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Can Amazon Transform the U.S. Health Care System?

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Six months ago, three companies announced their intention to form a nonprofit organization with a seemingly modest goal: “figuring out ways to address health care for our employees, with the aim of improving employee satisfaction and reducing costs.” Earlier this month they hired a prominent physician to head the as-yet unnamed health care improvement enterprise.

Who are those three companies? Berkshire Hathaway, JPMorgan Chase and Amazon. Three imposing titans of industry with a combined market cap of $1.8 trillion.

The persistent elephant in the room is employers’ mounting frustration with the failure of the current system to control rising health care costs. Warren Buffet, Berkshire Hathaway chief: “The ballooning costs of health care act as a hungry tapeworm on the American economy. Our group does not come to this problem with answers. But we do not accept it as inevitable.” Jamie Dimon, JPMorgan Chase CEO: “The health care system is complex, and we enter into this challenge open-eyed about the degree of difficulty.” Jeff Bezos, head of Amazon: “Hard as it might be, reducing health care’s burden on the economy while improving outcomes for employees and their families would be worth the effort.”

So, can this new “health care improvement laboratory” become a true game-changer—not only for the alliance, but for the country as a whole? Will it disrupt the status quo in substantive and sustainable ways that will permanently change how health care needs are determined, delivered and paid for in this country? Will it result in lower system costs while achieving better health status?

The new CEO of the Amazon alliance is Dr. Atul Gawandi, a well-known surgeon, researcher, author and health care improvement guru. His daunting new job: oversee the health care coverage for 1.2 million employees and their families—and find ways to transform health care and achieve the Triple Aim: 1) improved population health, 2) enhanced patient experience, and 3) reduced per capita cost of health care.

Details on how this big, hairy, audacious goal will be achieved are still scarce. A comprehensive plan of action has yet to be developed. But Dr. Gawandi believes the path to success exists: “I have devoted my public health career to building scalable solutions for better health care delivery … saving lives, reducing suffering and eliminating wasteful spending.” He says that with “the backing of these three, remarkable organizations” he cannot only impact their 1.2 million employees and their families, but “incubate better models of care for all. This work will take time, but must be done. The system is broken and better is possible.”

This isn’t the first time that large companies have combined to grapple with the ever-increasing cost of providing health care to their employees. But if the result of this high-profile experiment is merely a set of incremental improvements in care delivery, and modest, one-time cost reductions for the alliance, it will be a big disappointment—a monumental, but unrealized, opportunity for disruptive and transformative system change.

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