Several years ago an important but little-known meeting was held in Siberia. The Russian vice minister of justice, who was in charge of Russia's prisons, was to give his blessing to a large new effort to bring an epidemic of tuberculosis under control in the region, particularly behind bars - calming skeptics who were suspicious of the health project's foreign leadership. On one side of the banquet hall sat the vice minister and 10 Russian military officials. On the other side were the foreigners.

The division, as described in a remarkable book called Mountains Beyond Mountains, was "unbreachable." Finally one foreigner, a Korean-American, had an idea. "I'm a terrible singer, but in my culture, Korean culture, if you respect someone and you have a deep affection and admiration for the people you're with, you should embarrass yourself by singing for them. So I will sing for you."

The man fired up a karaoke machine and belted out "My Way." He was followed by a British health official who sang "Summertime" and a two-star Russian general singing a local favorite. Eventually there was dancing.

"The night of the singing gulagmeisters," the American said afterward. "We're not going to see that again soon."

The ice had been broken, the program was endorsed, the inmates were treated.

That American, Jim Yong Kim, is the new president of Dartmouth College. When he speaks of turning out graduates who can set big goals, solve unsolvable problems and change the world, he knows what he's talking about. He's done it.

Kim helped run Partners in Health, a medical program that serves poor people in Siberia, Haiti, Peru and beyond. Kim's genius was not just karaoke. He helped identify - first in Peru and later elsewhere - a rampant strain of tuberculosis that was resistant to conventional treatment. In fact, treating multi-drug-resistant TB with regular medicine was making the epidemic worse. Kim convinced the world's biggest health charities to endorse a better treatment regimen. When skeptics balked at the cost, he figured out a way to lower the cost of the drugs, making the cure accessible to more patients and slowing the spread of an international plague.

Kim's goals for Dartmouth are no less ambitious. The school, he says, should lead the way in changing the delivery of health care - across the country and across the globe.

His timing couldn't be better. The generally high cost of health care and the wide disparities in costs and outcomes are vexing Congress and the president as they try to build a better system. Dartmouth has already pioneered research in this area. Kim wants to build on that, making the effective and efficient delivery of care an essential part of the Dartmouth Medical School curriculum. The school could, he told the Valley News recently, "become the center of the world" in thinking about health care delivery.

Watching the health care debate in Washington at arm's length can make you weary. It's complicated, expensive, political and sometimes mean-spirited. Generations of politicians have failed to make a significant difference. Yet Kim's essential optimism about health care is encouraging.

"There have been fundamental frame shifts in what human beings feel is morally defensible, what not," he told author Tracy Kidder. "The world doesn't bind women's feet anymore, no one believes in slavery. . . . We know that things change all the time. Culture changes all the time. Advertising people force changes in culture all the time. Why can't we do that?"

At the very least, Kim has provided his new students with a remarkable role model.