In Phillip Zane's classroom, students weigh an invitation to jump out of an airplane. The skydiving lesson and jump are free, and the exercise assumes there is zero risk of death. But an injury could mean $10,000 in medical expenses and $1,000 in lost wages.
Some have health insurance. Others don't. Everyone has to decide whether to take the leap.
The imaginary jump brings a question of health economics within reach: how insurance can change the risks people are willing to take, and what happens when those choices add up across a health care system.
Zane, an associate professor in the Department of Health Administration, Policy, and Informatics, has built his Health Economics and Policy course around such experiments, pulling students into questions that can seem abstract or remote on a textbook page.
He and his colleagues, including associate professor Debora Goetz Goldberg , describe the approach in a new paper, "More Than a Game," published in a special issue of The Journal of Health Administration Education focused on gamification.
Course evaluations from 129 students between 2022 and 2025 suggest the approach resonated: about 89 percent found the class environment engaging, and 85 percent said the teaching methods enhanced their learning. In written feedback, students said the games clarified challenging concepts and exposed them to classmates' different approaches.
Invitation to play
The idea took hold during a summer of online teaching in 2022, when most students kept their cameras off. Zane wanted a way to keep them engaged. "It's a topic that I love, but they didn't seem to get it," he said.
Many of his health administration students came to the course with little background or interest in economics. Game theory—which examines how people make decisions when their outcomes depend on others' choices—offered a way in. A former antitrust lawyer, Zane had used its principles in the past to help clients decide whether to settle lawsuits. Now he thought it might help students understand the economic forces underpinning health care.
Zane started with the "ultimatum game," a well-established experiment in which one party offers to divide a financial windfall with another. In his version, Kit Kats stand in for cash. One student makes a proposal to their classmate, who can accept it or turn it down, with a rejection leaving both empty-handed. As it turns out, some students would rather get nothing than accept an unfair share—prompting a discussion about why fairness can outweigh personal gain.
From there, Zane began adding more exercises, some adapted from existing game-theory models and others of his own design, and adjusting according to student feedback.
In his original orange juice game, students are assigned to groups with different levels of competition, from a single seller with a monopoly to a crowded market with many sellers. Zane tells each group he will pay up to $5 for a bottle of juice. The monopolist can hold near that ceiling, while competing sellers must undercut each other. In the most crowded market, the price can fall close to zero, showing students how competition drives down prices.
The games are only part of the lesson. After playing, students explain their choices and compare their reasoning with others in the class. Reading those reflections helped Zane see whether the economic lessons were landing.
"It became pretty clear that most of the students were getting it," he said.
In addition to Zane and Golberg, additional co-authors to the paper were doctoral students Shaan Muberra Khan and Sravya Vunnam of the Department of Health Administration, Policy, and Informatics.
