Dr. Atul Gawande to Lead New Insurance Company for Amazon, JP MorganChase and Berkshire Hathaway

Dr. Atul Gawande, the well respected and well known author of Being Mortal, a bestseller which pushed for a more patient centered approach to health care has been appointed as CEO to lead the new insurance company announced by Amazon, Berkshire Hathaway and JP Morgan Chase.  The company is a new effort to reform health care and the hiring of Dr. Gawande is a sign of the direction they want to take.

Dr. Gawande does not have business experience but has been in the trenches on health care especially for those with serious illnesses.  In his book, Being Mortal, which was at the top of the bestsellers list,  Dr. Gawande has supported providing more person-centered care,  with a better quality of life especially at the end of life.  He supports hospice and palliative care at the end of life rather than expensive over treatment which does not extend life by much and could provide less than comfort.  He write

The three large companies wanted to establish an insurance company to “operate as an independent entity that is free from profit-making incentives and constraints.”  The companies have 1.2 million workers so as large employers they may be able to steer health care coverage for those employees in a new way.

Many Democrats Push Medicare for All as Trump Efforts to Harm ACA Hurt Medicare Too

In Congressional campaigns across the country, many incumbent Democrats and challengers in Republican districts are rebelling against problems in the health care system and are pushing a Medicare for All plan that would be simpler and cut out private insurance costs.   The plan would also allow for negotiations on prescription drug prices.  The failure to allow negotiation of drug costs for Medicare is a reflection of the campaign contributions of pharmaceutical companies.

In recent days the Trump Administration has indicated it will seek to further de-stabilize  health coverage under the Affordable Care Act  (ACA) by refusing to defend in court provisions that protect patients with pre-existing from being denied coverage.    Previously Trump rejected the individual mandate to have coverage which has led to increases in insurance premiums in the ACA.

While Trump as a candidate said he was not going to cut Medicare, his actions with the ACA harm Medicare because some uncompensated hospital costs will come from Medicare since there may be more people without health insurance.   The recent report in early June by the Medicare Trustees reported that Medicare is now likely to not be able to pay its full costs in 2026, three years earlier than last year’s report.  Higher payments to Medicare Advantage plans and for ever increasing drug costs also are stretching Medicare finances.

The Trump economic plan says that the major tax cut enacted will increase employment and lead to higher wages that will benefit Social Security and Medicare.  In other words, the program’s finances will be resolved by increased economic growth.  That has not happened so far and a huge federal budget deficit will likely result instead, increasing political pressure to cut both programs.

So, the fall election pits two diametrically opposed ideas:  Medicare for All vs. the Republican House plan to turn Medicare into a fixed voucher plan, shifting more costs to beneficiaries.    Candidates for Congress need to be challenged on where they stand on the future of Medicare and Social Security.   They are the two pillars which stand against income inequality in older age especially, and it is critical that they be preserved and strengthened for beneficiaries.



RFK Inspired the Young to Change the World 50 Years Ago

For many of us old enough to remember we are observing media retrospectives of the events of our youth 50 years ago during the tumultuous, watershed year of 1968.  It seems strange now in my mid 60s to think that we were serious or even knowledgeable about the world as teenagers, However, today’s Parkland teenagers remind us of our own passions and desire to change the world when the divisive war in Vietnam dissolved the American pride our parents achieved after winning World War II.  

Bobby Kennedy had been a hero to me as my views on public issues first were formed. Two months after the assassination of Martin Luther King, Bobby Kennedy’s assassination during the Presidential campaign was a devastating political and human event.   My brother woke me up to tell me that Bobby Kennedy had been shot. I had gone to bed after he won the California Democratic primary. His death seemed so personal. My parents were the same age as Robert and Ethel Kennedy. I was the same age as his son, Robert Jr.  

There was no internet or social media then.  We were glued to the television on a Saturday watching RFK’s funeral in New York and as the funeral train make its way as people solemnly lined the tracks from New York to Washington and Arlington National Cemetery.

Everyone thought that the country was coming apart.   Some wanted Senator Edward Kennedy to run for President in his brother’s place, but in conversations people had at the time, friends would say, “He will be shot too.”   We got used to political shootings just like we hold our breath waiting for another school shooting today. And, every week there was a Defense Department press release reporting that hundreds of young Americans had been killed in Vietnam the previous week.

Bobby was a regular visitor to Albany.  In 1957, he spoke to the New York State Democratic party in Albany in place of JFK and  said, “Brother John would be much happier here than in his sickbed, for he loves a good gathering of Democrats and he knows that there are no finer Democrats anywhere in the country than those gathered here in Albany tonight.”

It is hard for one not living at the time to know of the impact RFK had after JFK was assassinated.  Bobby resigned as Attorney General and and ran and won a seat as our Senator from New York. With the state and country still in grief in 1964 over JFK’s assassination, Bobby was  mobbed like a rock star as he campaigned all over the state. Thousands came to see him in Troy and Albany and in small towns across the North Country. My father who worked for the local media stood near him on Public Square in Watertown as thousands turned out.   In Glens Falls, he was five hours late but so many waited faithfully for him, even in pajamas, after he arrived past midnight in Glens Falls he said, “I promise that win or lose, the day after election day, I’m coming back to Glens Falls.”  And, he did.

In the four and a half years after JFK’s death, Bobby’s political persona changed.  He had been the political operative for his brother. On his own, he spoke of idealism and wanted to inspire people “to seek a newer world”  in a time of terrible turmoil during the Vietnam War. There was a kind of a soul force to him as he quoted the Greeks and urged calm following Martin Luther’s King’s murder.  For a man born in privilege, power and money, he had a remarkable ability to relate to blue collar workers, the poor and the minorities. He went to Mississippi to see the shacks where poor African Americans lived.  He was with Cesar Chavez and championed the farmworkers in California.

Most of all he was the one who appealed to and embraced the young.  Like JFK who started the Peace Corps and the push to the moon, he had optimism for the future because of young people.  He urged them to do great things. In South Africa, he made his famous Day of Affirmation speech to South African youth living in a country divided by Apartheid and saw young people as the hope for change,

“This world demands the qualities of youth; not a time of life but a state of mind, a temper of the will, a quality of the imagination, a predominance of courage over timidity, of the appetite for adventure over the love of ease.”

The Kennedys inspired many young people at the time like me to pursue careers in community action and public service.  Out of college in the 1970s, I “enlisted” in the war on Poverty, I moved to Albany to work in state level grassroots advocacy, a path that eventually led to public service as director of a state agency.

In 1968, Bobby Kennedy had a chance to heal the nation, to end the Vietnam War, to seek racial peace. He was calling on America to be its best, forward thinking, patriotic and strong.  He believed in American democracy despite its flaws in that era of Vietnam and racial tensions. He was intent on trying to address them. We missed him all through the years of our youth.   How we still need someone like Robert Kennedy who can try to appeal to our best and heal this badly divided nation.


Michael Burgess, Delmar

Former Director, New York State Office for the Aging