If Gawande lacks a conventional resume for this job, the one he has should still do nicely. He's spent years grappling with issues that have caused health care spending to spiral in the U.S without much improvement in outcomes. These include things like overtreatment, overdiagnosis — and the bad incentives that encourage it — geographic disparities in cost and outcomes, and outsize spending on end-of-life care.
Gawande hasn't just spent time pondering the issues. In 2013, he founded Ariadne Labs, a joint effort by Brigham and Women's Hospital and Harvard's public health school aimed at figuring out practical ways to reduce health care costs and improve outcomes around the world. One prominent byproduct of their efforts is the creation of a surgery checklist that can help substantially reduce the likelihood of post-operative complications.
If Gawande gets autonomy and support to take a similar tack with this joint venture — to test scientifically sound, data-focused, and potentially scalable interventions in different areas of health care — it could have a far-reaching impact.
That said, the venture won't change from a collection of industry talking points into something real overnight.
Approaching the cost problem from the employer perspective is going to be novel for Gawande and comes with complications and constraints. If Gawande's efforts anger employees — a real possibility, given the tendency of cost-saving interventions to reduce choice— the companies funding him may not like it. Figuring out novel insurance designs and new provider relationships or whatever else Gawande ends up doing will be challenging within that context.
But at the end of the day, giving the keys of this initiative to someone who has devoted his career to intelligent efforts to make health care less wasteful, cruel and stupid is likely to pay dividends.
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Max Nisen is a Bloomberg Gadfly columnist covering biotech, pharma and health care. He previously wrote about management and corporate strategy for Quartz and