Lessons from an Oracle: What Would Warren Do?
“Be fearful when others are greedy, and greedy when others are fearful.”
Last week, legendary investor Warren Buffett announced he’s retiring as CEO of Berkshire Hathaway. Known as the “Oracle of Omaha” for his mastery of markets and humble Midwestern roots, Buffett remains an icon of American business, even at age 94. The Oracle didn’t need risky bets, self-aggrandizing, or grift—he achieved success through patience, pragmatism, and an uncanny eye for value.
Buffett’s famous quote above is a testament to the concept of zigging while others are zagging—finding opportunity by going against the grain. As he steps away from the company he built to record-breaking returns, what lessons can healthcare learn from the Oracle of Omaha’s approach?
If he were to invest in healthcare today, what would Warren do?
Greedy v. Fearful
ZIRP-era low interest rates and a pandemic-fueled telehealth surge led to a frothy market. Health tech greed was everywhere—a lot of it focused on easily scalable digital health platforms and capital/personnel-light virtual solutions.
As that era unwinds, the companies that survived are facing uncertain exits despite massive valuations. Hinge Health and Omada Health are set to test the IPO market. Investor sentiment towards these companies is expected to set the tone for the broader digital health ecosystem.
Despite these headwinds, healthcare innovation sentiment is more cautious than fearful. Greed has shifted from virtual care platforms to the new darlings: AI tools to replace…everything…and longevity startups promising improved healthspan. Investment dollars are flowing aggressively into these companies.
Greed still exists—for AI and longevity. Fear now resides in traditional care delivery.
Investors are shying away from the complexity of brick-and-mortar clinics, healthcare workforce management, and operational discipline. For good reason, several got burned:
CVS’s $10.6 billion acquisition of Oak Street Health and its broader retail-care aspirations haven’t gone as planned.
Walmart completely abandoned its ambitious Walmart Health initiative, closing all 51 of its clinics.
Walgreens Boots Alliance undertook massive write-downs on VillageMD, closed clinics, and undertook a strategic retreat after investing more than $6 billion.
Amazon’s $3.9 billion acquisition of One Medical remains an open question—the company is hedging in-person care with its online offerings.
These failures have created fear—many would rather not invest in brick-and-mortar care delivery. Therein lies an opportunity to be greedy when others are fearful.
Buffett didn’t succeed by greedily chasing trends. He built wealth by seeking opportunities where others feared to tread—seeing value where others didn’t.
Value vs. Hype
Buffett isn’t necessarily anti-innovation, but he’s also not one to follow hype. He famously avoided cryptocurrency despite significant enthusiasm on the part of other billionaire investors. Innovation can’t be smoke and mirrors—too much sizzle and not enough steak. Investable businesses must have:
Enduring demand and organic growth
Strong fundamentals
Rational operators
Defendable moats that protect margin and mission
Many ZIRP-era health tech companies would fail to meet most, if not all, of these criteria. Despite raising hundreds of millions on the promise of disruption, few built sustainable businesses. Consider:
Babylon Health, once valued at $4 billion, filed for Chapter 7 bankruptcy in 2023.
Once valued at over $10 billion, Bright Health’s stock price fell below $1/share. The company pivoted its core business and rebranded to NeueHealth.
Virtual mental health company Cerebral hit a $4.8 billion valuation after raising a $300 million Series C. The company became embroiled in controversy, and CEO Kyle Robertson was forced to step down.
These companies, and others, were fueled by hype, overinvestment, and inorganic growth. Too often, a charismatic founder and flashy pitch deck superseded a clear understanding of the problem and path to profitability. Buffett would have seen right through these shiny wrappers and inflated numbers.
The Oracle of Omaha loves value, and real value in healthcare comes from high-quality physicians and facilities delivering proven outcomes. Building a sustainable business means doing the arduous work of aligning with payors through bundles, capitation, and direct contracting. Buffett would invest in a care approach that succeeds by doing hard things the right way—not looking for shortcuts.
He’d also partner with founders building companies with consideration and intent, not empty accolades and polished narratives. Instead of chasing big term sheets and bigger hype—they'd be quietly building something that matters.
