- Atul Gawande, the newly-named CEO for the healthcare company being formed by Amazon, J.P. Morgan and Berkshire Hathaway, said Thursday at the annual conference for America’s Health Insurance Plans he feels “incredibly lucky in this role that I will get 1 million new patients and they will be people from across the country."
- The surgery professor at Harvard Medical School and New York Times best-selling author did not give any details about his new role in a previously scheduled speech about end-of-life care, but acknowledged his words would have greater significance in light of the news. “I’m delighted that’s true,” he said.
- Gawande criticized recent efforts to roll back aspects of the Affordable Care Act, saying eliminating protections for people with pre-existing conditions and relying only on catastrophic coverage plans would be a “disaster” that could lead people with chronic conditions to stop seeking care.
Gawande touched on a number of ideas that likely piqued the interest of Amazon et al as the companies sought a leader for their joint venture. He spoke of his personal experiences as a son and a physician and the problems he sees in determining the true goals of care for patients.
People have different priorities for their life beyond simply surviving, but they aren't being asked what those priorities are.
“The results we see over and over again are that the care we provide is not in alignment with the priorities,” he said. “And the results of that are waste, care that does harm or has no benefit, and enormous suffering.”
To accomplish this on a systematic level, healthcare organizations need to implement processes that have been successful for their peers and make them the norm across the sector. Providers and payers should also look more toward patient-reported outcomes to understand what care is best in what situation.
“We’re learning that a bunch of our stuff doesn't really work very well,” Gawande said.
Elsewhere, reaction to the appointment was largely — but not universally — positive. Former CMS Administrator Andy Slavitt said Gawande is compassionate and progressive, and the new company is “fortunate to have him, principally because of his moral leadership.”
Bob Wachter, chairman of the department of medicine at the University of California, San Francisco agreed. He posted on Twitter: “Inspired choice: no one understands the connection between the business of healthcare & the unique humanity of medicine better; getting this right is the key to success.”
There was skepticism as well, particularly due to Gawande’s lack of business background and his intention to keep his other jobs at Harvard, Brigham and Women’s Hospital and the New Yorker.
Craig Garthwaite, director of Kellogg School of Management’s Health Enterprise Management Program, said the choice of Gawande showed an interest in creating a “passion project” instead of a business. “Prediction: this firm will have the most eloquently crafted explanations as to why they haven't disrupted healthcare at all,” he wrote on Twitter.
Gawande said at the AHIP conference he isn't under the delusion that any of his lofty aims will be simple or quick. The solutions he described stuck to top-level concepts. While information is scarce about his new job, not to mention about the company he will head, it is likely to put him in a position to pressure the healthcare system to evolve.
While Gawande’s intentions may be somewhat vague, he has ambitious ideas.
“The goal of the healthcare system is not a good death,” he said. “It’s a good life — a good life all the way to the end.”
Rebecca Pifer contributed to this post.