Reader Reviews

“Through patient stories and lessons learned over Medicaid’s evolution, this book shows that public institutions can improve lives when leaders are willing to speak up and test what works. At a moment when trust in public health is under strain, this book is a source of hope."

- Debra Houry, MD, former Chief Medical Officer of the Centers for Disease Control and Prevention
"Cogle brings both analytical rigor and human insight to the story, making this an important and timely contribution to how we think about public systems, healthcare, and the future of care in America.”

- Jessica Lee, MD, CEO of the Maven Project and former Chief Medical Officer for Medicaid and CHIP at the Centers for Medicare & Medicaid Services
“An authoritative and passionate ode to Medicaid—scrappy, inventive, and far more effective than its critics claim.”

- Christopher F. Koller, former President of the Milbank Memorial Fund
“A grounded, real-world account of how Medicaid innovation actually happens. Essential reading for anyone serious about improving care at scale.”

- Kara Odom Walker, MD, MPH, MSHS, former Delaware State Health Officer and Executive Vice President and Chief Population Health Officer of Nemours Children's Health System
“The clearest explanation of how Medicaid works—and why improving imperfect systems matters more than abandoning them.”

- Mark Rosenberg, MDD, MPP, former Director of the CDC’s National Center for Injury Prevention and Control
“Chris Cogle shows how Medicaid’s dense rules hide powerful levers for improving health—a compelling argument for turning constraint into innovation.”

- Jeff Brosco, MD, PhD, former Director within the Health Resources and Services Administration
“Most public health leaders underestimate Medicaid’s potential. This book should be required reading for educators and practitioners alike.”

- Claude Earl Fox, III, MD, MPH, former Alabama State Health Officer and Administrator in HRSA

Reader Reviews

Discover what readers and colleagues are saying about Dr. Cogle’s health policy book. From policy insights to reflections on patient care, these reviews highlight the impact of his narrative nonfiction on health, innovation, and public service. Explore firsthand perspectives from those inspired by his research and writing.

About Public Startup

In Public Startup, physician-scientist Christopher R. Cogle reveals how a government program long dismissed as red tape and welfare became the nation’s most prolific innovation lab—quietly iterating on the very ideas Silicon Valley claims as its own, all while serving everyone in need.

Drawing from patient stories, heated policy battles, and first-person experience with the modern healthcare and policy systems, Public Startup reframes Medicaid not as a cost problem, but as a system of radical reinvention—one that now shapes care for nearly 1 in 4 Americans.

The book covers essential themes in health policy innovation, including:

Social Capital: Investments in improving social conditions pay off
Building Trust: Trusting patients works better than policing them
The Public Paradox: The safety net becomes the innovator
Innovation Under Constraint: Scarcity fuels invention
The Margins Lead the Middle: Ideas tested on the outskirts become mainstream
Bureaucrats as Entrepreneurs: Public servants take risks like startup founders

This innovative look at a seemingly familiar program shows how public institutions improve lives and will inspire readers to take action in shaping the policies that affect them most.

Pre-Order Public Startup Now

Reader Reviews

“Through patient stories and lessons learned over Medicaid’s evolution, this book shows that public institutions can improve lives when leaders are willing to speak up and test what works. At a moment when trust in public health is under strain, this book is a source of hope."

"Cogle brings both analytical rigor and human insight to the story, making this an important and timely contribution to how we think about public systems, healthcare, and the future of care in America.”

“An authoritative and passionate ode to Medicaid—scrappy, inventive, and far more effective than its critics claim.”

“A grounded, real-world account of how Medicaid innovation actually happens. Essential reading for anyone serious about improving care at scale.”

“The clearest explanation of how Medicaid works—and why improving imperfect systems matters more than abandoning them.”

“Chris Cogle shows how Medicaid’s dense rules hide powerful levers for improving health—a compelling argument for turning constraint into innovation.”

“Most public health leaders underestimate Medicaid’s potential. This book should be required reading for educators and practitioners alike.”

Reader Reviews

About Public Startup

In Public Startup, physician-scientist Christopher R. Cogle reveals how a government program long dismissed as red tape and welfare became the nation’s most prolific innovation lab—quietly iterating on the very ideas Silicon Valley claims as its own, all while serving everyone in need.