The Forgotten Gem of SimHealth: A Look Back at Maxis' Forlorn Effort

Looking back at classic Maxis titles, there are a few that really stand out to most people. SimCity, SimAnt, SimCity 2000, and SimTower are just a few examples of the company's most iconic games. However, one title that is almost completely forgotten is SimHealth: The National Health Care Simulation. Developed by Maxis and The Markle Foundation in 1994, this game was created by a team called Thinking Tools, Inc.

The Markle Foundation is a non-profit organization founded in 1927 and based in New York City. Their focus is on advancing health and national security through the use of information and technology. In the early days of the Clinton administration, there was an ongoing battle raging over healthcare reform, which reached its peak in the summer of 1994. During this time, Maxis had been seeing significant success with their simulation titles like SimCity.

With The Markle Foundation's agenda, Maxis' expertise in simulation games, and the goings-on in Congress, it was a perfect storm of timing that led to the creation of SimHealth. In 1993, Maxis Business Solutions received a $350,000 grant from The Markle Foundation exclusively for the development of SimHealth on MS-DOS PCs. Before its release, a preview version of the game was given to journalists and those involved in the healthcare debate at a press conference on Capitol Hill in November 1993.

Just before the summer of 1994, SimHealth was made available for purchase to the public by phone and mail-order, bypassing the usual wide retail release that Maxis titles typically received. The game's limited release strategy likely contributed to its low sales figures, as it only sold a few thousand copies. According to The Markle Foundation, this lackluster performance led to SimHealth being all but forgotten in the annals of gaming history.

Despite its commercial failure, SimHealth remains an interesting footnote in Maxis' and The Markle Foundation's collaboration on this ambitious project. It is a testament to the power of collaboration between industry leaders and non-profit organizations working towards a common goal. While it may not be remembered fondly by gamers today, SimHealth holds a special place in the history of simulation games and serves as a reminder of the impact that innovative ideas can have on public policy.

The game's creation also highlights the complexities of politics and healthcare reform during the 1990s. The ongoing debate over healthcare reform led to a convergence of interests between Maxis, The Markle Foundation, and government officials, resulting in a unique collaboration between industry leaders and non-profit organizations. This partnership demonstrates the potential for games to be used as tools for social commentary and public awareness.

The legacy of SimHealth is not limited to its commercial performance or its impact on politics. As one of the first attempts by Maxis to explore the world of healthcare simulation, it paved the way for future titles that would delve deeper into complex issues like disease management and policy-making. While it may not have reached the same level of success as other Maxis titles, SimHealth remains an important part of gaming history and serves as a reminder of the innovative ideas and collaborations that can emerge from unlikely partnerships.

