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When Iñaki Ereño assumed the role of Group CEO of Bupa in 2021, the global healthcare landscape was being rewritten in real time. At the helm of a company serving over a million customers worldwide, Ereño faces the challenge of transforming a large and established organization into a faster, more agile, and digitally enabled provider of care.
Founded in 1947 with the purpose of helping people live “longer, healthier, happier lives,” Bupa is more than a health insurer: It builds hospitals and dental centers, offers global private medical insurance, and invests heavily in digital health.
Ereño’s mission? To wake the sleeping giant. Through what he calls the “elephant strategy,” the 61-year-old CEO has sought to digitize the business, embed customer-centric listening (including 300,000 annual detractor calls), and align a global workforce of around 100,000 people behind a single agenda. “The elephant is now running and the majority of the people know the elephant is running. We keep reminding everyone: don’t let the elephant go back to sleep,” he says.
A self-described “fanatic of the digital economy,” Ereño believes technology will define the next era of healthcare. Bupa has accelerated its use of AI and virtual platforms such as Blua, launched initially in Spain, to connect doctors and patients digitally and make consultations faster, smarter, and more personal.
In an interview with Fortune, Ereño discussed his evolution from lawyer to retailer to healthcare CEO, explained how his triathlon training anchors his leadership, and why, for him, productivity isn’t just about profit—it’s about delivering better care, faster.
This interview has been edited for length and clarity.
Down to business
Fortune:Walk us through your career journey.
Ereño: My background is in law, and very quickly I realized I didn’t want to be a lawyer. So I did an MBA and moved into corporate life. I view my life in three distinct periods. For one period of my life, I worked as a retailer. In another, I was an entrepreneur, and in the most recent period, I have worked in healthcare.
I joined Bupa 20 years ago in Spain [in Spain, Bupa is called Sanitas]. I joined Sanitas and was appointed CEO of Sanitas, and in 2012, I was appointed CEO [of a regional division within Bupa]. My evolution has progressed from my initial role as marketing director of Sanitas, then CEO of Sanitas, followed by CEO of a region, and finally Group CEO. It’s been a bit of a journey.
What was your role in the digital shift?
Covid was a huge challenge for all healthcare systems. For Bupa, we realized that our healthcare system was not digitized enough. Health can be digitized. I was in the executive team of Bupa for many years and that was my big fight: We needed to digitize the business more quickly. [Since then] it’s been a bit of a journey.
After Covid, we started calling ourselves the “sleeping elephant,” and so we built a strategy called the “elephant strategy.” I remember I went to the board with one slide: an elephant asleep on the left, an elephant waking up in the middle, and an elephant running on the right, with a big arrow from 2020 to 2024. We needed to wake up.
The elephant is now running, and the majority of the people know that the elephant is running. We keep reminding everyone: Don’t let the elephant go back to sleep.
What are you most proud of in the last five years?
In every presentation, we highlight the Triangle of Performance. At the top of the triangle is Financial Performance, supported by the two other sides: Customer Performance and Employee Engagement. We need to be good at all.
Customers are very important. We have 25 businesses in various countries that follow the same pattern. We map businesses by micro movements, and every year we do 300,000 detractor calls asking customers: “Why don’t you like us?”
Every year, we measure the results in terms of customer experience improvement and we take this very seriously. There is a lot of engineering work and logistics involved in making this happen.
We also have a team of 100,000 people. You’d assume that all of them have health coverage provided by Bupa—especially since we are Bupa. But that was not the case.
[Despite the fact] that it would cost around 50 million pounds to do this [it was essential that our own employees] have health coverage provided by Bupa. Now in the Bupa world, every employee is supported by Bupa.
We try to find out why we are not good, and work on it.
Which long-term trend are you most bullish or positive about for society and the economy at the moment?
The digital economy. We [Bupa] started a bit late but we’re catching up very quickly. We’re now fully digitized in all countries. Blua [is an example], which Bupa launched years ago. I like the digital economy and am a fanatic because it will help health.
When you look at Europe versus the U.S., how do you think people like yourself in a leadership role can address the productivity challenge?
Bupa and the whole healthcare industry are currently more focused on growth. We [believe we] are productive, but it’s not at the top of our mind. We think about how we can be more productive so that our customers will be happier and better served, rather than thinking about, “how can we make more money?”
We’ll be implementing an AI generative project where, instead of taking seven minutes for a doctor to see you [and understand who you are and what your issues are], it will take 30 seconds. So in 30 seconds, a doctor will be able to see you and a consultation that usually happens in maybe 15 minutes will now take only 30 seconds. This is the productivity we care about and is the productivity that has a positive impact on our customers.
Being productive
When do you get up in the morning and what sets up your routine for the day?
