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).
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):
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.