Internationally, state-funded health care wasn't a thing. Most commonly, a doctor—almost none with any training in chakra—would go from village to village, taking care of problems as he (because it was almost always a 'he') went. Larger villages might have a permanent doctor, and cities might even have more than one. For nobles, a private physician was a status symbol. Within most hidden villages, a small subset of ninja were typically taught iryo-ninjutsu, maybe some non-chakra related medicine too.

But state-funded medical care?

Too expensive, Daimyos argued. Unnecessary, Kages dismissed.

Death, illness, all of this was a part of life, and medicine—well, that was just for those who could afford it.

Except in Konoha.

When Konoha was founded, Mito required there to be medical care for any Konoha-resident—something that was done in Uzu, too, something she missed from her home country.

The First Hokage could not deny his wife, and included the hospital in his plans, included its funding in the village's budget.

And its lifetime healthcare had been one of Konoha's greatest expenses.

Actually, depending on how you divided up the expenses—as long as you did not treat all wages as one category, for instance—it was Konoha's greatest expense.

But no one ever really did more than grumble about it, because it was Mito's vision, and it had been around since the founding, and at this point it was tradition, wasn't it?

Most just saw it as a useful tool in building Konoha's reputation, and left it at that.

Now, now after the years of struggles and war and the byoki attack—

Now the benefits were plain to see.

Since three years after its founding, Konoha had been forced to limit immigration, had to account for the lack of room, the lack of jobs, the lack of resources—

But now there were more than enough to go around.

And Konoha had been encouraging immigration, pushing for their civilian population to grow, to rebuild, to become large enough to support the village as it wanted to be.

And it had been working.

Immigrants, not only from the former Land of Water, but also all over Fire, all over the continent—

They came.

And when the immigration officials asked what had drawn them to Konoha, what had convinced them to come despite the still lurking byoki, despite the blatant anti-Konoha sentiment that the other major nations were expressing?

One answer stood out.

Was so much more common than any other answer that it was an outright majority, not even just a plurality.

Healthcare.

A man with one arm came to Konoha, asked the immigration official about the hospital, about the prostheses he'd heard about. The official had explained that there was a basic model anyone could get, or more advanced models if you paid, or if you were a shinobi. The man, having spent years without an arm, could only get the basic model.

It had taken less than a month for him to get fitted, for the prosthesis to be made, for him to learn how to use it.

Now he'd finished training as a railroad worker, was self-sufficient for the first time in years, was taking courses in accounting and saving up to purchase one of the more advanced prosthetics. Was dating, was vocally supportive of Konoha to anyone he came across.

A family with a sick daughter came to Konoha, asked the immigration official about the healthcare. She would end up spending nearly four months in the hospital, had to have heart surgery—was running around, now, in the Academy alongside her brothers.

The parents had opened up a tailor shop, finally turned a profit just last month, were encouraging their extended family to come while there was still room, send their children to the Academy too.

Healthcare.

Minato smiled, looking down at the report the immigration office and hospital had co-written.

It was—

It was even better news than expected, honestly.

After the byoki attack, after the initial flood of deaths from it and the war, after the emigration rush as people felt unsafe—

It had felt like Konoha was teetering on the brink of collapse.

Ready to crumble at the slightest additional pressure.

But it hadn't.

The will of fire had burned through Water, burned through betrayal, would in time burn through the byoki too—

And Konoha had survived.

Had done better than expected.

Had huge Academy classes in both Konoha itself and its island port of Kaiso.

Had built back its civilian population, had shown through the International Chuunin Exam that they would build back its shinobi population in no time too—they'd won, after all, had dominated throughout, had shown the wonder of their rebuilt Uzu, the Kaiso port, had shown the wonder of the active construction in Konoha, its ability to rebound.

For its lifetime, Konoha had treated the healthcare as a burden, as something which was only around for tradition's sake, something which should be pared back when possible.

They hadn't been pleased when Minato had refused.

He'd always, always considered the hospital to be far more important than Konoha's leading voices did.

But he'd still hesitated, still worried that they were right about the hospital, about healthcare, about the hundreds of other things they disagreed about.

And then, during the worst time Konoha had ever faced, it had been healthcare which had seen them through, which had allowed them to treat the survivors, draw in new residents.

If he was right about healthcare, then he was willing to take a shot on being right about a lot of his other less-than-popular ideas.

Minato smiled, and knew it was time to make his proposal.

To hear everyone argue against it.

And then to push it through anyway.

Konoha was a shining beacon of progress, and it was time to ensure that it would continue as such far into the future.

(And, of course, the amount of changes his proposal would force would also draw attention even further away from the secrets he was hiding in the remnants of Kiri. It would be some time until a solution was found, there, and the less eyes on it until then, the better.)

.

The volume was painful.

Literally, physically, painful.

There was no way that anybody could hear themselves speak, much less anyone else, but that wasn't stopping them.

Wasn't stopping anyone.

