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What to know about Atul Gawande during his first week<\/h2>
As the new CEO of the Amazon-Berkshire-JPMorgan Chase healthcare venture, Atul Gawande began his first week as the head of the future health brand. To mark this moment\u2014which could have a huge impact on how employers select and pay for healthcare and prescriptions in the future\u2014we have gathered 10 points those in the healthcare industry may not know about the new executive.These highlights range from his views on the group healthcare market, the dilemma of medical waste and his support for the Affordable Care Act. Information was pulled from Gawande\u2019s articles in The New Yorker as well as coverage from Forbes, Bloomberg, CNBC and Reuters.<\/p>

The push for incremental care<\/h2>
In Gawande\u2019s June 26, 2017, article in The New Yorker,<\/i> \u201cHow the Senate\u2019s health-care bill threatens the nation\u2019s health<\/a>,\u201d the noted surgeon and Harvard educator emphasized the importance for Americans to have regular checkups at their local physician rather than waiting for extreme medical cases to arise: Conservatives often take a narrow view of the value of health insurance: they focus on catastrophic events such as emergencies and sudden, high-cost illnesses. But the path of life isn\u2019t one of steady health punctuated by brief crises. Most of us accumulate costly, often chronic health issues as we age. These issues can often be delayed, managed, and controlled if we have good health care \u2014 and can\u2019t be if we don\u2019t.<\/i><\/p>

Support for Medicaid<\/h2>In the same article, Gawande addresses Republican dismissals of Medicaid<\/a> being inadequate or unsatisfactory. He says compared to private coverage, Medicaid produces at least as much improvement in access to care, measures of health and morality reduction: Polls indicate that recipients like Medicaid more than private coverage, even with the difficulties finding doctors who take Medicaid, because the program provides them with better financial protection.<\/i><\/p>

Having healthcare available to all<\/h2>Gawande published an article, \u201c Is health care a right?<\/a>\u201d on Oct. 2, 2017, where he explains that as humanity has developed more advanced means of extending life and curing illness, the government, particularly in the United States, has struggled to regulate care effectively: Medical discoveries have enabled the average American to live eighty years or longer, and with a higher quality of life than ever before. Achieving this requires access not only to emergency care but also, crucially, to routine care and medicines, which is how we stave off and manage the series of chronic health issues that accumulate with long life. We get high blood pressure and hepatitis, diabetes and depression, cholesterol problems and colon cancer. Those who can\u2019t afford the requisite care get sicker and die sooner. Yet, in a country where pretty much everyone has trash pickup and K-12 schooling for the kids, we\u2019ve been reluctant to address our Second World War mistake and establish a basic system of health-care coverage that\u2019s open to all. Some even argue that such a system is un-American, stepping beyond the powers the Founders envisioned for our government.<\/i><\/p>

Tying healthcare to employment; a generations-old error<\/h2>While many American receive their healthcare from their employer, Gawande insists this is an error that has made it disastrously difficult to discipline costs and insure quality<\/a>, while severing care from America\u2019s foundational agreement, that when it comes to the most basic needs and burdens of life and liberty, all lives have equal worth: The prospects and costs for health care in America still vary wildly, and incomprehensibly, according to your job, your state, your age, your income, your marital status, your gender, and your medical history, not to mention your ability to read fine print .<\/i><\/p>

Support for the ACA<\/h2>Long before tax overhaul became law, Gawande wrote in a March 6, 2017, article, \u201c Trumpcare vs. Obamacare<\/a>\u201d <\/i>that the Affordable Care Act had done a lot of good for the country. Despite ending the individual mandate \u2014 the requirement by law for most individuals to purchase health insurance coverage or pay a penalty\u2014having continuous coverage would mean that people who lose their insurance temporarily, because they change of jobs or suffer a financial setback, would also lose their preexisting-condition protections: For these people and for others left behind, Price and Ryan advocate state-run \u201chigh-risk pools.\u201d But, in the thirty-five states that offered high-risk pools to the uninsurable before the A.C.A., inadequate funding delivered terrible coverage, with extremely high premiums and deductibles, and annual limits as low as seventy-five thousand dollars. Hardly anyone signed up.<\/i><\/p>

Disrupting the healthcare market<\/h2>In a recent article in Forbes,<\/i> \u201cWhy Atul Gawande will soon be the most feared CEO in healthcare<\/a>,\u201d Robert Pearl, MD, highlighted that because Gawande lacks the experience of running an insurance company or contracting with providers, it does not prove him unqualified. In fact, the industry is ripe for disruption: Jeff Bezos, Warren Buffett and Jamie Dimon did not hire a big-thinking industry outsider to set up a conventional insurance system or haggle with doctors and hospitals over prices. Dr. Gawande was selected 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.<\/i><\/p>

