Ah, the ol' MAGA argument.

I have never heard anything from Gawande that made me question his judgement. Whereas I have heard a lot from the MAGA guy that made me question his.

This would actually seem to be the misunderstand antecedent to the MAGA argument, which uses successful examples of exactly this type of "disruption" to fallacious claim replacing governance experience with business experience will have positive results.

This is exactly the same logic I heard used by many people voting for Trump. The truth is that there usually is a real downside from failure, even if it feels like our huge systems are as bad as they can get. In other words, while we do have an expensive system with worse outcomes than peer nations, at least right now we have healthcare being delivered at a first-world level, and we shouldn't take that for granted.

Well... uhh... this guy is not in charge of everyone's healthcare - he's in charge of a rather small group of companies instead.

The consequences of failure here are not exactly analogous to your example. 330 million people are not going to impacted by whatever is considered a failure here.

Exactly.

The three companies [Amazon, JPMorgan, and Berkshire Hathaway] are self-insured employers, which means that when you're an employee going to a doctor's appointment, your employer, rather than a health insurer, is ultimately footing the bill for the MRI exam you receive... "We're already the insurance company, we're already making these decisions, and we simply want do a better job," - JPMorgan CEO Jamie Dimon http://www.businessinsider.com/amazon-jpmorgan-and-berkshire...

Surely, that should be manageable for an insider like Atul Gawande. And it is nowhere same as wrangling with legacy American healthcare system (where one is dealing with insurance companies among others).

For now, but if I remember correctly, the goal is for these companies to offer this as their employees' health plans before expanding more broadly. For those people (and there are somewhere around a million customers between the companies), this could be worse than not being offered insurance.

They have no publicly stated goal to expand more broadly. That's nothing more than media speculation and or wishful thinking.

Buffett has repeatedly said this is not an entity that is meant to offer services beyond the scope of the three companies or similar. They plan to share what they learn, and Buffett has said he hopes that can help other companies and the wider healthcare system.

Here's probably the best talk he has given on the subject (13 minutes long, from a few months ago):

https://www.youtube.com/watch?v=F4fuVC6zCJI

He will.be in charge of a relatively small company that still has very vague goals. He won't be running Medicare. If we are afraid of experiments on even the smallest scale there will never be any improvement.

Comparing the presidency to this CEO position is just silly.

The "outsider" in this case is still a surgeon, and teaches at Harvard. I don't think the comparison is apt.