Ten years after the release of “Being Mortal,” Atul Gawande’s groundbreaking book on death and end-of-life care, the celebrated surgeon and author has shifted his focus from American healthcare to global issues.
“Trust in public health authorities is based on trust in government. What we are seeing is that there are vastly different levels of trust that have declined in governments around the world,” Gawande said Thursday at the STAT Summit 2024 in Boston. “That is in many ways a bigger problem than health care.”
In the wake of the coronavirus pandemic, Gawande has done just that urged Public health leaders must stop juggling “one emergency after another” and invest in a long-term global strategy. This recommendation follows Gawande’s past four years of using his expertise in public health crises in countries outside the U.S. as the Assistant Administrator for Global Health at the U.S. Agency for International Development.
During his first months on the job in 2022, Gawande said, he had to figure out how to provide Ukrainians with the necessary medicines after Russia invaded Kiev and closed the country’s pharmacies.
The conversation also touched on Gawande’s time as CEO of Haven, a healthcare company led by Amazon, JPMorgan Chase and Berkshire Hathaway and launched in 2018 with the goal of reducing out-of-control costs and mediocre patient outcomes. Gawande stepped down as CEO in 2020 and the company shut down in 2021.
“The crazy thing about health is that you are not rewarded for optimizing the outcome. You don’t gain financially by lowering costs,” said Gawande, explaining that public sector policy can play an important role even in private healthcare reform efforts.
Although Gawande now spends a lot of time addressing inequality in life expectancy around the world, the questions he asks today are remarkably similar to those he asked a decade ago in his book on end of life.
“If we can achieve an average life expectancy of more than 80 years, we will spend half our lives in care, needing help along the way,” he said. That means it’s important not only to extend people’s lives, but also to understand their priorities.
“Whether it’s wearing a mask or taking chemotherapy for cancer, the questions are the same,” he told the audience. ‘What are you willing to sacrifice? What are you not willing to sacrifice for more time?”
Correction: An earlier version of this story incorrectly suggested that Russia invaded Ukraine in 2020. It was in 2022