(Note: Yesterday in Part 1 we highlighted Gawande’s view of the three big systemic problems with healthcare. Today in Part 2 we’ll summarize his vision for the ABJ-HCE.)
Last week Amazon/Berkshire/JP Morgan Chase announced the appointment of renowned author, surgeon, and researcher Atul Gawande to head up their ambitious new healthcare endeavor (still unnamed, we’ll refer to it as ABJ-HCE for now). In a long form interview at the Aspen Ideas Festival Gawande expounded on his view of the problem facing the U.S. healthcare system and his thoughts on what the ABJ-HCE can do to make the whole system work better.
(So, Atul, what’s really up with your new gig dude?)
Here are few of Gawande’s thoughts on what he’s been charged to do, some of the resources he has to work with, and then his big picture leap.
First, in separate conversations with each, Messers Bezos, Buffett, and Dimon were very clear and very consistent about the three things they want Gawande to accomplish:
- Improve Patient Outcomes. Improve Patient Satisfaction. And, Improve Cost Efficiency.
- Create Scalable Models That Can Benefit All. (“what they discover has to be open to everybody”)
- Gear It to a Long-Term Horizon (He went on to say “part of our problem in healthcare is short-term ism”.)
On the resources he has to work with:
- “Resources won’t be a problem. Human behavior will be. Achieving scale will be.”
- ABJ-HCE will be an independent non-profit entity. No money will go back to Amazon, Berkshire, or JP. He reiterated that the only goal will be to improve, scale, and do it for the long haul.
- 1.2 million employees (plus dependents) representing a broad spectrum of people (fulfillment centers (Amazon), traditional and established industries (Berkshire), financial services (JP), geographically dispersed (many locations across the country)
- Interestingly, he mentioned that most of the people ABJ-HCE will be serving fall into the gap between Medicare and Medicaid. While these folks are not covered by either, Gawande said they are the ones paying the taxes to enable and that Medicaid is better coverage – no copays , no deductibles, no premium — than the ABJ-HCE employees could ever get.
So, netting it all out — it sounds like he has a boatload of financial resources, a critical mass of covered lives, a cross section of people that are geographically dispersed, under a not-for-profit operating mode and a long-term horizon.
And, he must deliver better outcomes, greater patient satisfaction, significantly reduce financial waste in the system, create scalable new models for better healthcare delivery (right care, right time, right way, right cost) and can then be shared with all.
In a future post, we’ll summarize the potpourri of other interesting and compelling Gawande related thoughts including the what, the why, and the how (with the help of changes in public policy) we get to a “consistent system where every human being has a regular source of care for most of their healthcare needs”.