A Sneak Peek At ‘Health Reform: The Comic Book’

MIT economist Jonathan Gruber calls health care reform the “biggest social policy legislation since Medicare.” So what better way to explain such a serious, complex and far-reaching topic than through comics?

Gruber, an advisor to President Obama on national reform and a key architect of Massachusetts reform, says he was hesitant to distill such a weighty subject into comic book form but in fact, by explaining the problem graphically, through characters like Betty on Medicare or unlucky Carlos who has to buy his own health insurance, Gruber covers a lot of ground, and is able to lay out the various issues and make his case for the national health law on both a macro level and through gritty details. (“There are no death panels,” the comic-book Gruber, black-and-white and bespectacled, tells a ranting grandmother-type shaking her cane.)

One measure of the book’s clarity and accessibility is that my 8-year-old daughter picked up my review copy and started reading. Health Care Reform: What It Is, Why It’s Necessary, How It Works, will be published by Hill and Wang in January. I spoke briefly with Gruber this week and agreed to post only one image, for now. There’s more to come, though, so stay tuned.

Mitt Romney is the single person most responsible for health care reform in this country.

What’s the appeal of a comic book on health reform?

I think what really convinced me, when you want to educate people, the comic is a great way to do it. When an airline wants you to know what to do in case of an accident, they give you a comic.

Here we have perhaps one of the most complicated topics that people deal with in society, so the idea of explaining it in a comic form is appealing. Really, it’s not a comic book, it’s a graphic novel, it’s trying to use pictures to make compelling what is essentially dry — let’s face it, this is not exciting, it’s not funny, it’s fundamentally a policy argument. Using pictures allows you to use fewer words. I didn’t appreciate it until I got into the process. Health reform is incredibly hard. I mean, there’s an easy way — single-payer — but that wasn’t in the cards. If you’re going to do reform through a private-based system, it’s going to be complex.

What was the challenge of distilling the content?

I’ve spent a lot of time speaking about this at a not-so-high level so I’ve already figured out how to explain it in plain English. I had a co-writer, [HP Newquist] a guy who the company works with to do these graphic novels. I submitted a 30-page outline with all the points I wanted to make in the order I wanted to make them. And he helped me turn them comic book-y. I don’t think I could do this on my own. The thing that was hardest was all the stuff about cost control at the beginning of the book, but it was less about the wording and more about the pace and layout. Like, ‘You want to make this point, that can be made in one panel, but this point will take three panels.’ The difference was the emphasis, how to spread it out to fit with the pictures.

Who do you imagine will be the audience for this book?

Lots of people say, ‘I’m hearing all these things about Massachusetts health reform, what’s the deal?’ Or, my father called and said, ‘My colleagues heard Massachusetts health care is a disaster.’ The audience is people who haven’t made up their minds, but are worried about what they hear — for the people on the right and the left who are worried. The other audience is people on the left who are not as excited as they should be — that just drives me bonkers. The fact that the left aren’t thrilled with Obama is crazy.

How do you hope the book will influence the politics of health care reform?

I want to get the left excited in the re-election campaign…This is the biggest social policy legislation since Medicare. What would make me happiest is if the people at the center who are skeptical become supportive and people on the left who are mildly supportive become wildly supportive.

What about Mitt Romney?

I think Mitt Romney is the hero of this story. But I want to make clear that the way he’s portrayed in this book has nothing to do with his presidential campaign.

Mitt Romney is the single person most responsible for health care reform in this country: Without his leadership we don’t get reform in Massachusetts, and without Massachusetts reform we don’t get national reform.

For a book marketed as a “comic” it’s not double-over-with-laughter funny. Do you regret that?

I wish I could have made it more funny, but at the end of the day, it wasn’t worth forcing humor in. It wasn’t worth sacrificing clarity.

I have to say, I was hesitant about doing this — I used to give my son such a hard time about all the time he spent on his graphic novels. My kids were the ones who insisted I do it. When they were younger they used to ask, ‘Why don’t you do research on something interesting?’

