The Case of the U.S. Healthcare System
A new way to think through what’s broken — together, the way a medical team would.
Every American has a healthcare story. Maybe it was waiting months for an appointment. Fighting with an insurance company. Watching someone you love struggle with a chronic illness. Or feeling grateful for extraordinary care, while wondering why that same care isn’t available to everyone.
We spend more on healthcare than any other nation on earth, and we still keep coming back to one simple question: how do we build a system where everyone can get the care they need to live healthy, flourishing lives?
At Moonshot Press, we don’t think that question gets answered by louder arguments or better slogans. It gets answered the way hard problems always have — by people thinking it through together. So we’re trying something different: The Case of the U.S. Healthcare System, a public conversation modeled on an unlikely source — the medical case conference.
Why a case presentation?
When physicians face a difficult case, they don’t start by arguing over treatments. They start by understanding the patient — gathering the history, reviewing the evidence, considering different diagnoses, weighing treatments, and listening to colleagues who see it differently. Only then do they decide on a plan of care.
We think healthcare, as a system, deserves the same approach. So instead of asking “which side is right,” we’re asking: what’s actually happening to the healthcare system, why is it happening, and what would it take for it to become healthy again?
Together, we’ll work through it like a case:
What symptoms is the system showing?
What are the underlying causes?
Which treatments have helped — and which have failed?
How do we know if we’re making progress?
What would a genuinely healthy healthcare system look like?
The goal isn’t to win an argument. It’s to make better decisions.
A different kind of conversation
Most public debates start with solutions and work backward to justify them. A case presentation starts with understanding, and lets the solutions follow from it. That one shift changes everything — instead of defending a position, you get to explore evidence, ask real questions, weigh tradeoffs, and learn from people who see a piece of the picture you don’t.
Because no one has the whole picture. Patients, clinicians, caregivers, researchers, employers, insurers, policymakers, and everyday citizens each hold a piece of it. Put together, we can see more than any of us can see alone.
Part of something larger
This isn’t only about fixing today’s healthcare system — it’s about relearning how Americans solve hard problems together. Healthcare is one of four major deliberative initiatives inside Project 2026, Moonshot Press’s effort to strengthen the country’s civic infrastructure as America approaches its 250th anniversary. Each of the four asks a foundational question about our future; this one asks how we build a system where everyone can get the care they need to live healthy, flourishing lives.
Join the case conference
You don’t need to be an expert. You need to be curious, willing to listen, and ready to contribute. Over the coming months, we’ll publish each part of the case, open it for public discussion, host live deliberative forums, and fold in what we hear from participants across the country.
Sign up here to join the Healthcare Case Conference →
Because this question belongs to all of us. Let’s examine the case — together.