The end of the Resource Wars saw the global economy collapse, and the end of foreign aid and subsidies around the world. It was a bleak time. The governments that were born in the Dark Age were largely socialist in nature, sharing goods and resources. This initially started as military protection, but expanded to food and medical aid. The governments were not the only powers that did this, some companies that trace their roots back to the Petroleum Age survived as well. They were organized, and had a sense of belonging that made them in a sense their own communities and economically secular governments. The Atlantic Federation, and large parts of the other world powers share this rather common ancestry of communalism, be it corporate or socialist.
Once the Second Renaissance began and really started spreading, medical complexes started growing like weeds. It was first basic services, vaccinations and dealing with infectious diseases. A little touched topic is that the Second Renaissance involved several pandemics as previously isolated communities were reintroduced. During the Petroleum Age there was a new round of influenza every year, and sometimes as many as two or three strains active at a time. After the collapse of the global community, the yearly Influenza outbreak subsided and it was reduced to as few as one new strain every ten to twenty years.
Better known as GeneSystems, Wyatt Jaffa and Silver is a private medical company that started in Dallas, Republic of Texas, and makes no great claims of Corporate Lineage. WJ&S is the main PMC in the Republic of Texas and operates both publicly funded 'White Hospitals' as well as privately funded 'Black Hospitals'. The corporation pioneered the division of medical complexes, with both the white and black buildings being located in the same complex in Dallas. Patients using state insurance, or other medical assistance programs were run through the larger white hospital. The white complex was noted for it's large volume and often long waits are large numbers of people were handled by the system.
Patients willing to pay money up front for treatment, or those who had private medical care rather than relying on public institutions could instead opt to go to the 'black building' in the complex. Lines were short to non-existent and the quality of health care was much higher. Most doctors trained in medical schools and worked in white hospitals and clinics, and aspired to be accepted into the black building.
The Rupert Wyatt Medical Center, aka the black building, was only black by accident. There was no plan that the building was to be black, it was an incident of construction. The main complex was built by one conventional construction company, while the R. Wyatt Center was built by a second company that employed construction hard suits and industrial mecha. Rather than using the same white cladding material as the other company, the mecha construction company opted to use a locally produced synthetic black stone. The resulting building was done first and was dramatic in it's appearance. It was later decided that the private medical practice would be moved into the black building, and the initial plan to have the offices was moved to the central tower of the white complex. Later medical complexes in the Republic adopted both the model and the color scheme, white for public health, and black for private health.
State of the Art versus Solid State
The two complexes, and the two complex system quickly spread beyond the Republic of Texas and has since been largely adopted around the world. The Atlantic Federation, ACPS nation China, Nippon/Japan, and other smaller powers have adopted the twin system. Not all copy the black versus white. In the SAUR, private hospitals are blue, while public institutions are white with red markings, and in continental Europe there is no color difference but PMCs will be located in a demi-arcology, while public facilities are in complexes not attached to an arcology.
Black medical centers are more known for pioneering medical technology, producing drugs and procedures and other cutting edge technologies. The white medical centers are more known for taking a wait and see procedure and practicing tried and true methods rather than experimental treatments. There is a common misconception that the two sides of the system are not connected, but this is far from true. In some instances, it would be better for the medical consumer if the two were separate. Black hospitals typically attract the best talent from the medical profession, leaving fewer top quality doctors in the public sector. Many public doctors are also working not for their patients, but with an eye for gaining admittance to one of the hallowed Ebony Towers. Conversely, many of the medical treatments and surgeries are tested in the public hospitals. It wouldn't do for an experimental treatment to kill a wealthy patient.
Zenimax Medical of Nippon is not a large company, it only runs a single medical facility, the Zenimax Demi-Arco in Neo Kyoto. The Zenimax company is one of the few companies that deals with CogNet medical dysfunctions, such as biological issues like infection or rejection of a Wachowski probe or much more commonly soft dysfunctions like addiction to CogNet, or addiction to black feed content. Zenimax runs special 'Methadone' simulations that therapeutically restore brain function and serotonin centers.
Wearing the Black
Color is a common theme in the Private medical world. Hospitals are strongly associated with certain colors, antiseptic greens, fluorescent whites and other sterile color palettes. The private companies counter with a more natural or 'rich' feel. White is almost non-existent, and the staffs have more stringent dress requirements. A black clinic doctor is much more likely to wear a smock covered suit and slacks rather than scrubs and nurses are more likely to wear dresses with associated covering smocks than scrubs. They are either allowed to cultivate a personal style that fits with the spirit of the company, or follow a company associated dress/color code. Some examples include the natural physician code for California's Golden State Medical where doctors affect Norman Rockwellian old time traveling doctor's clothing, to the almost stripper-ific attire at the posh Hollywood Medical Centre. Doctors and staff at one clinic might all have a black with red highlights dress code, while another could actually have a top level fashion designer created uniform.
Medical vehicles share the division of public and private. There are ten white ambulances for every one black one, but there are five black air evacuation craft for every one white one. White vehicles sustain patients until they reach a hospital, while a black medivac VTOL could have things as cutting edge as Flash MRI handhelds, bioscanners, and an in flight operating theatre.
The Black Ship is a surface naval vessel that operates in the Caribbean League of the Atlantic Federation. The ship is one of several that cruises the waters of the League, and when there is a medical emergency on one of the resorts, or seacologies, a fast moving hydrofoil or VTOL can ferry a wealthy patient or properly insured patient to one of these ships for cutting edge medical treatment. There are very few 'white' medical ships, and those that exist are either funded by maritime nations that would benefit from them, such as the Caribbean League, or are the property of the military or a maritime megacorporation.
The Private and Public medical systems exist now, and there are even television programs about it, contrast ER, Scrubs, etc versus Private Practice. Shadowrun has the DocWagon program, where medics appear out of nowhere if the PC is harmed. Taking these two and weaving them together creates the tandem system, a high cost private option, and a low cost public option. Adding a dash or three of corporatism completes the mix. Money isn't the only concern in the Cosmic Era. The world population contracted greatly before the Second Renaissance and still hasn't recovered, nor is it recovering very quickly. There is a shortfall of manpower, leading to greater emphasis on healthcare, as well as things like cloning programs and androids. In the Cosmic Era everyone (or the majority of people) have access to passable Healthcare. This change is most dramatic in second and third world nations, and the difference in first world nations is marginal.
Additional Ideas (1)
Butchers, murderers, thieves. The black hospitals are everything evil about the Cosmic Era. Immortality for the wealthy! But for the common man, nothing but tough luck and flu shots. It's a damned joke!
The Black Hospitals have many detractors. When there are periods of social unrest and civil disobedience, the primate medical industry is often a target. Despite the existence of cloned organs, there are still people waiting on organ donation lists. The only difference is that the lists are a bit shorter than they were in the Petroleum era. Many people are offended that if a person has a medical plan that will cover the cost of a cloned organ, or are willing to pay cash for a cloned replacement they can get one in a matter of weeks, generally the time needed to take a sample and grow a new organ.
Many people also blame the lines and waits in the public health system on the sheer existence of the private corp health system. In some cases this is true, as some black centers are just as large as white centers and have equipment that sits idle while in the white center next door or across town the same machine has a six week backlog of patients waiting to use it.