"WEBVTTKind: captionsLanguage: enAaahh!Looking back at classic Maxis titles,there are a few that really stand out to most people.SimCity, SimAnt, SimCity 2000, SimTower.But one that is almostcompletely forgotten is SimHealth,The National Health Care Simulation.This was released by Maxis andThe Markle Foundation in 1994,developed by a team callingthemselves Thinking Tools, Inc.It's forgotten for a few reasons,the biggest being... uh, it's actually a long story,so let me just start at the, uh...start.The Markle Foundation is a non-profit organizationfounded in 1927 and is based in New York City.Their focus is advancing health and national securitythrough the use of information and technology.During the early Clinton administration,there was ongoing battle raging over healthcare reform,coming to a head in Summer of 1994.During that same time, Maxishad been seeing tons of successwith simulation titles like SimCity,so with Markle's agenda, Maxis' simulation expertise,and the goings on in Congress,it was a perfect storm of timing.And with a $350,000 grant from Markle,Maxis Business Solutions gotto work on SimHealth in 1993,exclusively for MS-DOS PCs.Before release, a preview version ofSimHealth was given to journalistsand those involved in the healthcare debateat a press conference on Capitol Hillin November of 1993.Then right before Summer of 1994,SimHealth was made availablefor purchase to the publicby way of phone and mail-order,forgoing the usual wide retailrelease of other Maxis titles.According to The Markle Foundation,it only sold a few thousand copiesand was simply \"not entertaining enough\"to ever see the regular store shelves.It came in this box,which is a bit thinner than other Maxis titles,and it's actually the same size as theSimCity 2000 expansions released that year.I've also come into possession of this odd versionwhich I've dubbed the \"Silver Box.\"It's got different artwork, a different subtitle,different screenshots on the back, and it's dated 1993instead of 1994.I have a feeling this is either an early versionavailable from The Markle Foundationor perhaps even the 1993 preview version.I don't really know for sure.So, that's the backstory.Let's get into the game.SimHealth comes with the game ontwo high-density 3.5-inch floppy disks,as well as a helpful and witty-written manualpenned by none other than Michael Bremer,who is famous for doing the documentationfor practically every Maxis game,from SimCity on through The Sims.Being released shortly after SimCity 2000,Maxis ended up using many ofthat game's assets in SimHealth,starting with the installation program.As such, the requirements were a bit high for the time,requiring VGA graphics and 4 MB RAM minimum.Once the game starts, you'regreeted with a classical tuneand a cool title screen by Bruce Ariss,who is known for painting muralsin California in the 1930salongside the social reformpolicy questions of those days.From here, you can choose to read a bit about the game,start a new game, or take the tour.I highly recommend taking the tour,as it's a very easy-to-useinteractive tutorial of SimHealthand all of its features.It's worth noting that an easy way to tell ifyou're playing the preview version or notis to try the tour,since the preview version lacks all of the tutorialsand will give you an error message.The preview version also requiresSVGA and has better graphics.Not really sure why theydowngraded to VGA 16-color mode.The tour is also a good introductionto the SimHealth recording function.During the simulation, you canchoose to record your activityand then play it back with or without notes,which was meant to be used forclassroom and presentation purposes.You can even view built-indemonstrations of various politicians'proposed healthcare plans.You can start a new game at any time–and okay, now pay attention,because the most exciting partof SimHealth is about to occur.Yes, you see a nasty wreck at an intersectionand it is revealed that you wereone of the passengers in the car.After being taken to the hospital andbeing poked and prodded in waysthat really irked you to no end,you are then overcharged on top of all thatand decide is enough is enoughand proceed to run for political officeon the platform of healthcare reform.From here you get another musical dittyin the options letting you choose your stance and goals.This will determine the entireoutcome of the simulation.You are judged not by the values you select–a balance of community, efficiency, liberty and equality–but rather how well you stick to those valuesover the course of sixteen years.You're given some backgroundon each of these options,as well as the ever-useful What andWhy buttons in the top-right corner,which are context-sensitive query tools.After selecting your values,you are automatically electedand a simulation begins.The main street view here is called...uh... Main Street,and as you can see, it uses manyof the graphics from SimCity 2000to represent different parts of SimHealth.It also serves as a vivid yet ambiguous representationof how your policies are affecting America at large.You have the policy office, police station,insurance headquarters, courthouse,medical technology building,small businesses, big businesses,resident citizens, primary care and specialists,and of course, the hospital.And for some reason that initial crash of yoursnever disappears from this screen,just staying there, rotting,reminding you that the good times are overand it's all serious political loveliness from now on.These buildings serve as amore interesting representationof the policy-making interface at the top of the screen.And they'll also change in appearance in congruencewith the effects of your active policies.Enact big policies that will benefitbig business but hurt smaller clinics,big businesses will get even biggerand the clinics will soon be smaller and in shambles.This is a really basic way to judge your performance,although it's made pretty clearthere are no right or wrong answers,only results.That is, the entire point of SimHealthis to manipulate the healthcare systemby simulating the years 1992 to 2008,and every couple of years it will be re-election time.And you will either win or lose the election,depending on how you'veperformed since the last election.This is shown through polls, as wellas the condition of your Main Street.Even if you make it all the way to 2008,all you get is a score based on mostlyhow much you've held to your initial principles.In fact, you can just set your promises,set the game speed to max,and a notification will have to be clicked here and thereand the entire sixteen years will be overin about sixteen minutes.Obviously, you are meant to do more than that,but that gives you an idea of what SimHealth really is.You'll notice I haven't called it a game once,and there's a good reason for that.It's not a game whatsoever.It's really an economics model simulatorthat happens to have a fancy UI slapped on top of it.This is really obvious when youcheck out the Assumptions menu.This should be a familiar sight to anyonewho paid even a little bit of attentionin their introductory economics class.These assumptions are set atthe beginning of the simulationto allow, disallow or tweak certaindata from entering the modelthat SimHealth uses to decidethe effects of your policies.Anyone who's worked witheconomics or statistics knowsthat any model is only as good as your assumptions,so it's nice to be able to tweak thesefor a larger variety of potential models.Of course, you can't actually see the maththat's behind the models in the first place,so there are some limitations toSimHealth's calculations and possibilities.That said, what it's meant to do it does very well.A typical gameplay routine consists ofyou starting off in the Policies Roomand choosing the basis for your healthcare system.You can then refer to the then-current U.S. model as a basisand then change it from there to your heart's content.You can also choose from theUniversal New York Care systemor even the Canuck healthcare system.And you can also fine-tune individual benefits,cost control and insurance funding sources.Fun times.But there are only so many choices you can makein any given policy-making session,which is determined by your overall performance.For every action, you are either givenor charged a certain number of chips.Each policy change costs acertain number of these chips.There's also a budget to maintain,but honestly, who cares?It doesn't really seem to affect anything.It's not used as a currency, it'sjust another one of those thingsto let you know how you're doing.You're probably going to go into the red anyways.And as long as you have thechips and keep getting re-elected,just keep passing legislationand hope the populous endures.Each of these options are representedby the bar of icons across the bottom of the screen,which provides easy access to each of your policies.Otherwise, all you'll want to do is waitaround for something wild to happen,like ambiguous new technologies andcures that you'll decide whether or notto include in your healthcare system,budget reports, health conferencesand elections every two years,which are not interactive –it just lets you know the results.You really can be as involved or uninvolved as you'd like.As long as you're in office, it's all good.And then if you last sixteen years, it's all over,and you're scored based on howwell you've held onto your principles.Eh, you might be thinking,\"Wow, this looking frickin' boring.\"And you'd be right.I'd blame it on the bland subject matter, buturban planning isn't exactly themost entertaining subject, either,and I find SimCity very enjoyable, whereas this I do not.And SimHealth is a very well-madesimulation of healthcare policiesand making a very tedious set of modelsvery approachable, simple tomanipulate and see results.On those merits, it's really stood the test of time.In fact, it's still being used by schools like Penn Statein their HPA 101 class.But if you start the programhaving played other Maxis titles,you're really setting yourself up for disappointmentbecause it's simply not very fun to play with.I mean, you can't really play it at all.It's basically a teaching aid withSimCity 2000 graphics on top of it.And there's nothing wrong with thatbecause that was its purpose.So it's a lot like eating dry oatmeal or granola.It might theoretically be good for you,but unless you're being commanded to partakeor you're just strangely curious,you probably don't want to have anything to do with it.\n"