My task of creating a participatory problem solving machine, with democratic, utopian and non-deliberative (organized in such a way as to avoid deliberation) qualities seemed impossible, but as I listened to Republicans declare that they will cripple steps towards national health care, I become very angry and a solution crystallized in my mind. The machine could be in the form of a dice game in which the experience of taking part would provide information, provoke an emotional response and transformative action in solving the problem of denial of health care to millions of people. A dice and random picks from consequence cards would govern most of the game.
Theoretically, our culture has options about health care and healthy living, and allows us to choose how we live, even though some choices are very hard to bring about. Most cannot revert to living off the land, or to a utopian simple existence, so we are largely glued into the processes of every day modernity in which access to medical care is denied because of economics. Even in cultures where there is little knowledge or ability to provide care, humanitarian actions and counseling are not withheld because of an institutionalized resolve not to provide them. Knowing that you may not be qualified to receive care is part of the fabric of US life. It is an integral condition that we seem unable to alter. What ever one’s view on having a longer life, or taking up too many resources on the planet, we have undemocratic inequity in access to care. We deny sections of the community the dignity of being cared about. We shut them out of being able to make the choice about length and quality of life.
I decided to make a game similar to Monopoly but played with real cash, with money amounts based on health insurance premiums, and minimum wage. Community Chest and Chance Cards would be researched and have consequences based on actual misfortunes of uninsured people, and the anxieties of individuals trying to keep insurance through their jobs. Consequences could also be good outcomes e.g. spontaneous remissions, or secret donors paying a bill, establishment of nationalized health care. Game pieces would be miniature (for the table top version) people: a pregnant woman, a child, a person with a pre-existing condition, a self-employed person, a part- time worker, a homeless person. Properties would be medicines, hospital beds, dental offices, emergency rooms, organic vegetable gardens, other countries with health care systems, etc. Games typically have a fictional, feel good quality to them, but my game will not have this soft appeal. I intend it to be given to people who make decisions about health policy, to acquaint them with the reality of life with no access to health care. The goal is to survive, and it will not be enjoyable.
Death (leaving the game) would be the penalty for a player who runs out of money. Who would win? The last player to die. Death in my game would not be literal, although it would be a tempting way of making the game very memorable! Much as I want to compel reform, bringing about actual death is not part of the game. The goal is to provide role play for decision makers so that they can fully understand the difficulties of life without access to health care. The game will not provide a solution to the problem of access to health care. Rather, it will offer an experience that can make problem solving more desirable, more urgent and relevant to decision makers who appear disconnected and ignorant about the problem.
Could this game be played by other parts of “Earth”? It could be devised so that each non-human species could have their concerns examined, or each biological habitat, or plant form. Assuming that destruction of habitat, loss of food, polluted water, over-hunting, predation, disease, climate change, old-age, decline, reproduction are all concerns of living things. If humans were playing, we would be playing on another biome’s or organism’s behalf. How would we really know what another life-form’s concerns are? What if my cat were playing? Could she even play, or be aware of gaming or luck? Non-living things presumably don’t have concerns. Perhaps they worry about entropy?
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