WAS_VBD IT_PNP A_AT0 PRESS_NN1 RELEASE_NN1 ,_PUN or_CJC a_AT0 declaration_NN1 of_PRF war_NN1 ?_SENT 
How_AVQ else_AV0 to_TO0 explain_VVI the_AT0 media_NN0 and_CJC market_NN1 frenzy_NN1 that_CJT followed_VVD the_AT0 announcement_NN1 ,_PUN issued_VVN at_PRP 7_CRD a.m._AV0 on_PRP Tuesday_NP0 ,_PUN Jan._NP0 30_CRD ,_PUN 2018_CRD ,_PUN that_CJT Amazon_NP0 ,_PUN Berkshire_NP0 Hathaway_NP0 ,_PUN and_CJC JPMorgan_NP0 Chase_NP0 —_PUN three_CRD of_PRF the_AT0 nation_NN1 's_POS largest_AJS ,_PUN most_AV0 high-profile_AJ0 ,_PUN and_CJC best-run_AJS companies_NN2 ,_PUN then_AV0 with_PRP some_DT0 $_NN0 534_CRD billion_CRD in_PRP revenues_NN2 between_PRP them_PNP —_PUN were_VBD teaming_VVG up_AVP to_TO0 take_VVI on_PRP the_AT0 evermore-expensive_AJ0 ,_PUN ever-more-complex_AJ0 problem_NN1 that_DT0 is_VBZ American_AJ0 health_NN1 care_NN1 ._SENT Or_CJC what_DTQ Berkshire_NP0 CEO_NN1 Warren_NP0 Buffett_NP0 colorfully_AV0 described_VVN in_PRP that_DT0 press_NN1 release_NN1 as_PRP "_PUQ a_AT0 hungry_AJ0 tapeworm_NN1 on_PRP the_AT0 American_AJ0 economy_NN1 ._SENT "_PUQ 
Specifically_AV0 ,_PUN the_AT0 companies_NN2 were_VBD aiming_VVG to_TO0 improve_VVI satisfaction_NN1 and_CJC reduce_VVB the_AT0 cost_NN1 of_PRF the_AT0 health_NN1 care_VVI they_PNP purchase_VVI and_CJC subsidize_VVI for_PRP their_DPS employees_NN2 and_CJC their_DPS employees_NN2 '_POS families_NN2 in_PRP the_AT0 form_NN1 of_PRF health_NN1 benefits_NN2 —_PUN collectively_AV0 ,_PUN a_AT0 $_NN0 4_CRD billion_CRD annual_AJ0 commitment_NN1 ._SENT They_PNP planned_VVD to_TO0 do_VDI this_DT0 by_PRP forming_VVG "_PUQ an_AT0 independent_AJ0 company_NN1 that_DT0 is_VBZ free_AJ0 from_PRP profit-making_AJ0 incentives_NN2 and_CJC constraints_NN2 "_PUQ and_CJC focusing_VVG on_PRP "_PUQ technology_NN1 solutions_NN2 ._SENT "_PUQ 
The_AT0 announcement_NN1 contained_VVD both_DT0 notes_NN2 of_PRF humility_NN1 —_PUN Buffett_NP0 :_PUN "_PUQ Our_DPS group_NN1 does_VDZ not_XX0 come_VVI to_PRP this_DT0 problem_NN1 with_PRP answers_NN2 "_PUQ ;_PUN Amazon_NP0 's_POS then-chief_NN1 Jeff_NP0 Bezos_NP0 :_PUN "_PUQ The_AT0 health_NN1 care_NN1 system_NN1 is_VBZ complex_AJ0 ,_PUN and_CJC we_PNP enter_VVB into_PRP this_DT0 challenge_NN1 open-eyed_AJ0 about_PRP the_AT0 degree_NN1 of_PRF difficulty_NN1 "_PUQ —_PUN and_CJC a_AT0 spirit_NN1 of_PRF grand_AJ0 sacrifice_NN1 :_PUN As_CJS JPMorgan_NP0 's_POS Jamie_NP0 Dimon_NP0 put_VVD it_PNP ,_PUN "_PUQ Our_DPS goal_NN1 is_VBZ to_TO0 create_VVI solutions_NN2 that_CJT benefit_VVB our_DPS U.S._NP0 employees_NN2 ,_PUN their_DPS families_NN2 ,_PUN and_CJC ,_PUN potentially_AV0 ,_PUN all_DT0 Americans_NN2 ._SENT "_PUQ 
