Bob Wachter

We use it to transform the way we do a procedure or the way we treat a disease.

And thank goodness for that, because we're much better at that than we used to be.

So why is health care delivery still so sloppy?

There are a lot of reasons that we are pretty static.

The fixed costs are very high to get into the business.

It's almost impossible for a startup to build and launch a new hospital.

The incumbents are quite powerful, although you could argue that's true for a lot of other industries, but doctors, nurses, et cetera, are powerful.

The economics are really funky.

If Amazon or Netflix or you name your favorite disruptor comes up with a better mousetrap, the relationship is largely between a customer and the vendor.

And the customer says, this is better or cheaper or whatever, I'm going to buy it.

In healthcare, you have this assorted mishmash of insurance companies, businesses, government.

And also because healthcare is so important and we have the capacity to kill people if we don't do it right, it is highly regulated, which is yet another barrier for innovators to come in and disrupt us.

We like technology, but we like it in very, very specific ways.

We have not embraced it as a mechanism to make care better and safer and less expensive.

You call your book A Giant Leap.

I want to understand this concept of the giant leap.

My sense is you're arguing that healthcare...

Yeah.

The quote I like is Hemingway's quote from The Sun Also Rises.

Now, 100 years ago, one of the characters goes bankrupt and another character says, how does a man go bankrupt?