Tackling medical waste<\/h2>When Gawande was appointed to his current position, he told Bloomberg<\/a> <\/i>he plans to target three kinds of waste in the healthcare system: administrative costs, high prices and improper healthcare usage. \u201cOne source of waste is our very high administrative costs,\u201d he said during a conversation with journalist Judy Woodruff at the Spotlight Health event. \u201cThere are a lot of middlemen in the system, and there have to be solutions that simplify that, take some of the middlemen out of the system.\u201d<\/i><\/p>

Healthcare as an engine<\/h2>Gawande has been vocal about his ideas to improve health care and lower costs. He has advocated more integration in healthcare, saying in a 2012 TED Talk<\/a> that the ones getting the best results at the lowest costs have found ways to get all the different pieces to come together into a whole. "There's a famous thought experiment that touches exactly on this that said, what if you built a car from the very best car parts? Well it would lead you to put in Porsche brakes, a Ferrari engine, a Volvo body, a BMW chassis. And you put it all together and what do you get? A very expensive pile of junk that does not go anywhere. And that is what medicine can feel like sometimes. It's not a system."<\/i><\/p>

The cost of care<\/h2>
At the annual meeting of America\u2019s Health Insurance Plans, Gawande said that drug costs are an impediment to recovery. \u201cWe are screaming right now about pharmaceutical costs ... and that is just 10 percent\u201d of total U.S. healthcare spending, Gawande said, noting how patients faced with a $200 drug co-pay see that as standing between them and their health.<\/i><\/p>

Healthcare is too complex in America<\/h2>The high cost of healthcare is also having an impact on doctors and hospitals in how they do their job, he wrote in a 2015 New Yorker<\/i> article based on his 2009 book, \u201cThe Cost Conundrum<\/a>.\u201d But, whichever way we go (and this being America, we\u2019ll no doubt try to do some hodgepodge of it all), we cannot let the complexities blind us to the core concern. The one thing the medical profession is not rewarded for is providing better, higher-value care. We are financially rewarded either for doing more stuff or for securing monopoly power. In a fee-for-service payment system \u2014 a system of paying doctors and hospitals by pill and procedure \u2014 we are actually penalized for making the effort to organize and deliver care with the best service, quality, and efficiency we can. That\u2019s why both public and private insurers are rolling out reforms like \u201cbundled payments\u201d (paying a package price for certain conditions) and \u201caccountable care\u201d (sharing savings doctors and hospitals produce from more efficient care) \u2014 they want to replace our system of paying for stuff with one that pays for outcomes.<\/i><\/p>

","saveContent":"
What to know about Atul Gawande during his first week<\/h2>
As the new CEO of the Amazon-Berkshire-JPMorgan Chase healthcare venture, Atul Gawande began his first week as the head of the future health brand. To mark this moment\u2014which could have a huge impact on how employers select and pay for healthcare and prescriptions in the future\u2014we have gathered 10 points those in the healthcare industry may not know about the new executive.These highlights range from his views on the group healthcare market, the dilemma of medical waste and his support for the Affordable Care Act. Information was pulled from Gawande\u2019s articles in The New Yorker as well as coverage from Forbes, Bloomberg, CNBC and Reuters.<\/p>

The push for incremental care<\/h2>
In Gawande\u2019s June 26, 2017, article in The New Yorker,<\/i> \u201cHow the Senate\u2019s health-care bill threatens the nation\u2019s health<\/a>,\u201d the noted surgeon and Harvard educator emphasized the importance for Americans to have regular checkups at their local physician rather than waiting for extreme medical cases to arise: Conservatives often take a narrow view of the value of health insurance: they focus on catastrophic events such as emergencies and sudden, high-cost illnesses. But the path of life isn\u2019t one of steady health punctuated by brief crises. Most of us accumulate costly, often chronic health issues as we age. These issues can often be delayed, managed, and controlled if we have good health care \u2014 and can\u2019t be if we don\u2019t.<\/i><\/p>

Support for Medicaid<\/h2>In the same article, Gawande addresses Republican dismissals of Medicaid<\/a> being inadequate or unsatisfactory. He says compared to private coverage, Medicaid produces at least as much improvement in access to care, measures of health and morality reduction: Polls indicate that recipients like Medicaid more than private coverage, even with the difficulties finding doctors who take Medicaid, because the program provides them with better financial protection.<\/i><\/p>

Having healthcare available to all<\/h2>Gawande published an article, \u201c Is health care a right?<\/a>\u201d on Oct. 2, 2017, where he explains that as humanity has developed more advanced means of extending life and curing illness, the government, particularly in the United States, has struggled to regulate care effectively: Medical discoveries have enabled the average American to live eighty years or longer, and with a higher quality of life than ever before. Achieving this requires access not only to emergency care but also, crucially, to routine care and medicines, which is how we stave off and manage the series of chronic health issues that accumulate with long life. We get high blood pressure and hepatitis, diabetes and depression, cholesterol problems and colon cancer. Those who can\u2019t afford the requisite care get sicker and die sooner. Yet, in a country where pretty much everyone has trash pickup and K-12 schooling for the kids, we\u2019ve been reluctant to address our Second World War mistake and establish a basic system of health-care coverage that\u2019s open to all. Some even argue that such a system is un-American, stepping beyond the powers the Founders envisioned for our government.<\/i><\/p>

