In the neo-feudalist future, a serf will contract with a lord. The contract will say: I, the serf, does what work the lord tells me to do, for what they choose to pay me. In return, the lord takes care of -everything- else. Housing, health, lawyers, religion...everything.
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The serf will be able to freely leave their lord for another lord in the same bloc, since e.g. healthcare costs will be aggregated at higher levels. However, if they need to change blocs, they will first have to buy out their serfdom.
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Otherwise the poor lord of San Fran's gay district will get all the AIDS cases, and, unable to properly fund anything else, everyone healthy will flee, thus leaving them with no funding at all.
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Replying to @Alrenous
This is probably worth exploring in some detail. Imagine a circumstance which could lead to it happening, and work out the bugs.
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Replying to @anomalyuk
Didn't I just do that exact thing? Entering serfdom incurs a debt, which actuaries can already calculated, based on expected health insurance dues (for example). If you want to leave the contract you need to buy out the time-discounted debt.
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No, three tweets is not thoroughly working out a social mechanism. It's a start, though, I like it.
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