The Center of the Star: Understanding and Changing the US Healthcare System

How do we fix a healthcare system that’s too complex, costly, and often unequal? In The Center of the Star, Judith Kunisch offers a groundbreaking perspective on reform, introducing a practical framework that makes sense of healthcare’s tangled web of consumers, providers, payers, policymakers, and the health industrial complex.

Drawing from decades of leadership in healthcare strategy and operations, Kunisch reveals the interdependencies that drive systemic challenges and opportunities for improvement. With a systems thinking approach, she unpacks the “Hidden Triple Aim” of power, control, and money, showing how these forces shape outcomes and costs. Her insights empower readers to rethink how we collaborate across sectors to drive meaningful, sustainable change.

This book is an essential resource for healthcare professionals, policymakers, students, and anyone passionate about creating a fairer, more efficient system. From understanding the nuances of healthcare economics to identifying actionable strategies for reform, The Center of the Star provides the clarity and tools needed to navigate complexity and spark innovation.

Whether you’re working within the system or advocating for change from the outside, this guide will inspire and equip you to play a pivotal role in reshaping the future of US healthcare.

JUDITH KUNISCH is a healthcare strategist, executive leader, and educator with extensive experience in healthcare economics, operations, and reform. A former Vice President of Medical Strategies at a Fortune 100 insurer, she also directed the Doctor of Nursing Practice (DNP) Healthcare Leadership program at Yale University. Kunisch has served on boards for public and private organizations, including the Donaghue Medical Research Foundation and the Connecticut Partnership for Patient Safety, which she co-founded.

An advocate for systemic change, Kunisch has co-authored peer-reviewed articles, presented at national conferences, and been recognized with the Robert U. Massey, MD Award for Distinguished Service. Through her work, she blends expertise with actionable insights to help leaders and policymakers transform healthcare into a more effective, equitable system.