The January announcement that Amazon, JPMorgan Chase and Berkshire Hathaway are joining to create a health care company has captured broad attention. Many who are frustrated with the high cost of the U.S. health care system are hoping that the management and technological expertise of the three large and innovative companies can bring about the kind of fundamental changes that so far have eluded government policymakers.
There is reason to cheer the entry of companies like Amazon, JPMorgan Chase and Berkshire Hathaway into the health debate. It is a reminder that not all significant policy changes come from government actions. Over the years, employers – and especially large companies – have been among the key innovators in promoting equity in the workplace, among other policies.
Still, the challenge of health reform is daunting. On the heels of the announcement, The Upshot blog in the New York Times cited some of the challenges the new venture will face. Among the issues cited by bloggers Margot Sanger-Katz and Reed Abelson are these:
- Health care is local. It is hard to make national changes in a system that is defined by local clinics, hospitals and regulators who often act independently of their counterparts in other states.
- While the new venture seeks to shake up the health marketplace, health care isn’t subject to the traditional effects of disruptive strategies. Typically, disruptive companies succeed by introducing low-cost products and services to an existing marketplace. Think low-cost airlines and foreign cars. It’s not clear, though, that health consumers are willing to purchase solely on the basis of cost. Instead, evidence suggests that they will pay higher prices based on real and perceived quality, convenience and, perhaps most importantly, the counsel of their doctor or other trusted health provider.
- Will Amazon, JPMorgan Chase and Berkshire Hathaway be willing to sell what they learn to other companies, including competitors? As large as the three companies are, they aren’t big enough to change a health marketplace that consumes 17 percent of the U.S. economy simply by changing the behavior of their own employees. They will need to take their efforts to other companies. Yet, if what they learn and share is effective in controlling health costs, they would be helping competitors reduce their rapidly rising health costs, giving them more resources to invest in the people, technologies and other investments that will make them even more effective competitors.
All these points, but especially the last one, open the door to another new organization, United States of Care. This new group isn’t focused on lobbying government, but on engaging the public and experts in developing and promoting new solutions.
The national grassroots effort intends to provide “resources and actionable approaches to state and federal policymakers, drawing on a wide range of expertise, facilitating stakeholder engagement, and connecting the dots between the interests of citizens and their elected representatives,” according to the group’s mission statement.
“We will aim to grow our footprint and work directly with policymakers and experts in states to build support from the public, develop best practice approaches and shift our national culture to create lasting change.”
United States of Care and the Amazon-JPMorgan Chase-Berkshire Hathaway reflect the growing frustration many have with a political system that seems unable to move from assessing blame to finding solutions. These and other initiatives that almost certainly will arise from the partisan bickering will succeed if they heed the advice the Minneapolis Star Tribune offered in an editorial at the time HealthBasics launched:
“The ideology-fueled divide is reflective of the angry debate over health care and underscores the urgency in forging common ground. But another insight yielded by the (HealthBasics survey of Minnesotans) may prove most valuable in moving the debate forward, because it points to the surprising but critical ingredient needed to do so: honesty.
“That quality often has been sorely missing from the messages delivered by politicians, policymakers and industry representatives as health care reform discussions have played out. Consumers understandably want more and better health care, but they also want to pay less. What neither free-marketers nor advocates for a bigger government role in health care have admitted often enough is that trade-offs will have to be made…
“’A strong majority of Minnesotans say when it’s all said and done, we don’t want limits placed on our own interactions with the health care system. Minnesotans want whatever treatment is prescribed by a physician; we want to see specialists without referrals; and we want our health insurance to pay the full cost of care. And never mind the contradictions,’’ HealthBasics researchers concluded.
“It’s hard to blame consumers for the disconnect. Politicians have pandered to voters for years on this issue, talking vaguely about painless efficiencies and eliminating waste and fraud somewhere else. The hard truth is that compromises will have to be made whether you’re a fan of less or more government involvement in health care.”