Quote:
Originally Posted by SteveS
Meanwhile, people in Cancun who depend on the national health care get the sort of care one might expect in a country on the border between developed and third world. It's probably much better than the care a poor person in the US gets, but far short of what wealthy or well-insured people in the US get, or what one can get in the medical tourism hospital.
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This. One of the most gameable and sad realities about tourism is the massive inequalities that it creates and engenders, as well as the cultural hegemony it can then exert. The people who live in a tourist destination often make far less money than is needed to pay the prices aimed at the wealthy tourists, and (worse, perhaps) the only way they can come close is by working for the resorts or whatever that attract the tourists. Things only get worse when there's a 3-TL (frex) difference between the two groups, and the tourism is medical. You could run an entire campaign (either single-system or circuit hospital ship) telling these kinds of stories, including everything from natives begging tourists to pay for their children's or elder's healthcare to theft and sabotage by the lower classes to out-and-out class warfare. And where do the various nobles involved stand on these issues?
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As a transwoman (genderqueer, but transwoman works as well as anything else does), this also brings to mind the phenomenon of transfolk going to Thailand (most famously) to get their gender-affirming surgery. Obviously, it's because of cost and it's same TL, but it's also because of inherent prejudice in our culture, society, economy, and insurance system. Play around with all of those, maybe mix and match them. Any spaceship with a doctor might find itself asking what it should do when a local celebrity, politician, or religious figure of a world without the technology to perform gender-affirming surgery beyond a sharp knife shows up at the spaceport, asking them to do the surgery. Does their answer change if the planet's culture is very accepting of trans identities?
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I also think of the brain GAIN Cuba has experienced for some time. It's because they built one of the best medical education systems in the world ~ and, like true communists, offered to allow at least a good chunk of the tuition to be paid in labor. Sure, embargoes meant that you had outdated, inadequate, or just very little equipment while you did the two years guest labor to pay off your schooling, but it meant you were top of your field globally. Imagine that happening on one of the lower-TL planets in your subsector. They can't provide the whizbang tools, but they've managed to scrape together enough money for databases and virtual holographic teachers and direct skill download from the higher-TL planets that their medical education system is the best in the subsector, but you have to work for them for 4 years to pay for that schooling.
Northern Exposure in the Third Imperium, anybody? A character who took the training and ran from the labor? Wars developing as the planetary noble, desperate to keep his edge faces losing one of the suppliers of educational materials?