The_AT0 effort_NN1 was_VBD "_PUQ in_PRP its_DPS early_AJ0 planning_NN1 stages_NN2 "_PUQ —_PUN a_AT0 management_NN1 team_NN1 ,_PUN headquarters_NN0 ,_PUN key_AJ0 operational_AJ0 details_NN2 ,_PUN all_DT0 TBD_NP0 —_PUN and_CJC it_PNP had_VHD come_VVN as_PRP a_AT0 total_AJ0 surprise_NN1 to_PRP virtually_AV0 everyone_PNI ,_PUN including_PRP JPMorgan_NP0 's_POS health_NN1 care_NN1 bankers_NN2 ,_PUN who_PNQ had_VHD reportedly_AV0 been_VBN given_VVN a_AT0 heads-up_NN1 only_AV0 the_AT0 night_NN1 before_AV0 ._SENT What_DTQ did_VDD it_PNP all_DT0 mean_VVB ,_PUN practically_AV0 ?_SENT No_ITJ one_PNI knew_VVD for_PRP sure_AJ0 ._SENT Nonetheless_AV0 ,_PUN news_NN1 of_PRF the_AT0 fledgling_AJ0 venture_NN1 seemed_VVD to_PRP many_DT0 a_AT0 promise_NN1 of_PRF disruption_NN1 to_TO0 come_VVI ._SENT 
They_PNP were_VBD in_PRP many_DT0 ways_NN2 blasting_VVG the_AT0 current_AJ0 configuration_NN1 of_PRF the_AT0 health_NN1 insurance_NN1 industry_NN1 ,_PUN in_PRP very_AV0 strong_AJ0 terms_NN2 ,_PUN "_PUQ says_VVZ Matthew_NP0 Borsch_NP0 ,_PUN a_AT0 managing_AJ0 director_NN1 at_PRP BMO_NP0 Capital_NN1 Markets_NN2 ._SENT "_PUQ You_PNP got_VVD the_AT0 sense_NN1 that_CJT they_PNP were_VBD making_VVG this_DT0 revolutionary_AJ0 commitment_NN1 to_PRP some_DT0 kind_NN1 of_PRF transformation_NN1 to_PRP the_AT0 relationship_NN1 between_PRP employer_NN1 groups_NN2 and_CJC the_AT0 health_NN1 insurance_NN1 carriers_NN2 ._SENT "_PUQ 
Sure_AV0 enough_AV0 ,_PUN the_AT0 stocks_NN2 of_PRF major_AJ0 health_NN1 care_NN1 companies_NN2 including_PRP UnitedHealth_NN1 ,_PUN CVS_NN2 ,_PUN Cigna_NP0 ,_PUN and_CJC Aetna_NP0 tanked_AJ0 ._SENT By_PRP the_AT0 end_NN1 of_PRF the_AT0 week_NN1 the_AT0 S_ZZ0 &_NN1 P_ZZ0 500_CRD Health_NN1 Care_NN1 index_NN1 had_VHD fallen_VVN 4.8_CRD %_NN0 ._SENT Those_DT0 inside_PRP the_AT0 system_NN1 seemed_VVD cowed_VVN by_PRP the_AT0 replaced-url_AJ0 Express_NN1 Scripts_NN2 issued_VVD a_AT0 statement_NN1 more_AV0 or_CJC less_AV0 acknowledging_VVG it_PNP had_VHD to_TO0 do_VDI better_AV0 ._SENT A_AT0 senior_AJ0 executive_NN1 at_PRP Optum_NN1 ,_PUN the_AT0 $_NN0 136_CRD billion_CRD subsidiary_NN1 of_PRF UnitedHealth_NN1 ,_PUN the_AT0 $_NN0 257.5_CRD billion_CRD insurer_NN1 —_PUN which_DTQ counted_VVD JPMorgan_NP0 and_CJC some_DT0 of_PRF the_AT0 Berkshire_NP0 companies_NN2 as_PRP customers_NN2 —_PUN later_AV0 testified_VVN in_PRP court_NN1 that_CJT some_DT0 of_PRF his_DPS employees_NN2 "_PUQ were_VBD very_AV0 scared_VVN this_DT0 company_NN1 would_VM0 take_VVI over_AVP the_AT0 world_NN1 ._SENT "_PUQ 
To_PRP those_DT0 who_PNQ had_VHD toiled_VVN in_PRP the_AT0 world_NN1 of_PRF employer-sponsored_AJ0 health_NN1 care_NN1 for_PRP decades_NN2 ,_PUN trying_VVG but_CJC never_AV0 really_AV0 succeeding_AJ0 to_TO0 come_VVI up_AVP with_PRP new_AJ0 ways_NN2 to_TO0 control_VVI costs_NN2 and_CJC improve_VVB outcomes_NN2 —_PUN promoting_VVG wellness_NN1 activities_NN2 and_CJC chronic_AJ0 disease_NN1 management_NN1 programs_NN2 ;_PUN investing_VVG in_PRP navigation_NN1 tools_NN2 and_CJC second-opinion_AJ0 services_NN2 ;_PUN embracing_VVG high-deductible_AJ0 health_NN1 plans_NN2 in_PRP an_AT0 effort_NN1 to_TO0 make_VVI benefi-ciaries_NN2 better_AJC ,_PUN more_AV0 cost-conscious_AJ0 users_NN2 of_PRF care_NN1 —_PUN the_AT0 statement_NN1 ,_PUN from_PRP three_CRD powerful_AJ0 CEOs_NN2 ,_PUN was_VBD cause_NN1 for_PRP celebration_NN1 ._SENT Here_AV0 was_VBD a_AT0 rare_AJ0 show_NN1 of_PRF leadership_NN1 from_PRP corporate_AJ0 chieftains_NN2 with_PRP heft_NN1 and_CJC a_AT0 shot_NN1 across_PRP the_AT0 bow_NN1 at_PRP an_AT0 industry_NN1 (_PUL insurers_NN2 ,_PUN health_NN1 providers_NN2 ,_PUN pharmacy_NN1 benefit_NN1 managers_NN2 ,_PUN or_CJC PBMs_NN2 )_PUR that_CJT for_PRP too_AV0 long_AJ0 had_VHD been_VBN allowed_VVN to_TO0 profit_VVI by_PRP maintaining_VVG the_AT0 miserable_AJ0 status_NN1 quo_NN1 ._SENT 
The_AT0 illustrious_AJ0 trio_NN1 looked_VVD like_PRP a_AT0 dream_NN1 team_NN1 actually_AV0 capable_AJ0 of_PRF shaking_VVG things_NN2 up_AVP in_PRP America_NP0 's_POS bloated_AJ0 and_CJC entrenched_AJ0 $_NN0 3.8_CRD trillion_CRD health_NN1 industry_NN1 ._SENT Their_DPS CEOs_NN2 were_VBD all_DT0 visionaries_NN2 in_PRP their_DPS industries_NN2 ._SENT Berkshire_NP0 and_CJC JPMorgan_NP0 brought_VVD fi-nance_NN1 chops_NN2 ._SENT Amazon_NP0 had_VHD the_AT0 proven_AJ0 playbook_NN1 —_PUN a_AT0 consumer-first_ORD ethos_NN1 ,_PUN big_AJ0 data_NN0 ,_PUN bold_AJ0 and_CJC patient_AJ0 investment_NN1 —_PUN for_PRP audacious_AJ0 disruption_NN1 ._SENT Between_PRP them_PNP ,_PUN they_PNP had_VHD deep_AJ0 pockets_NN2 ,_PUN ample_AJ0 resources_NN2 ,_PUN and_CJC the_AT0 purchasing_AJ0 power_NN1 that_CJT came_VVD with_PRP their_DPS combined_AJ0 1.2_CRD million_CRD employees_NN2 ._SENT 
Five_CRD months_NN2 in_PRP ,_PUN the_AT0 team_NN1 announced_VVD another_DT0 star_NN1 would_VM0 lead_VVI the_AT0 venture_NN1 :_PUN Atul_NP0 Gawande_NP0 ,_PUN the_AT0 surgeon_NN1 and_CJC influential_AJ0 New_AJ0 Yorker_NN1 writer_NN1 whose_DTQ clear-eyed_AJ0 analysis_NN1 of_PRF America_NP0 's_POS dysfunctional_AJ0 health_NN1 care_NN1 system_NN1 had_VHD earned_VVN him_PNP the_AT0 admiration_NN1 of_PRF Barack_NP0 Obama_NP0 and_CJC Buffett_NP0 ._SENT 
Other_AJ0 hires_NN2 were_VBD announced_VVN ,_PUN but_CJC little_DT0 news_NN1 emerged_VVD ._SENT A_AT0 legal_AJ0 dispute_NN1 involving_VVG a_AT0 former_DT0 Optum_NN1 employee_NN1 who_PNQ accepted_VVD a_AT0 job_NN1 at_PRP the_AT0 new_AJ0 entity_NN1 in_PRP late_AJ0 2018_CRD —_PUN allegedly_AV0 violating_VVG his_DPS noncompete_NN1 —_PUN allowed_VVN perhaps_AV0 the_AT0 fullest_AJS peek_NN1 behind_PRP the_AT0 curtain_NN1 ._SENT The_AT0 court_NN1 proceedings_NN2 indicated_VVD that_CJT as_CJS of_PRF January_NP0 2019_CRD ,_PUN the_AT0 still-nameless_AJ0 venture_NN1 had_VHD 20_CRD employees_NN2 and_CJC a_AT0 plan_NN1 that_CJT was_VBD extremely_AV0 nebulous_AJ0 ._SENT (_PUL More_AV0 revealing_VVG ,_PUN at_PRP