In my profession it’s often hard to get out there and connect with people…Now my wife’s the most excited about [the book]. Her friends don’t know exactly what I do, now she has something to show them.

(By the way, if anyone puts out an edifying comic book on what’s wrong with health reform, we’ll gladly publish images from that, too.)

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  • http://twitter.com/MedMalStore MedMalStore

    I work for a medical malpractice insurance company and in the past I’ve heard similar arguments by physicians more than once.


  • dadgumgenius

    I read the findings of the 9/11 Commission in a comic book.  It was great — I really understood what happened and what was found out. I gave it to my 80-year-old dad and he read it, too.

    Great idea!!

  • Thuds

    ‘Comic book’ is not the preferred nomenclature. ‘Graphic novel’ please.

  • pajpaj

    Where can I get one of these?

  • Pearl298

    My family has 3 MDs (!) who are about as far apart politically as you could imagine.

    The ONLY thing they ALL agree about is the need for a SINGLE set of rules.

    As one of them put it recently “I did not go through the ^%%^$ of Medical School to spend 30-40% of my time pushing paper for Insurance companies! I spend far too much time matching THIS patient’s needs with THIS insurance company’s rules!”

    Just imagine if we had 30%+ MORE MDs FOR THE SAME COST!

  • Brennan511

    Truely important concepts should be illustrated with geometric logic and a minimum of international type english [& characters] if any. Then lay out the advanced english with blunt poetic passion [translators are the window]. And if the concept is truely important or exportant, people will look at the mosaic …and see.
    And if any angles emerge that inspire evil or neglect, those components must be treated both  strategically and urgently. Otherwise glamourized images may paint those crucial characters into a corner of “wrong angles”, when compositionally the health of our hearts & minds is as simple as the line of contention and the tone of prevention and the tangent of convention perpendicular to inaction and american traction post-passion comical distraction. heh?
    My experience is that people argue when they’re in denial about unwritten/unspoken words and actions. And if a comic is affraid to offend in the vector of justice, well it’s not really comical. It doesn’t have to be neo-modern, just meta-functional. 

  • Brian

    “For a book marketed as a “comic” it’s not double-over-with-laughter funny. Do you regret that?”Not to sound like a jerk, Rachel, but you do know that the definition of “comic book” has nothing to do with it being humorous, right?

    • commonhealth

      I get that comics aren’t always comic. Apparently Mr. Gruber wishes this one was funnnier, according to his response…

  • http://pulse.yahoo.com/_2OL2ASFGRIIXW4PQJS3VEJECXQ M

    Humans are adverse to change.  

    Take your place of employment.   How often are the employees happy to be notified there are changes on the horizon?   

    Once the full effects of Health Care Reform are in place and people realize their benefits have improved or increased, they’ll forget they were ever against reform.  

    If things work according to plan, the double and triple digit annual premium increases (there is NO reasonable explanation for health care costs to skyrocket more than inflation – other than insurance company’s paying more for administrative costs and showering their CEO’s with excessive salaries, pensions and benefits – it’s definitely not trickling down to the employees or consumers) should cease as the insured are no longer paying for those without insurance.

    It’s comforting to know insurance company’s can no longer deny coverage for pre-existing conditions or if a catastrophic injury should occur you cannot be dropped.

    It would be nice if they further improved reform by:

    - opening the doors to competition; 3 options at work isn’t very competitive
    - allow foreign pharmaceuticals to sell in the United States
    - malpractice reform

    these would further reduce the cost of health care and insurance.

  • http://wbur.argosit.es/about/rachel-zimmerman/ Rachel Zimmerman

    I get that “comic” isn’t always “comic” but apparently Mr. Gruber wished his book was funnier, according to his comments…

  • http://wbur.argosit.es/about/rachel-zimmerman/ Rachel Zimmerman

    Gruber goes back and forth, characterizing his book as both a “comic” and a “graphic novel,” as is clear in our interview. His marketing people, by the way, also call it a “comic book” and one that is “often humorous.” But thanks for the clarification. RZ