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    Letters

    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).

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    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

    Director

    The Dartmouth Institute for Health Policy

    and Clinical Practice

    Hanover, N.H.