I don’t sleep that much and usually wake up around 6 a.m. and I start reading the newspaper. I read three Spanish newspapers, the FT and the Economic Times. I have my first coffee, take a shower, go to the office, and normally am in meetings by 8 a.m.
Sports have always been a big part of my life. I’m into triathlons and usually go to the gym with my youngest son, who lives with me in London. We go to the gym together, go to the supermarket, buy dinner (we usually go to an Amazon Fresh store or Whole Foods), have dinner, and then go to bed. I live a fairly basic life and it works for me.
What kind of coffee do you have in the morning?
I have a black coffee in the morning, a double espresso. When I share [my coffee intake] with doctors, they say maybe too much, Iñaki! But I can share this with you.
So I start with a double espresso, and then I have another one in the office with a little bit of milk, like a cortado. Then, after lunch, I have another cortado. I know it’s a lot of coffee.
Do you check back in later in the evening? Are you working over the weekend?
I might sound a bit naive, but I like the job I do and I like my company. I don’t feel like I need to be disconnected. When I am away on holiday, I take my mobile phone with me and I’m checking emails. I’m paid well, I have an [important] job and we’re a big company, so I need to stay connected.
Do you have any apps that you use, or any methods that you use to be as productive as possible?
I use [most digital tools], to be honest, but I’m not mega techy.
I used to take notes with a notebook and pencil, but not anymore, because one day I realized that it was taking me more time. I asked myself, “How many times have you come back to your notes?” and it was zero. So I stopped. I prefer to be present and in listening mode.
Getting personal
Who is on your personal board and who inspires or motivates you?
I work with a coach whom I met a few years ago. He is 75, very wise, and a member of my personal board. I have a Chief Executive Committee; there are always people that you tend to call more when you have a problem or need good advice. I also have people on my team that I can call. I have great conversations with my son. We all need people who really care.
Do you have a favorite company that you admire and why?
I love Amazon. Whole Foods is also fantastic.
What is your favorite cuisine to cook and to eat?
I eat too much, but thank God I enjoy exercising. I like all types of food, including a big steak, good paella, and seafood. I also like sweet food and desserts. My coach taught me to be kind to myself and I have learnt over the years to be kind to myself. If I want to eat ice cream, I will enjoy my ice cream.
CEO Agenda provides unique insights into how leaders think and lead, and what keeps them busy in a world of constant change. We look into the lives, minds and agendas of CEOs at the world’s most iconic companies.Dive into our other CEO Agenda profiles.
After two decades of climbing the corporate ladder at companies ranging from ABC, ESPN, and Charter Communications (commonly known as Spectrum), Timm Chiusano quit it all to become a content creator.
He wasn’t just walking away from high titles, but a high salary, too. In his peak years, Chiusano made $600,000 to $800,000 annually. But in June of 2024, after giving a 12-week notice, he “responsibility fired himself” from his corporate job as VP of production and creative services at Charter.
He did it all to help others navigate the challenges of a workplace, and appreciate the most mundane parts of life on TikTok.
most people are posting their 2024 recaps; these are a few of my favorite moments from the year that was, but i need to start reintroducing myself too i dont have a college degree, no one in my life knew that until i was 35 when i eventually got my foot in the door in my early 20’s after a few years of substitute teaching and part time jobs, i thought for sure i had found the career path of my dreams in live sports production i didn’t think i had a chance of surviving that first college football season but i busted my ass, stuck around and got promoted 5 times in 5 years then i met a girl in Las Vegas, got married in 7 months, and freaked out about my career that had me travelling 36 weeks a year i had to find a more stable “desk job”, i was scared shitless that i was pigeonholed and the travel would eventually destroy my marriage i crafted a narative for espn arguing they needed me on their marketing team because of my unique perspective coming from the production side i got rejected, but kept trying and a year i got that job the 7 years with espn were incredible, but also exhausting and raised all kinds of questions about corporate america, toxic situations, and capitalism in general why was i borderline heart attack stressed so often when i could see that my ideas were literally generating 2,000 times the money that i was getting paid? in 2012 i had a kid and in 2013 i got the biggest job of my career to reinvent how to produce 20,000 commercials a year for small business it took 12 rounds of interviews, a drug test i somehow passed, and a background check that finally made me tell my wife of 8 years that i didnt have a college degree they brought me in the thursday before my first day and told me what i told grace in that clip the next decade was an insane blur; i saw everything one would ever see in their career from the perspective of an executive at a fortune 100 i started making tiktoks, kinda blacked out at some point in 2019 and responsibly fired myself in 2024 to see what i might be capable of on my own with all the skills i picked up along my career journey now the mission is pay what i know forward, and see if i can become the mr rogers of corporate america cc: @grace beverley @Ryan Holiday @Subway Oracle
What started as short-video vlogs on just about anything in 2020 (reviews on protein bars, sushi, and sneakers) later transitioned to videos on growing up, and dealing with life’s challenges, like coming to terms when you have a toxic boss. Today, his platform on TikTok has over 1 million followers.
