A healthcare forum in Des Moines today featured a panel of leaders from advocacy groups, the healthcare industry and business. One portion of the discussion focused on the increasing number of employers who are no longer paying for healthcare — and whether businesses or individuals should pay for healthcare coverage in the future.

The president of the American Hospital Association, Richard Umbdenstock, says he knows who will end up paying the insurance bill. Umbdenstock says the answer is simple, "we do", it’s only a matter of how we want to pay for it. He says the government and companies have no money, it’s our money they’re using in some form, so it’s only a matter of how we want to pay for it, and what are the best incentives to pay for it efficiently. "That’s why we say, coverage for all, paid for by all," Umbdenstock says.

Umbdenstock says people who think the government and businesses are going to handle insurance costs aren’t realistic. He says we have to find the right mechanisms, the right channels and incentives for the system, but he says if we think everyone isn’t paying for healthcare, "then we are kidding ourselves."

Members of the panel were asked if the system can be changed to find the proper way to provide efficient service at a lower cost. Bruce Koepple, the state director of the A-A-R-P joked that everyone had to be locked in a room until they came up with a solution, but says his organization has shown how its possible in a bipartisan effort.

Keopple says they went across the state and held 40 conversations in communities on healthcare, and at time where there was no common ground, they found common ground. Keopple says it can be done in Iowa and across the country, but "we have to be engaged and we have to keep the pressure on."

By pressure, he’s talking about pressuring Congress and the next administration to make changes. The executive director of the Iowa Business Council, Elliott Smith, says changing the system won’t be easy and will require some sacrifices.

Smith says it’s going to take courageous leadership without partisanship to try and make the best long-term decision without inflicting too much damage. Smith says there’s not doubt that some people will be affected in a negative way in the short term.

Smith says those who’re impacted in the short term will have to ride out the change. He says the long-term goal and objective is to radically change the system, so it’s hoped the short-term pain is worth the long-term results. Smith says he hears the same thing on tax panels and education panels, and it applies to the healthcare issue as well.

Doctor Tom Evans, the C-E-O of the Iowa Healthcare Collaborative, moderated the panel and says things are lining up to actually get some change accomplished. Evans says this is an interesting time, where these historically "waring factions" over healthcare are agreeing the problem has to be solved. Evans says the two sides haven’t worked together before, so they have to figure out a way to work together.

Evans and others say the first 100 days of the new presidential administration will be key to pushing forward and getting changes made to the healthcare system. The forum was held at Iowa Methodist Medical Center in Des Moines.