least_AV0 in_PRP terms_NN2 of_PRF how_AVQ industry_NN1 incumbents_NN2 viewed_VVD the_AT0 project_NN1 ,_PUN was_VBD the_AT0 vigor_NN1 with_PRP which_DTQ Optum_NP0 had_VHD gone_VVN after_PRP the_AT0 exemployee_NN1 ,_PUN a_AT0 member_NN1 of_PRF the_AT0 corporate_AJ0 strategy_NN1 team_NN1 ._SENT After_PRP performing_VVG a_AT0 forensic_AJ0 analysis_NN1 of_PRF printouts_NN2 and_CJC searching_VVG his_DPS office_NN1 ,_PUN Optum_NP0 accused_VVD him_PNP of_PRF stealing_VVG trade_NN1 secrets_NN2 ,_PUN including_PRP an_AT0 unrecovered_AJ0 "_PUQ Project_NN1 Orange_NN1 Fact_NN1 Book_NN1 ._SENT "_PUQ The_AT0 court_NN1 case_NN1 ,_PUN parts_NN2 of_PRF which_DTQ both_DT0 companies_NN2 argued_VVD to_TO0 keep_VVI under_PRP seal_NN1 ,_PUN was_VBD eventually_AV0 dismissed_VVN ._SENT )_PUR 
In_PRP March_NP0 2019_CRD ,_PUN the_AT0 venture_NN1 finally_AV0 got_VVD a_AT0 name_NN1 ,_PUN Haven_NP0 ._SENT The_AT0 first_ORD major_AJ0 departure_NN1 came_VVD in_PRP May_NP0 ;_PUN COO_NP0 Jack_NP0 Stoddard_NP0 ,_PUN an_AT0 alum_NN1 of_PRF Comcast_NP0 (_PUL which_DTQ has_VHZ one_PNI of_PRF the_AT0 most_AV0 innovative_AJ0 health_NN1 benefits_NN2 programs_NN2 in_PRP the_AT0 country_NN1 )_PUR ,_PUN stepped_VVD down_AVP eight_CRD months_NN2 after_PRP joining_VVG ._SENT Many_DT0 followed_VVD —_PUN the_AT0 venture_NN1 ,_PUN once_AV0 thought_VVD to_TO0 have_VHI abundant_AJ0 resources_NN2 ,_PUN even_AV0 laid_VVN off_PRP some_DT0 people_NN0 —_PUN and_CJC then_AV0 Gawande_NP0 ,_PUN who_PNQ had_VHD never_AV0 left_VVN his_DPS teaching_NN1 ,_PUN writing_VVG ,_PUN and_CJC doctoring_VVG positions_NN2 ,_PUN transitioned_VVN from_PRP CEO_NN1 to_PRP chairman_NN1 in_PRP May_NP0 2020._CRD The_AT0 project_NN1 officially_AV0 sputtered_VVD to_PRP an_AT0 end_NN1 earlier_AV0 this_DT0 year_NN1 ,_PUN when_CJS the_AT0 companies_NN2 released_VVD a_AT0 joint_AJ0 85-word_AJ0 statement_NN1 on_PRP Haven_NP0 's_POS website_NN1 ._SENT In_PRP the_AT0 end_NN1 ,_PUN Haven_NP0 's_POS short_AJ0 life_NN1 was_VBD n't_XX0 even_AV0 dignified_AJ0 by_PRP a_AT0 corporate_AJ0 press_NN1 release_NN1 ._SENT 
so_AV0 ,_PUN WHAT_DTQ HAPPENED_VVD with_PRP Haven_NP0 ?_SENT What_DTQ can_VM0 be_VBI learned_VVN ?_SENT Readers_NN2 ,_PUN after_PRP months_NN2 of_PRF reporting_NN1 ,_PUN I_PNP 'm_VBB sorry_AJ0 to_TO0 confess_VVI I_PNP can_VM0 offer_VVI only_AV0 a_AT0 hazy_AJ0 ,_PUN partial_AJ0 picture_NN1 ._SENT 
My_DPS assignment_NN1 ,_PUN back_AVP in_PRP February_NP0 ,_PUN had_VHD been_VBN to_TO0 get_VVI "_PUQ the_AT0 inside_AJ0 story_NN1 "_PUQ on_PRP what_DTQ transpired_VVD ._SENT What_DTQ ,_PUN after_PRP all_DT0 ,_PUN could_VM0 be_VBI a_AT0 better_AJC ,_PUN more_AV0 important_AJ0 case_NN1 study_NN1 for_PRP the_AT0 Fortune_NN1 500_CRD ?_SENT At_PRP the_AT0 outset_NN1 ,_PUN the_AT0 founding_AJ0 CEOs_NN2 had_VHD expressed_VVN a_AT0 desire_NN1 to_PRP better_AV0 our_DPS health_NN1 system_NN1 for_PRP everyone_PNI ,_PUN and_CJC Gawande_NP0 had_VHD built_VVN his_DPS public_AJ0 career_NN1 on_PRP case_NN1 studies_NN2 ._SENT This_DT0 is_VBZ a_AT0 man_NN1 who_PNQ appreciates_VVZ learning_NN1 lessons_NN2 and_CJC sharing_VVG them_PNP ._SENT 