With the help of going viral from his “loop” format where videos end and seamlessly circle back to the beginning, he began making more videos as a side-hustle on top of his day-to-day tasks in the office.
“How can I get people to be smarter and more comfortable about their careers in ways that are gonna help on a day-to-day basis?” Chiusano told Fortune.
Today, he could go by many titles: former vice president at a Fortune 100 company, motivational speaker, dad, content creator, or as he labels himself, the Mister Rogers of Corporate America.
Just as the late public television icon helped kids navigate the complexities of childhood, Chiusano wants to help young adults think about how to approach their careers and their potential to make an impact.
“Mister Rogers is the greatest of all time in his space. I will never get to that level of impact. But it’s an easy way to describe what I’m trying to do, and it consistently gives me a goal to strive for,” he said. “There are some parallels here with the quirkiness.”
Firing himself after 25 years in the corporate world
Even with years in corporate, Chiusano doesn’t resemble the look of a typical buttoned-up executive. Today, he has more of a relaxed Brooklyn dad attire, with a sleeve of tattoos and a confidence to blend in with any trendy middle aged man in Soho. During our interview, he showed off one of the first tattoos he got: two businessmen shaking hands, a reference to Radiohead’s OK Computer album.
“This is a dope ass Monday in your 40s,” began one of his videos.
It consisted of Chiusano doing everyday things such as eating leftovers, going to the gym, training for the NYC marathon, taking out the trash, dropping his daughter off at school, a rehearsal for a Ted Talk, eating lunch with his wife, and brand deal meetings. Though the content sounds pretty normal, that’s the point.
“The reason why I fired myself in the first place was to be here,” he says in the video while picking his daughter up from school.
Today, Chiusano spends his days making content on navigating workplace culture, public speaking, brand deals, brand partnerships, executive coaching, writing a book, and the most important job: being a dad to his 13-year-old daughter Evelyn.
“I’m basically flat [in salary] to where I was, and this is everything I could ever want in the world,” he said. “The ability to send my kid to the school she’s been going to, eat sushi takeout almost as much as I’d like, and do nice things for my wife.”
In fact, when sitting inside one of his favorite New York City spots, Lure Fishbar, he keeps getting stopped by regulars who know him by name. He points out that one of his favorite interviews he filmed here was with legendary filmmaker Ken Burns.
Advice to Gen Z
In a time where Gen Z has been steering to more unconventional paths, like content creation or skill trades rather than just a 9-to-5 office job, Chiusano opens up a lens to what life looks like when deciding to be present rather than always looking for what’s next—a mistake he said he made in his 20s.
Instead, he wants to teach the younger generation to build skills for as long as you can, but “if you are unhappy, that’s a very different conversation.”
“I think some people will make themselves more unhappy because they feel like that’s what’s expected of a situation,” he said.
“I would love to be able to empower your generation more, to be like somebody’s gonna have to be the head of HR at that super random company to put cool standards and practices in place for better work-life balance for the employees.”
For Mark Zuckerberg, the most significant creation from his two years at Harvard University wasn’t the precursor to a global social network, but a prank website that nearly got him expelled.
The Meta CEO said in a 2017 commencement address at his alma mater that the controversial site, Facemash, was “the most important thing I built in my time here” for one simple reason: it led him to his wife, Priscilla Chan.
“Without Facemash I wouldn’t have met Priscilla, and she’s the most important person in my life,” Zuckerberg said during the speech.
In 2003, Zuckerberg, then a sophomore, created Facemash by hacking into Harvard’s online student directories and using the photos to create a site where users could rank students’ attractiveness. The site went viral, but it was quickly shut down by the university. Zuckerberg was called before Harvard’s Administrative Board, facing accusations of breaching security, violating copyrights, and infringing on individual privacy.
“Everyone thought I was going to get kicked out,” Zuckerberg recalled in his speech. “My parents came to help me pack. My friends threw me a going-away party.”
It was at this party, thrown by friends who believed his expulsion was imminent, where he met Chan, another Harvard undergraduate. “We met in line for the bathroom in the Pfoho Belltower, and in what must be one of the all time romantic lines, I said: ‘I’m going to get kicked out in three days, so we need to go on a date quickly,’” Zuckerberg said.
Chan, who described her now-husband to The New Yorker as “this nerdy guy who was just a little bit out there,” went on the date with him. Zuckerberg did not get expelled from Harvard after all, but he did famously drop out the following year to focus on building Facebook.
While the 2010 film The Social Network portrayed Facemash as a critical stepping stone to the creation of Facebook, Zuckerberg himself has downplayed its technical or conceptual importance.
