American - Businessman | 1949 -
I think reasonable people could agree that, at some point, there's enough income that someone should be expected to participate in the health-care system.
Ron Williams
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In my career, there have been many things I am fortunate enough to be proud of. Yet one of the things I feel most strongly about is the culture we created during the ten years I was at Aetna, and its enduring impact.
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In my experience, it is the leader - the CEO - who plays the crucial role in creating and 'owning' an organization's culture, setting the tone, and executing on that consistently.
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We know a culture doesn't just happen; it is the result of what you do every day.
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As a CEO, I had significant exposure to private equity, enough that I had in no way bought into the media's caricature: rapacious privateers who destroy companies.
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As CEO of Aetna, I was a buyer of portfolio companies rather than a participant in the value creation process. From the end of the assembly line, what happened in manufacturing wasn't visible to me.
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When I retired from Aetna, I became part of the private equity world. It turned out to be a natural fit.
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When I was a CEO, I thought I understood private equity. I didn't. And what I've learned since my retirement, and since becoming directly involved in the world of private equity, points the way to a new career path for thousands of talented senior executives - and a new engine for value creation.
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The ACA's reliance on mandatory participation in exchanges as the only way to obtain a health insurance subsidy is fundamentally flawed.
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The ACA - popularly known as 'Obamacare' - has been an important step forward toward an admirable goal: providing access to health insurance for all Americans. But like many reforms generated by the political process, the ACA is problematic.
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King v. Burwell pointed at but did not directly challenge the ACA's most essential weakness: Government-mandated participation in health insurance exchanges as a precondition to receiving a subsidy is not the best or most effective means of achieving its goal of expanded access to health coverage.
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There are several problems with the ACA's reliance on means-based inclusion criteria and mandatory participation in exchanges - the complexity of the exchange mechanism, and the potential for income-based subsidies to become a disincentive to earn if insurance rates escalate for those beyond the income threshold.
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