Healthcare in GLMZ is delivered through three formally recognized systems that do not interact and were not designed to. The Corporate Medical Provision Network (CMPN), operated primarily by Helix-Vantage Medical Group under franchise agreements with the major employers, serves Tier-One and Tier-Two citizens through embedded clinic infrastructure in corporate towers, residential arcologies, and the premium transit nodes of the Lakefront Precinct. CMPN facilities provide full diagnostic neural scanning, rapid-response nano-therapeutic protocols, and elective augmentation services under corporate wellness plans. The second system, the Meridian Surface Authority Civic Health Program (CHP), nominally serves Tier-Three citizens through a network of 23 licensed district clinics distributed across the mid-grid. CHP wait times average 11 to 34 days for non-emergency consultations, and the program's formulary — the list of treatments covered under the civic health subsidy — has been reduced seven times in the past decade under successive MSA austerity packages negotiated with the Corporate Civic Council.

The third system is not a system at all. It is an improvised ecology of unlicensed practitioners, community care networks, stripped-down diagnostic hardware, and pharmaceutical gray markets that serves the Tier-Four population, the Unlisted, and the growing segment of Tier-Three residents who have fallen through CHP coverage gaps. In the Pressed Steel Quarter, a collective known as the Meridian Free Clinic operates from a converted freight depot at the corner of Vance Spur and the 14th Sub-Level access road, staffed by a rotating group of suspended and de-licensed medical professionals, nursing graduates who cannot afford credential registration fees, and trained community health workers with no formal certification. The Free Clinic sees approximately 400 patients per week. It has no surgical suite, no licensed neural diagnostic equipment, and no legal standing — but it has not been closed because the MSA has quietly calculated that its elimination would increase emergency presentations at licensed CHP facilities beyond manageable capacity.

Neural interface health represents a particular crisis in the lower tiers. Approximately 74 percent of Meridian's adult population carries some form of neural interface hardware, but the distribution of interface quality follows the citizenship tier curve almost exactly. Tier-One and Tier-Two residents carry current-generation Nexus-7 or Helix-Vantage Cortex Series hardware with active firmware maintenance contracts. Tier-Three and below residents disproportionately carry older-generation or third-party gray market interfaces — particularly the Shenzhen-derivative 'Foxbrick' units that flooded Meridian's sub-grid market following the 2181 import restriction collapse. Foxbrick units have a documented failure rate three times higher than licensed hardware and are associated with a cluster of neurological conditions colloquially called 'drift syndrome': fragmented short-term memory consolidation, persistent sensory artifacts, and in severe cases, involuntary memory loop events. Drift syndrome appears in no official MSA disease registry, a classification gap that advocates and Free Clinic staff have documented and challenged without institutional response.

The body itself becomes a class marker in ways that are visible and socially encoded. Residents of the lower tiers display the physical signatures of deferred care: undertreated fractures that healed with visible deformity, untreated dental deterioration, the neurological micro-tremors associated with long-term Foxbrick interface degradation, and the complexion changes linked to chronic Substrate exposure — Substrate being the proprietary nutritional supplement that serves as the primary caloric source for residents who cannot afford or access conventional food markets. Upper-tier residents, by contrast, display the smoothed, maintained appearance that CMPN elective programs produce: corrected vision, regulated metabolic profiles, cosmetic neural interface housings in brushed titanium or medical-grade ceramic. The visual grammar of tier is readable at a distance, and its legibility is not incidental — it functions as a continuous social sorting mechanism that reinforces the hierarchy it reflects.