“And, you know, that movie made it seem like Facemash was so important to creating Facebook. It wasn’t,” he said during his commencement speech. But he did confirm that the series of events it set in motion—the administrative hearing, the “going-away” party, the line for the bathroom—ultimately connected him with the mother of his three children.
Chan, for her part, went on to graduate from Harvard in 2007, taught science, and then attended medical school at the University of California, San Francisco, becoming a pediatrician.
She and Zuckerberg got married in 2012, and in 2015, they co-founded the Chan Zuckerberg Initiative, a philanthropic organization focused on leveraging technology to address major world challenges in health, education, and science. Chan serves as co-CEO of the initiative, which has pledged to give away 99% of the couple’s shares in Meta Platforms to fund its work.
You can watch the entirety of Zuckerberg’s Harvard commencement speech below:
For this story, Fortune journalists used generative AI as a research tool. An editor verified the accuracy of the information before publishing.
The Committee for a Responsible Federal Budget (CRFB) is a nonpartisan watchdog that regularly estimates how much the U.S. Congress is adding to the $38 trillion national debt.
With enhanced Affordable Care Act (ACA) subsidies due to expire within days, some Senate Democrats are scrambling to protect millions of Americans from getting the unpleasant holiday gift of spiking health insurance premiums. The CRFB says there’s just one problem with the plan: It’s not funded.
“With the national debt as large as the economy and interest payments costing $1 trillion annually, it is absurd to suggest adding hundreds of billions more to the debt,” CRFB President Maya MacGuineas wrote in a statement on Friday afternoon.
The proposal, backed by members of the Senate Democratic caucus, would fully extend the enhanced ACA subsidies for three years, from 2026 through 2028, with no additional income limits on who can qualify. Those subsidies, originally boosted during the pandemic and later renewed, were designed to lower premiums and prevent coverage losses for middle‑ and lower‑income households purchasing insurance on the ACA exchanges.
CRFB estimated that even this three‑year extension alone would add roughly $300 billion to federal deficits over the next decade, largely because the federal government would continue to shoulder a larger share of premium costs while enrollment and subsidy amounts remain elevated. If Congress ultimately moves to make the enhanced subsidies permanent—as many advocates have urged—the total cost could swell to nearly $550 billion in additional borrowing over the next decade.
Reversing recent guardrails
MacGuineas called the Senate bill “far worse than even a debt-financed extension” as it would roll back several “program integrity” measures that were enacted as part of a 2025 reconciliation law and were intended to tighten oversight of ACA subsidies. On top of that, it would be funded by borrowing even more. “This is a bad idea made worse,” MacGuineas added.
The watchdog group’s central critique is that the new Senate plan does not attempt to offset its costs through spending cuts or new revenue and, in their view, goes beyond a simple extension by expanding the underlying subsidy structure.
The legislation would permanently repeal restrictions that eliminated subsidies for certain groups enrolling during special enrollment periods and would scrap rules requiring full repayment of excess advance subsidies and stricter verification of eligibility and tax reconciliation. The bill would also nullify portions of a 2025 federal regulation that loosened limits on the actuarial value of exchange plans and altered how subsidies are calculated, effectively reshaping how generous plans can be and how federal support is determined. CRFB warned these reversals would increase costs further while weakening safeguards designed to reduce misuse and error in the subsidy system.
MacGuineas said that any subsidy extension should be paired with broader reforms to curb health spending and reduce overall borrowing. In her view, lawmakers are missing a chance to redesign ACA support in a way that lowers premiums while also improving the long‑term budget outlook.
The debate over ACA subsidies recently contributed to a government funding standoff, and CRFB argued that the new Senate bill reflects a political compromise that prioritizes short‑term relief over long‑term fiscal responsibility.
“After a pointless government shutdown over this issue, it is beyond disappointing that this is the preferred solution to such an important issue,” MacGuineas wrote.
The off-year elections cast the government shutdown and cost-of-living arguments in a different light. Democrats made stunning gains and almost flipped a deep-red district in Tennessee as politicians from the far left and center coalesced around “affordability.”
Senate Minority Leader Chuck Schumer is reportedly smelling blood in the water and doubling down on the theme heading into the pivotal midterm elections of 2026. President Donald Trump is scheduled to visit Pennsylvania soon to discuss pocketbook anxieties. But he is repeating predecessor Joe Biden’s habit of dismissing inflation, despite widespread evidence to the contrary.
“We fixed inflation, and we fixed almost everything,” Trump said in a Tuesday cabinet meeting, in which he also dismissed affordability as a “hoax” pushed by Democrats.
Lawmakers on both sides of the aisle now face a politically fraught choice: allow premiums to jump sharply—including in swing states like Pennsylvania where ACA enrollees face double‑digit increases—or pass an expensive subsidy extension that would, as CRFB calculates, explode the deficit without addressing underlying health care costs.
Politics8 years ago