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The Harvard surgeon and author picked to run a heralded new health-care venture has compared the U.S. medical system to a car built with Porsche brakes, a Ferrari engine and a BMW chassis.

“You put it all together and what do you get?” Atul Gawande asked the audience at a 2012 TED conference. A very expensive pile of junk that does not go anywhere.”

Now the 52-year-old physician is in the driver’s seat. \

Gawande was chosen Wednesday to run a startup company that aims to improve medical care and lower health costs for the more than 1 million employees of Amazon.com Inc., JPMorgan Chase & Co. and Berkshire Hathaway Inc. Whether the venture runs more smoothly than his rhetorical car will depend on whether he can bring down soaring costs, a problem he’s called the deepest crisis of medicine’s existence.”

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