And_CJC yet_AV0 ,_PUN perhaps_AV0 like_PRP Haven_NP0 itself_PNX ,_PUN my_DPS project_NN1 was_VBD conceived_VVN a_AT0 bit_NN1 too_AV0 ambitiously_AV0 ._SENT The_AT0 entity_NN1 that_CJT set_VVD out_AVP to_TO0 fix_VVI health_NN1 care_NN1 in_PRP fact_NN1 suffers_VVZ from_PRP one_CRD of_PRF the_AT0 industry_NN1 's_POS worst_AJS traits_NN2 —_PUN a_AT0 lack_NN1 of_PRF transparency_NN1 ._SENT To_PRP date_NN1 ,_PUN those_DT0 involved_VVN have_VHB n't_XX0 shared_VVN much_AV0 ._SENT All_DT0 three_CRD companies_NN2 declined_VVD repeated_AJ0 requests_NN2 for_PRP interviews_NN2 ._SENT Dimon_NP0 offered_VVD a_AT0 note_NN1 of_PRF 174_CRD words_NN2 in_PRP his_DPS annual_AJ0 letter_NN1 to_PRP shareholders_NN2 :_PUN "_PUQ We_PNP learned_VVD a_AT0 lot_NN1 about_PRP how_AVQ the_AT0 health_NN1 care_NN1 system_NN1 could_VM0 be_VBI improved_VVN ,_PUN "_PUQ he_PNP remarked_VVD ._SENT Buffett_NP0 ,_PUN when_CJS asked_VVN at_PRP Berkshire_NP0 's_POS shareholder_NN1 meeting_NN1 in_PRP May_NP0 about_PRP what_DTQ was_VBD learned_VVN ,_PUN was_VBD hardly_AV0 more_AV0 illuminating_AJ0 :_PUN "_PUQ The_AT0 tapeworm_NN1 won_VVD ,_PUN "_PUQ he_PNP said_VVD ,_PUN while_CJS adding_VVG Berkshire_NP0 probably_AV0 got_VVD more_AV0 out_AVP of_PRF the_AT0 venture_NN1 than_CJS the_AT0 others_NN2 ._SENT "_PUQ We_PNP found_VVD some_DT0 dumb_AJ0 things_NN2 we_PNP were_VBD doing_VDG ._SENT So_AV0 we_PNP got_VVD our_DPS money_NN1 's_POS worth_NN1 ._SENT "_PUQ 
Gawande_NP0 also_AV0 declined_VVD Fortune_NP0 's_POS invitations_NN2 (_PUL over_PRP several_DT0 months_NN2 )_PUR to_TO0 be_VBI interviewed_VVN ._SENT Ironclad_NN1 nondisclosure_NN1 agreements_NN2 have_VHB kept_VVN other_AJ0 former_DT0 Haven_NN1 employees_NN2 from_PRP speaking_VVG ._SENT 
It_PNP 's_VBZ a_AT0 shame_NN1 ._SENT I_PNP say_VVB that_CJT as_CJS a_AT0 humbled_AJ0 journalist_NN1 ,_PUN but_CJC more_AV0 on_PRP behalf_NN1 of_PRF the_AT0 dozens_CRD of_PRF people_NN0 I_PNP spoke_VVD to_PRP who_PNQ are_VBB struggling_VVG with_PRP the_AT0 same_DT0 issues_NN2 Haven_NP0 was_VBD tackling_VVG and_CJC were_VBD hopeful_AJ0 to_TO0 learn_VVI from_PRP its_DPS efforts_NN2 ._SENT After_PRP all_DT0 ,_PUN this_DT0 is_VBZ about_PRP how_AVQ to_TO0 make_VVI health_NN1 care_NN1 more_AV0 affordable_AJ0 and_CJC accessible_AJ0 to_PRP employees_NN2 ._SENT 
