Hustlin’ Health Care holds a special place in my body of work. It not only was the first game I designed, but it lead me to realize that I could use games as an interactive medium for promoting social change. Through an iterative design process, the game started as a question: “How can I get people to talk about the real costs associated with medical treatments?” At first, Hustlin’ Health Care wasn’t a game. It was a website for crowd reporting of medical bills. Upon finding Medicare data for treatment costs on a per hospital basis through Change:Healthcare‘s website, I was able to focus on the intervention rather than the data collection.
Early paper prototypes were designed thinking that the game would ultimately be digital. It wasn’t until I started creating digital prototypes that I could see the conversation I wanted to start was being lost. At this point, I started to strip away as much complexity from the game as I could without losing the message. The magic of the board game came from players inserting their own personalities into how they played the game. By roleplaying as insurance companies, the conversations would center around costs but with less political zeal and more honest curiosity about how the system works.