Opportunistic Fiscal Arbitrage and Dual-Use Infrastructure for Disaster Resilience: Leveraging Primary Healthcare Buffers in Isolated Geographies

Remote, island, and low-density peripheries face a systemic disaster governance failure: statutoryemergency mitigation agencies operate on episodic, post-disaster budgets, rendering permanent standing outposts financially unsustainable. During severe meteorological or seismic disruptions (7–14 day disaster failstates), the absence of frontline human presence produces critical information and response latency. Conversely, single-payer health systems maintain continuous statutory operating budgets but penalize low-density clinics through regressive capitation formulas, locking rural outposts into structural insolvency (-79.5% operating margin). This paper formalizes an institutional model of opportunistic fiscal arbitrage. By superimposing disaster early-warning medical triage and routing protocols onto autonomous primary care concessions (Ovsepian, 2026a, 2026b) augmented by paraprofessional community health buffers (Ovsepian, 2026c), disaster authorities acquire a permanent earlywarning and first-response network at zero marginal public payroll cost. Because preventing just 0.32 chronic hemodialysis cases per year (360,000 RUB/year buffer cost vs. 1,127,412 RUB/year statutory dialysis tariff) achieves full clinical self-financing, and preventing one disabled infrastructure specialist retains 3.56M to 4.26M RUB/year in direct cash expenditures (Ovsepian, 2026d), the dual-use outpost functions as a self-funding fiscal and territorial hedge.