That_DT0 's_VBZ no_AT0 trivial_AJ0 matter_NN1 ._SENT Roughly_AV0 160_CRD million_CRD Americans_NN2 currently_AV0 get_VVB health_NN1 insurance_NN1 through_PRP their_DPS employers_NN2 ._SENT They_PNP have_VHB been_VBN considered_VVN the_AT0 lucky_AJ0 ones_NN2 ,_PUN but_CJC as_CJS Gawande_NP0 noted_VVD in_PRP a_AT0 recent_AJ0 conversation_NN1 with_PRP UCSF_AJ0 Department_NN1 of_PRF Medicine_NN1 chair_NN1 Robert_NP0 Wachter_NP0 —_PUN one_CRD of_PRF the_AT0 few_DT0 occasions_NN2 when_CJS he_PNP 's_VBZ commented_VVN publicly_AV0 on_PRP Haven_NP0 —_PUN for_PRP many_DT0 working_AJ0 Americans_NN2 ,_PUN employer-sponsored_AJ0 insurance_NN1 is_VBZ not_XX0 much_DT0 of_PRF a_AT0 benefit_NN1 anymore_AV0 ._SENT With_PRP the_AT0 average_AJ0 annual_AJ0 family_NN1 premium_NN1 standing_VVG at_PRP $_NN0 21_CRD ,_PUN 342_CRD and_CJC deductibles_NN2 often_AV0 topping_VVG $_NN0 2_CRD ,_PUN 000_CRD ,_PUN the_AT0 cost_NN1 of_PRF coverage_NN1 is_VBZ simply_AV0 too_AV0 high_AJ0 ._SENT 
The_AT0 opportunity_NN1 to_TO0 address_VVI that_DT0 problem_NN1 ,_PUN Gawande_NP0 told_VVD Wachter_NP0 ,_PUN was_VBD in_PRP part_NN1 what_DTQ drew_VVD him_PNP to_PRP Haven_NP0 ._SENT Haven_NP0 's_POS health_NN1 plan_NN1 ,_PUN rolled_VVD out_AVP to_PRP tens_CRD of_PRF thousands_CRD of_PRF JPMorgan_NP0 beneficiaries_NN2 in_PRP Ohio_NP0 and_CJC Arizona_NP0 ,_PUN was_VBD a_AT0 step_NN1 toward_PRP that_DT0 ,_PUN he_PNP said_VVD ._SENT The_AT0 plan_NN1 ,_PUN which_DTQ he_PNP described_VVD as_AV0 popular_AJ0 and_CJC "_PUQ financially_AV0 viable_AJ0 ,_PUN "_PUQ is_VBZ still_AV0 available_AJ0 to_PRP those_DT0 employees_NN2 today_AV0 ._SENT Members_NN2 have_VHB no_AT0 coinsurance_NN1 and_CJC no_AT0 deductibles_NN2 ,_PUN just_AV0 predictable_AJ0 co-pays_NN2 ,_PUN inexpensive_AJ0 mental_AJ0 health_NN1 and_CJC primary_AJ0 care_NN1 ,_PUN and_CJC free_AJ0 access_NN1 to_PRP 60_CRD essential_AJ0 drugs_NN2 ._SENT (_PUL JPM_AV0 already_AV0 offered_VVN the_AT0 prescription_NN1 benefit_NN1 ._SENT )_PUR 
Of_PRF course_NN1 ,_PUN the_AT0 costs_NN2 are_VBB crippling_AJ0 for_PRP businesses_NN2 as_CJS well_AV0 ._SENT Though_CJS they_PNP have_VHB recently_AV0 pushed_VVN an_AT0 increasing_AJ0 share_NN1 to_PRP their_DPS workers_NN2 ,_PUN employers_NN2 still_AV0 pay_VVB most_DT0 of_PRF the_AT0 health_NN1 care_NN1 bill_NN1 ,_PUN one_PNI that_CJT reliably_AV0 increases_VVZ at_PRP a_AT0 scandalous_AJ0 rate_NN1 of_PRF 5_CRD %_NN0 to_PRP 10_CRD %_NN0 every_AT0 year_NN1 (_PUL and_CJC at_PRP an_AT0 even_AV0 higher_AJC rate_NN1 for_PRP small_AJ0 businesses_NN2 )_PUR ._SENT That_DT0 's_VBZ money_NN1 firms_NN2 are_VBB plowing_VVG into_PRP a_AT0 health_NN1 care_NN1 industry_NN1 —_PUN to_PRP which_DTQ they_PNP pay_VVB ,_PUN on_PRP average_NN1 ,_PUN 250_CRD %_NN0 of_PRF Medicare_NP0 rates_NN2 —_PUN and_CJC not_XX0 into_PRP wages_NN2 or_CJC R_ZZ0 &_NN1 D_ZZ0 or_CJC anything_PNI else_AV0 ._SENT 
