J

onathan Bush didn’t set out to transform health care IT. In 1997, the nephew of President No. 41 (and first-cousin of No. 43) cofounded a birthing center. But after struggling to get simply paid for his center’s services, the health care entrepreneur pivoted to form a technology company, called Athenahealth, which focuses on making patient management and payment tracking simpler for hospitals and medical practices.

With an energy bordering on frenetic, Bush confidently told STAT from his Watertown, Mass., office that he knows how to fix America’s broken health care system.

What’s the biggest problem in health care today?

It’s not how expensive it is, that’s the second biggest problem. The bigger problem is that health care is not a choice. We are given it Soviet gruel-style, and it feels humiliating.

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Is there a fix?

The biggest cure is something we’re actually very good at but have largely smothered in health care: the ability for people to shop.

What do you mean?

Why cut your price if you won’t get any more patients? Why not raise your price if you won’t lose any patients? If there’s no shopping going on, just engage in price warfare monopoly practices and you’ll win.

You come from quite an illustrious family. Have they been supporters of Athenahealth?

In a great irony, my Aunt Bar took me out to lunch with Uncle George [in 2014] and said: “We just want to thank you. We donated $4 million to the Barbara Bush Children’s Hospital [in Maine] with money we made thanks to you.”

The irony is the Barbara Bush Hospital just bought [a competitor’s product] with that money, and is building a monopoly to capture referrals that they don’t have the volume to do well. And a lot of the stuff they do probably should be done somewhere else. I didn’t say all this to Bar. I said, “That’s just great,” pinching my fingernails under the table.

You have a stack of “Jeb!” bumper stickers on your office table, but a signed photo of Donald Trump on your desk. What’s up with that?

The narcissism of it! Trump saw me on CNN. He called my brother [Billy] who was the host of one of his shows and said [of me]: “He does very good work. I’m so happy with his work, I’m going to send him my autograph.”

And the microscope?

It was a gift from our retiring chief operating officer who was gently reminding me that I cover a lot of waterfront and that maybe zooming in a little more, getting a little closer to the earth would be helpful.

You sound like a politician. Will you be running for office any time soon?

I’m Bushed out myself. But needless to say, I’m all in for Jeb.

Jonathan Bush is cofounder, CEO, president, and chairman of Athenahealth. This interview has been edited and condensed.

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