Tying healthcare to employment; a generations-old error<\/h2>While many American receive their healthcare from their employer, Gawande insists this is an error that has made it disastrously difficult to discipline costs and insure quality<\/a>, while severing care from America\u2019s foundational agreement, that when it comes to the most basic needs and burdens of life and liberty, all lives have equal worth: The prospects and costs for health care in America still vary wildly, and incomprehensibly, according to your job, your state, your age, your income, your marital status, your gender, and your medical history, not to mention your ability to read fine print .<\/i><\/p>

Support for the ACA<\/h2>Long before tax overhaul became law, Gawande wrote in a March 6, 2017, article, \u201c Trumpcare vs. Obamacare<\/a>\u201d <\/i>that the Affordable Care Act had done a lot of good for the country. Despite ending the individual mandate \u2014 the requirement by law for most individuals to purchase health insurance coverage or pay a penalty\u2014having continuous coverage would mean that people who lose their insurance temporarily, because they change of jobs or suffer a financial setback, would also lose their preexisting-condition protections: For these people and for others left behind, Price and Ryan advocate state-run \u201chigh-risk pools.\u201d But, in the thirty-five states that offered high-risk pools to the uninsurable before the A.C.A., inadequate funding delivered terrible coverage, with extremely high premiums and deductibles, and annual limits as low as seventy-five thousand dollars. Hardly anyone signed up.<\/i><\/p>

Disrupting the healthcare market<\/h2>In a recent article in Forbes,<\/i> \u201cWhy Atul Gawande will soon be the most feared CEO in healthcare<\/a>,\u201d Robert Pearl, MD, highlighted that because Gawande lacks the experience of running an insurance company or contracting with providers, it does not prove him unqualified. In fact, the industry is ripe for disruption: Jeff Bezos, Warren Buffett and Jamie Dimon did not hire a big-thinking industry outsider to set up a conventional insurance system or haggle with doctors and hospitals over prices. Dr. Gawande was selected 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.<\/i><\/p>

Tackling medical waste<\/h2>When Gawande was appointed to his current position, he told Bloomberg<\/a> <\/i>he plans to target three kinds of waste in the healthcare system: administrative costs, high prices and improper healthcare usage. \u201cOne source of waste is our very high administrative costs,\u201d he said during a conversation with journalist Judy Woodruff at the Spotlight Health event. \u201cThere are a lot of middlemen in the system, and there have to be solutions that simplify that, take some of the middlemen out of the system.\u201d<\/i><\/p>

Healthcare as an engine<\/h2>Gawande has been vocal about his ideas to improve health care and lower costs. He has advocated more integration in healthcare, saying in a 2012 TED Talk<\/a> that the ones getting the best results at the lowest costs have found ways to get all the different pieces to come together into a whole. "There's a famous thought experiment that touches exactly on this that said, what if you built a car from the very best car parts? Well it would lead you to put in Porsche brakes, a Ferrari engine, a Volvo body, a BMW chassis. And you put it all together and what do you get? A very expensive pile of junk that does not go anywhere. And that is what medicine can feel like sometimes. It's not a system."<\/i><\/p>

The cost of care<\/h2>
At the annual meeting of America\u2019s Health Insurance Plans, Gawande said that drug costs are an impediment to recovery. \u201cWe are screaming right now about pharmaceutical costs ... and that is just 10 percent\u201d of total U.S. healthcare spending, Gawande said, noting how patients faced with a $200 drug co-pay see that as standing between them and their health.<\/i><\/p>

Healthcare is too complex in America<\/h2>The high cost of healthcare is also having an impact on doctors and hospitals in how they do their job, he wrote in a 2015 New Yorker<\/i> article based on his 2009 book, \u201cThe Cost Conundrum<\/a>.\u201d But, whichever way we go (and this being America, we\u2019ll no doubt try to do some hodgepodge of it all), we cannot let the complexities blind us to the core concern. The one thing the medical profession is not rewarded for is providing better, higher-value care. We are financially rewarded either for doing more stuff or for securing monopoly power. In a fee-for-service payment system \u2014 a system of paying doctors and hospitals by pill and procedure \u2014 we are actually penalized for making the effort to organize and deliver care with the best service, quality, and efficiency we can. That\u2019s why both public and private insurers are rolling out reforms like \u201cbundled payments\u201d (paying a package price for certain conditions) and \u201caccountable care\u201d (sharing savings doctors and hospitals produce from more efficient care) \u2014 they want to replace our system of paying for stuff with one that pays for outcomes.<\/i><\/p>

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What to know about Atul Gawande during his first week

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