Haven_NP0 was_VBD hardly_AV0 the_AT0 first_ORD effort_NN1 trying_VVG to_TO0 improve_VVI this_DT0 dismal_AJ0 state_NN1 of_PRF affairs_NN2 ._SENT Local_AJ0 ,_PUN regional_AJ0 ,_PUN and_CJC national_AJ0 coalitions_NN2 have_VHB focused_VVN on_PRP group_NN1 purchasing_NN1 and_CJC value-boosting_AJ0 strategies_NN2 ._SENT Innovations_NN2 by_PRP Walmart_NP0 ,_PUN Boeing_NP0 ,_PUN and_CJC GM_NP0 have_VHB been_VBN embraced_VVN as_PRP industry_NN1 models_NN2 ._SENT And_CJC in_PRP 2016_CRD ,_PUN the_AT0 Health_NN1 Transformation_NN1 Alliance_NN1 ,_PUN another_DT0 effort_NN1 aimed_VVN at_PRP reducing_VVG costs_NN2 and_CJC improving_AJ0 outcomes_NN2 ,_PUN launched_VVN with_PRP the_AT0 backing_NN1 of_PRF 20_CRD companies_NN2 including_PRP Macy_NP0 's_POS and_CJC Verizon_NP0 (_PUL not_XX0 to_TO0 mention_VVI JPMorgan_NP0 as_CJS well_AV0 as_CJS Berkshire_NP0 's_POS BNSF_NN1 )_PUR ._SENT The_AT0 spirit_NN1 in_PRP which_DTQ these_DT0 organizations_NN2 tend_VVB to_TO0 operate_VVI is_VBZ open_AJ0 and_CJC collaborative_AJ0 ,_PUN with_PRP a_AT0 feeling_NN1 that_CJT "_PUQ a_AT0 rising_AJ0 tide_NN1 lifts_VVZ all_DT0 boats_NN2 ._SENT "_PUQ 
That_DT0 's_VBZ not_XX0 to_TO0 say_VVI they_PNP have_VHB cracked_VVN the_AT0 code_NN1 ._SENT Catalyst_NN1 for_PRP Payment_NN1 Reform_NN1 ,_PUN an_AT0 employer_NN1 group_NN1 that_CJT advocates_VVZ for_PRP higher_AJC value_NN1 health_NN1 care_NN1 ,_PUN recently_AV0 completed_VVN a_AT0 comprehensive_AJ0 study_NN1 on_PRP aggregated_AJ0 purchasing_NN1 efforts_NN2 like_PRP Haven_NP0 's_POS that_CJT have_VHB been_VBN tried_VVN over_PRP the_AT0 years_NN2 ._SENT They_PNP found_VVD such_DT0 groups_NN2 are_VBB typically_AV0 doomed_VVN for_PRP a_AT0 few_DT0 reasons_NN2 :_PUN the_AT0 lack_NN1 of_PRF competitive_AJ0 health_NN1 care_NN1 markets_NN2 ;_PUN resistance_NN1 or_CJC "_PUQ sabotage_NN1 "_PUQ by_PRP players_NN2 that_CJT benefit_VVB from_PRP the_AT0 status_NN1 quo_NN1 ;_PUN and_CJC employers_NN2 '_POS unwillingness_NN1 to_TO0 compromise_VVI and_CJC act_VVI together_AV0 ._SENT 
Are_VBB any_DT0 of_PRF those_DT0 hurdles_NN2 what_DTQ felled_VVD Haven_NP0 ?_SENT My_DPS hunch_NN1 ,_PUN after_PRP speaking_VVG with_PRP dozens_CRD of_PRF people_NN0 —_PUN experts_NN2 ,_PUN employers_NN2 ,_PUN individuals_NN2 involved_VVN in_PRP similar_AJ0 initiatives_NN2 ,_PUN health_NN1 system_NN1 participants_NN2 ,_PUN and_CJC a_AT0 few_DT0 Haven_NP0 insiders_NN2 who_PNQ would_VM0 not_XX0 speak_VVI on_PRP the_AT0 record_NN1 —_PUN was_VBD that_CJT it_PNP was_VBD all_DT0 of_PRF them_PNP and_CJC more_AV0 ._SENT 
Haven_NP0 always_AV0 loomed_VVD larger_AJC in_PRP the_AT0 imagination_NN1 than_CJS it_PNP did_VDD on_PRP the_AT0 ground_NN1 ._SENT At_PRP its_DPS peak_NN1 ,_PUN it_PNP was_VBD a_AT0 startup_NN1 of_PRF 75-some_AJ0 employees_NN2 ,_PUN the_AT0 majority_NN1 of_PRF whom_PNQ worked_VVD out_AVP of_PRF a_AT0 coworking_AJ0 space_NN1 in_PRP downtown_AJ0 Boston_NP0 ._SENT 