The Long Game + Compounding
Buffett thinks in decades, not quarters. His strategy is built on embracing long-term thinking over immediate gains (i.e., the power of compounding).
Healthcare innovation, meanwhile, is trapped in short-term thinking. Startup investors want an exit in 3-7 years, founders abandon the mission at the first sign of trouble, and capital chases acceleration, not sustainability.
Healthcare is slow by nature. Resistance to change comes from an abundance of caution. Trust must be built over time. Few have the patience to play the healthcare long game. But you can’t growth hack clinical care, retain patients through engagement tricks, or circumvent the doctor-patient relationship.
Systemic change is possible, but it takes time. The problems run deep and are densely intertwined. They weren’t created overnight, and they won’t be solved in the typical startup exit timeline.
The most enduring approaches won’t necessarily be the fastest to scale. Instead, they’ll build a moat by compounding trust, fostering culture, and building infrastructure. The road is longer and slower, but it’s built to last. Blitzscaling produces tall weeds with shallow roots. Measured growth on fertile ground produces saplings that grow into deeply rooted trees.
Buffett accumulated 99% of his net worth after turning 50 and 97% of it after turning 65. His secret? Playing the long game and compounding wins.
What Would Buffett Do?
Warren Buffett famously avoided tech for decades. He and longtime partner Charlie Munger didn’t understand the industry well enough to make informed investment decisions (sadly, this same restraint is often lacking in healthcare). That approach changed when Berkshire found a company that operated less like a tech business and more like a manufacturer of consumer staples.
Buffett broke from his tech aversion not because Apple was innovative but because it made products consumers love. He liked that Steve Jobs’ successor, Tim Cook, was disciplined. Still, Berkshire was cautious, dipping its toes before eventually taking a massive—and massively successful—stake in Apple (the company has since converted some of its significant Apple gains into an enormous cash pile).
Applying this same logic, Buffett wouldn’t forgo his principles to back a flashy AI or longevity company. He’d look for one building a great consumer (patient) experience from the ground up—slowly, carefully, and with clinical conviction.
Buffett liked Apple because it recruited and trained high-performing engineers, designers, and coders. The company aligned its ecosystem with customer demands to deliver value—not by selling the cheapest products but by selling the most coveted. Meanwhile, Tim Cook is a supply chain master, controlling processes to ensure high quality at low COGS.
A Buffett-worthy healthcare company would follow the same playbook—recruiting high-performing clinicians, aligning payment with performance, measuring what matters, and controlling the healthcare value chain to shape patient experience and outcomes. In short, a company that makes money because it delivers great care, not in spite of it.
Buffett may view healthcare delivery much the way he views tech—with uncertainty and skepticism. But he knows smart innovation, even if it’s in a sector he typically avoids.
Haven Healthcare: The One That Got Away
As many remember, Warren Buffett took a swing at healthcare and missed. Haven Healthcare, a joint venture between Berkshire, JP Morgan, and Amazon, flamed out after only a few years. Reflecting on the experience, Buffett likened fixing healthcare to fighting a tapeworm—and the tapeworm won. In a career that had far more wins than losses, one can’t help but wonder if Buffett considers healthcare the one that got away.
As Charlie Munger put it:
“Even though you shot and missed, you were at least shooting at an elephant.”
That elephant—the inefficiency, opacity, and misalignment in American healthcare—is still there. Despite their best intentions, Buffett and his partners couldn’t overcome the entrenched complexity of the US healthcare system. If he had another decade in him, would Buffett take another swing? Not to jump on the hype train or pursue quick, empty wins, but to build a new system brick by brick.
Right now, the market is greedy for AI magic and longevity handwaving. It’s fearful of the hard, messy work of actually delivering care. But, as Buffett would agree, this fear is where value and opportunity lie. Not riding a trend or looking for a quick exit, but rolling up your sleeves, building with discipline, and betting that clinical excellence and operational rigor still matter.
It doesn’t take an Oracle to see that.
Ben Schwartz, MD, MBA
Editor-in-Chief, The Surgeon’s Record
Commons Clinic Senior Clinical Fellow
Well said Ben! Hopefully more Health Tech VCs will start listening to you.