Disrupting health care? Check your assumptions at the door

Regarding recent reports on plans for Amazon, JPMorgan Chase, and Berkshire Hathaway to create a new health care company: Kudos to Jeff Bezos, Jamie Dimon, and Warren Buffett for stepping forward to take on the bloated US health care system.

The challenges are clear: administrative waste, unnecessary treatment, monopoly pricing, inequitable access, and often lousy quality. Less obvious is how to address them.

A good start would be to question widely held assumptions: that current treatments — including drugs — all have been proven safe and effective (safe, maybe; effective, no); that physicians can tell you what’s best for you (they can, but only if they know what is important to you); or that more medical care is always better (it’s not).


The system is ripe for disruption and new thinking. But it will take a fearless commitment to keeping patients at the center and the profiteers at bay.

Dr. Elliott S. Fisher


The Dartmouth Institute for Health Policy

and Clinical Practice

Hanover, N.H.