And_CJC on_PRP closer_AJC inspection_NN1 ,_PUN the_AT0 dream_NN1 team_NN1 was_VBD really_AV0 more_DT0 of_PRF a_AT0 motley_AJ0 crew_NN1 ._SENT The_AT0 three_CRD companies_NN2 '_POS 1.2_CRD million_CRD employees_NN2 were_VBD dispersed_VVN across_PRP the_AT0 country_NN1 ,_PUN meaning_NN1 Haven_NP0 did_VDD n't_XX0 have_VHI market_NN1 power_NN1 in_PRP any_DT0 one_CRD place_NN1 —_PUN the_AT0 real_AJ0 key_NN1 to_PRP driving_VVG down_AVP prices_NN2 with_PRP providers_NN2 ._SENT 
Each_DT0 company_NN1 had_VHD its_DPS own_DT0 approach_NN1 to_PRP health_NN1 benefits_NN2 ,_PUN with_PRP differing_AJ0 priorities_NN2 and_CJC decisionmaking_AJ0 processes_NN2 ._SENT Amazon_NP0 is_VBZ consumer-focused_AJ0 ,_PUN JPMorgan_NP0 more_AV0 oriented_VVD around_AVP "_PUQ relationships_NN2 and_CJC loyalty_NN1 ,_PUN "_PUQ says_VVZ Owen_NP0 Tripp_NP0 ,_PUN the_AT0 CEO_NN1 of_PRF Grand_AJ0 Rounds_NN2 Health_NN1 ,_PUN a_AT0 second_ORD opinion_NN1 and_CJC navigation_NN1 service_NN1 whose_DTQ customers_NN2 include_VVB the_AT0 Haven_NN1 companies_NN2 ._SENT (_PUL He_PNP was_VBD also_AV0 a_AT0 candidate_NN1 for_PRP the_AT0 top_AJ0 job_NN1 at_PRP Haven_NP0 ._SENT )_PUR Berkshire_NP0 ,_PUN meanwhile_AV0 ,_PUN did_VDD n't_XX0 have_VHI one_CRD style_NN1 ,_PUN but_CJC many_DT0 :_PUN Its_DPS dozens_CRD of_PRF portfolio_NN1 companies_NN2 ,_PUN from_PRP Acme_NP0 Brick_NP0 to_PRP Dairy_NN1 Queen_NN1 to_PRP Berkshire_NP0 Hathaway_NP0 Energy_NN1 ,_PUN handle_VVB their_DPS benefits_NN2 independently_AV0 (_PUL allowing_VVG ample_AJ0 opportunity_NN1 for_PRP those_DT0 "_PUQ dumb_AJ0 things_NN2 "_PUQ )_PUR ._SENT 
That_DT0 meant_VVD that_CJT no_AT0 matter_NN1 how_AVQ good_AJ0 Haven_NP0 's_POS ideas_NN2 ,_PUN they_PNP could_VM0 n't_XX0 be_VBI easily_AV0 implemented_VVN across_PRP all_DT0 the_AT0 companies_NN2 ._SENT "_PUQ It_PNP was_VBD just_AV0 very_AV0 different_AJ0 deploying_VVG at_PRP Amazon_NP0 ,_PUN Berkshire_NP0 Hathaway_NP0 ,_PUN and_CJC JPMorgan_NP0 Chase_NN1 ._SENT There_EX0 are_VBB different_AJ0 cities_NN2 ,_PUN different_AJ0 populations_NN2 ,_PUN exceedingly_AV0 different_AJ0 cultures_NN2 of_PRF organization_NN1 ,_PUN "_PUQ Gawande_NP0 told_VVD Wachter_NP0 ._SENT Haven_NP0 ,_PUN then_AV0 ,_PUN would_VM0 n't_XX0 work_VVI as_PRP a_AT0 sort_NN1 of_PRF benefits_NN2 office_NN1 ._SENT Instead_AV0 ,_PUN Gawande_NP0 said_VVD ,_PUN it_PNP risked_VVD "_PUQ becoming_VVG a_AT0 very_AV0 expensive_AJ0 think_NN1 tank_NN1 ._SENT "_PUQ 
As_CJS Haven_NP0 dealt_VVD with_PRP joint_AJ0 venture_NN1 pains_NN2 and_CJC dabbled_VVD in_PRP pilot_NN1 projects_NN2 ,_PUN like_PRP building_VVG a_AT0 telehealth_NN1 platform_NN1 for_PRP providing_VVG primary_AJ0 care_NN1 ,_PUN Amazon_NP0 sped_VVD ahead_AV0 with_PRP its_DPS own_DT0 somewhat_AV0 similar_AJ0 health_NN1 care_NN1 offerings_NN2 —_PUN like_PRP Amazon_NP0 Care_NN1 ,_PUN a_AT0 sort_NN1 of_PRF virtual_AJ0 urgent_AJ0 care_NN1 offering_VVG that_CJT the_AT0 company_NN1 is_VBZ now_AV0 selling_VVG to_PRP employers_NN2 across_PRP the_AT0 country_NN1 ._SENT 
