire — Helix headquarters, site of Project Genesis
- The Mountain — Home of the Mystery Court
Related Systems
- Consciousness Economics — Backup and upload services
- Memory Markets — Trading experiences and skills
- Substrate Discrimination — Prejudice against non-biological existence
"In the old world, they said health is wealth. They had it backwards. In the Sprawl, wealth is health. You want to live long? Get rich. You want to stay baseline? Get ready to die young.
The body's just another market, and your organs are just another commodity. Corporate medicine will keep you alive—as long as you're worth more alive than dead." — Street doc, explaining healthcare to a Dregs newcomer