June 26, 2018
Health care innovation: As easy as ABC?
by Paul Carroll
The Amazon/Berkshire Hathaway/JPMorganChase health care partnership known as ABC announced last week that it had hired as CEO the well-known innovator, author and surgeon Atul Gawande. Count me a fan.
While some note that he has never run an organization anywhere close to the size that will be needed to coordinate the health care of the roughly one million people covered in the partnership, I believe he brings just the right qualities to a job that could create great change in U.S. health care in five to 10 years, slashing costs while improving care.
He has shown an ability to look at problems through beginner’s eyes, even when he has been immersed in the issue for years. His 2009 article in The New Yorker comparing care in two Texas towns showed just how destructive the profit-maximizing culture of his industry has become.
Gawande has consistently shown the sort of empathy that often gets lost when care collides with dollars and cents. His latest book, “Being Mortal,” on how life draws to a close, is remarkable. (Here is an interview that provides a look into his thinking: https://onbeing.org/programs/atul-gawande-what-matters-in-the-end-oct2017/)
He has also seen both how important and how hard it is to implement innovation. He devised a checklist for surgeons that is now used in hospitals around the world and that has greatly reduced post-operative infections. But surgeons, as dedicated as they are, bristle when told what to do, especially via something as rudimentary as a checklist, so progress hasn’t exactly moved in a straight line.
Even if Gawande succeeds—a big if, given the size and complexity of the issue—you have to figure that progress will take years. First, ABC will have to figure out how to take better care of the million souls in its care. Then the problem really gets hard, as ABC will have to figure out how to roll out its solutions into remote parts of the country, to small businesses, to people older than employees at the ABC companies and so on, or others will have to figure out how to pull ideas out of ABC and implement them more broadly.
A million people is a lot, but it isn’t 330 million. And the antibodies working against Gawande will be stronger than any he’s ever seen. People will do a lot to protect the going-on $4 trillion spent on health care in the U.S. each year.
Still, I can’t think of a better person to tackle the issue.
Have a great week.