Sakura—

The volume hurt.

The other Heads around her were screaming, were shouting, were becoming visibly irate, were becoming visibly willing to show their emotions through violence—

And Minato sat.

And waited.

And Sakura knew that many of the people in their room had forgotten that this was a military dictatorship, that the only one Minato needed the agreement of was the Daimyo.

She was sure he'd gotten it—he and Shin had talked a lot during the chuunin exams, and he and the Daimyo had disappeared a number of times too.

So it was a done deal, the restructuring.

But she understood.

She—

She'd known it was coming.

She'd offered some of her own ideas.

But she'd also, unusually, argued against Minato's suggestion, Minato's plan.

It was so sweeping, so unbelievably destabilizing—

"Where is Hiruzen?!" Someone shouted. Sakura winced—whoever it was must have used chakra to amplify their voice, and the three words all drove themselves deep into her head, pounded against her skull.

And Minato didn't even flinch.

It took a few more minutes—unsurprising in a meeting full of people with the title of 'Head'—but everyone finally went (relatively) quiet, allowing for individual complaints to be made.

Which meant Minato had to actually talk, instead of just watching the noise.

Sakura was sure he was so very, very happy about that.

"Why are so many people missing from this meeting?" Head Utatane said. "The Hokage isn't here," which, to be fair, was Hiruzen Sarutobi's title still, but most people tended to add 'retired' or something before it, "the Sannin Tsunade isn't here, the Yamanaka Head, isn't here, the Hyuuga Head isn't here—should such a massive change even be considered?"

"I did not request the Heads of each clan to arrive, I simply told each clan to send one representative."

Sakura shifted. Right. She was here as the Yamanaka representative. Probably should remember that.

"Is this really necessary?" Head Nara asked.

Which… yeah. Was Sakura's question too.

Minato shrugged. "Necessary? Probably not. But our current system is patchworked together, and I guarantee you that part of the reason we have as bad a spy problem as we do is because if someone walks into any office in this building and asks for information, they may very well actually need the information for some other department… or they might just be a spy."

"That's what sealing tags with security systems are for!" Someone—Sakura didn't know who, but she didn't like them—shouted.

"Those are very, very difficult to make, and we have a far greater need for seals than we have the resources to make them. Other solutions need to be found."

"And how can we be sure that this won't provide a very, very obvious opportunity for every other nation on the continent to go to war with us?"

"Well, they're kind of busy with the plague, if you hadn't noticed. Rising death tolls every day, and all that. Kind of figured that would take up a lot of their attention."

On.

And on.

And on it went.

Sakura asked a few questions—questions she'd asked before, that she wasn't very happy with Minato's answers about—and everyone else did too but, well, in the end this was a dictatorship.

And then it was ten at night, and time to go home.

Shikaku sidled next to her as they turned off the main street. "So, where is my best friend?"

"On your left."

"The other one."

Sakura shrugged. "No idea."

"Not even the slightest hint?"

Well, she knew that the former Hokage had disappeared basically immediately after defeating the whatever-it-was that was controlling Kiri, and she knew that Tsunade always left Ibiki heading east, towards Kiri, and she knew that Inoichi and Tsunade had come back at least once together—

"No."

Silence, for a couple seconds, then "I can't tell if you're lying or not."

"Thanks, that means a lot."

"Why do Yamanakas always think you're complimenting them when you say they might be lying?"

"What do Naras even do during family training anyway?"

"Shogi," Chouza answered for Shikaku.

"No!" Shikaku said. "Most of it's shadow-jutsu training, thank you. Shogi's just… the breaks, and stuff."

"Grown adults, all of us."

"Don't remind me."

"So—for or against Hokage's proposal? You definitely knew about it beforehand, don't deny it."

Sakura grimaced. "Both? I mean… I don't know. I think it's more efficient, but change is also…"

"You? Against change? Has the world turned upside down?"

Sakura huffed something approximating a laugh.

The truth was, it wasn't the change.

It was the time the change would take.

Sakura—

There were just too many things, too many memories, too much to do, too little time—

And now there was whatever Minato had cooked up.

And she was still half-sure he only did it so no one would think to question what was happening in Kiri.

It felt like little more than a distraction tactic, and so she found it very difficult to take seriously. Especially given all the other things she was trying to do—she'd only just managed to narrow down what, exactly, the Akatsuki were about, and now she had to deal with that, and—

"Maybe I'm just getting old," she said, instead of addressing any of the thoughts swirling in her head.

Shikaku snorted. "We're all in our twenties! None of us even have—okay, so you have a kid. Still."

"Thank you ever so for remembering my literally-adult-by-law child, Shikaku."

Chouza snorted. "Idiot."

"I did remember! It just took me a second! I'm… going to make my escape, though. Night!"

"Good night, Sakura."

"Good night, Chouza."

Above them the stars sparkled.

It was 46 Konoha, and Sakura knew there would only be a few short years until Naruto's birth.