Some more views on (and by) Atul Gawande on the JP Morgan-Berkshire-Amazon health combine

Often the best indicator of the success of a person in a new venture is to examine their own words. An interview with Dr. Gawande in STAT a few days after the Big Reveal of his new position as CEO of the JPM-BH-Amazon healthcare nonprofit indicates that he has an excellent grasp of the task before him. His main points:

  • Before accepting the position, he established that the healthcare company would be an independent entity and not part of the three companies
  • It is also non-profit and not expected to return money to those companies
  • He will be devoting 100 percent to the new job and have it be the number one priority, but he will be with patients and his surgery through at least the summer
  • “My job for them is to figure out ways that we’re going to drive better outcomes, better satisfaction with care, and better cost efficiency with new models that can be incubated for all. That is a tall fricking order. But what they’re saying to me is that resources won’t be the problem. Human behavior will be. And achieving scale will be.”

His speech at AHIP (America’s Health Insurance Plans) annual meeting a day after the announcement pointed out that unnecessary tests and treatments account for about 30 percent of healthcare spending, that our system fails the chronically ill in their needs to be asked about what they want to achieve through treatment, and for doctors to deliver the right and considerate treatment especially in end-of-life care. “Precision medicine has to be matched by precision delivery.”  Healthcare Finance

For the 1 million employees of the three companies, there may not be a lot of chronic illness or end-of-life consideration (people tend to fall out of the workforce under those circumstances). What kind of model will apply to them and save on the 25 percent of estimated healthcare spending which is wasted? The article in Forbes by another ‘big thinker’, Robert Pearl MD, sees a 5-10 year time frame for Dr. Gawande’s task: “…to fundamentally change how healthcare is structured, paid for and provided. He was hired to disrupt the industry, to make traditional health plans obsolete, and to create a bold new future for American healthcare.”

But in the meantime, how will those bank tellers, packers, IT workers, ice cream slingers, and railway workers fare with their health? What will they benefit from in two to three years time? And will the long-term backing and the promises to Dr. Gawande remain after Mr. Dimon, Mr. Buffett, and Mr. Munger (of BH, and possibly why Dr. Gawande is on board) are gone?

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