The 'HealthBound' Policy Simulation Game: An Adventure in US Health Reform

摘要

With support from the U.S. Centers for Disease Control and Prevention, we developed the HealthBound policy simulation game for those wanting to experience the possibility of transforming our troubled health system. The game's simulator tracks movement of the U.S. population among states of health, risk behavior, environmental exposures, and socioeconomic status. The model is quantified based on publicly available data from the early 2000s as well as studies from the professional literature on health care utilization and programmatic impact. Players try to steer the country's health system toward greater levels of health, equity, and cost-effectiveness. The goals are difficult to achieve, in part, because the game includes resource constraints, time delays, and side effects of intervention similar to those of the actual health system. The game allows tests of many types of interventions, individually or in combination, and at different points in time over a 25-year time horizon. Various types of output screens allow players to trace the precise reasons for their successes or failures. Those who aspire to lead change on a national scale, or in their own sphere of influence, may benefit by first testing and refining their ideas in this realistic, but simplified version of the U.S. health system, and learning its core lessons.