Airlines are arguably more operationally complex, asset-intensive, and regulated than hospitals, yet the best performers are doing a better job by far than most hospitals at keeping costs low and make a decent profit while delivering what their customers expect. Southwest Airlines, for example, has figured out how to do well the two operational things that matter most: Keep more planes in the sky more often, and fill each of them up more, and more often, than anyone else. Similarly, winners in other complex, asset-intensive, service-based industries — Amazon, well-run airports, UPS, and FedEx — have figured out how to over-deliver on their promise while staying streamlined and affordable.