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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.
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Treasury Secretary Scott Bessent said President Donald Trump’s proposal to send $2,000 “dividend” payments from tariffs to US citizens would require congressional approval.
“We will see,” Bessent said on Fox News’ Sunday Morning Futures. “We need legislation for that.”
Trump, who has touted the billions raised in US tariff revenue this year, has talked about the checks as public frustration mounts over the cost of living. Speaking to reporters on Air Force One on Friday, Trump said the checks would go out sometime next year to “everybody but the rich.”
“It’s a lot of money,” he said. “But we’ve taken in a lot of money from tariffs. The tariffs allow us to give a dividend.” He added that “we’re also going to be reducing debt.”
The plan could cost the US government double what it’s projected to take in for 2025, according to one estimate. The Committee for a Responsible Federal Budget, a centrist watchdog group, estimated a preliminary $600 billion cost for the proposal, if the dividends were designed along the lines of government stimulus payments during the Covid pandemic.
Net US tariff revenue for the fiscal year through September totaled $195 billion and many economists have penciled in about $300 billion for calendar-year 2025.
Bessent said Americans should start feeling more economic relief in the beginning of next year, citing the tax cuts in Trump’s signature policy bill passed earlier this year.
“So I would expect in the first two quarters we are going to see the inflation curve bend down and the real income curve substantially accelerate,” he said.
In justifying American military strikes on boats suspected of smuggling drugs, President Donald Trump has asserted that the longtime U.S. strategy of interdicting such vessels at sea has been a major failure.
“We’ve been doing that for 30 years,” he said last month, “and it’s been totally ineffective.”
Trump’s comments came around the same time that the U.S. Coast Guard announced it had set a record for cocaine seizures — a haul of 225 metric tons of the drug over the previous year. That milestone, however, has not dissuaded the Republican president from upending decades of U.S. counternarcotics policy.
Under Trump, the U.S. military has blown up 20 suspected drug boats, resulting in 80 deaths, in the Pacific Ocean and Caribbean Sea. Trump and other top officials have contended that such boats are being operated by narco-terrorists and cartel members with deadly drugs bound for America.
Veterans of the drug war, meanwhile, say U.S. resources would be better spent doubling down on the traditional approach of interdicting drug boats, especially in the long term. That is because crews of drug boats frequently have valuable intelligence that can help authorities better target cartels and trafficking networks. Dead men, they say, tell no tales.
The Coast Guard has fought the drug war a long time
The Coast Guard for decades has interdicted small vessels suspected of smuggling illicit narcotics. Much of that work is focused on halting shipments of cocaine, most of which is produced in the jungles of Colombia.
Working with partner nations and other federal agencies — the Drug Enforcement Administration, the departments of State and Justice as well as U.S. Southern Command’s Joint Interagency Task Force-South in Key West, Florida — the aim is to inflict heavy losses on traffickers and limit the amount of drugs entering the U.S.
That campaign, by at least one measure, has never been more successful, despite constant complaints by the Coast Guard that it lacks funding to seize even more drugs.
The Coast Guard’s recent record cocaine seizure was almost 40% higher than the past decade’s annual average. The haul included 38 tons of cocaine offloaded by the cutter Hamilton when it returned from a two-month patrol. It was the largest amount confiscated by a single Coast Guard ship during a deployment, the Coast Guard reported. The interdictions have continued as part of what’s known as Operation Pacific Viper even during the federal government shutdown, with several cutters reporting major seizures last month.
In almost every case, drug smugglers have been brought to the U.S. for prosecution, and valuable information about ever-changing smuggling routes and production methods was collected — all without any loss of life and a far lower cost to American taxpayers. Experts said each missile strike is likely to cost far more than the payload of cocaine on every ship.
“The Coast Guard has extraordinary powers and authorities to do effective drug interdiction without killing unidentified people on small boats,” said Douglas Farah, a national security expert on Latin America and president of IBI Consultants. “When resourced, they are far more effective, sustainable and likely legal than the current Pentagon-led operations.”
Trump administration officials say strategy needed to change
Secretary of State Marco Rubio this week defended the shift in strategy, saying that “interdictions alone are not effective.”
“Interdictions have limited to no deterrent effect,” he added. “These drug organizations, they’ve already baked in the fact they may lose 5% of their drug shipments. It doesn’t stop them from coming.”
Part of the problem is that demand for cocaine is high, and supplies have never been so robust, according to authorities and experts. A sign of that trend: Cocaine prices have been hovering at historical lows for more than a decade.
The Coast Guard also does not have enough vessels or crew to halt it all. At most, it seizes not even 10% of the cocaine that officials believe flows to the U.S. on small vessels through what is known as the “Transit Zone” — a vast area of open water larger than Russia.
Cocaine shipments bound for the U.S. primarily work their way up the west coast of South America to Central America and then overland into the U.S. via Mexico. Shipments heading to Europe are smuggled through the Caribbean, often hidden in container ships.
Such interdiction efforts target cocaine, not fentanyl
In social media posts, Trump has claimed that his strikes have blown up boats carrying fentanyl and that each destroyed vessel has saved 25,000 American lives. According to experts and former U.S. counternarcotics officials, Trump’s statements are either exaggerations or false.
For the past decade, U.S. officials have sounded the alarm about rising overdose deaths in the U.S., particularly from opioids and synthetic opioids. Overdose deaths from opioidspeaked in 2023 at 112,000 but dropped to 74,000 in April. Experts have attributed that decline mostly to Biden administration efforts to boost the availability of lifesaving drugs that prevent overdose deaths.
The drug flowing to the U.S. from South America is cocaine. Fentanyl, on the other hand, is typically trafficked to the U.S. overland from Mexico, where it is produced with chemicals imported from China and India. Cocaine overdose deaths are less frequent than those from fentanyl. In the last year, just under 20,000 people in America died from cocaine overdoses, federal data shows.
Trump and administration officials have also claimed that the crews of targeted vessels were narco-terrorists or members of cartels.
The Associated Press visited a region in Venezuela from which some of the suspected boats have departed and identified four men who were killed in the strikes. In dozens of interviews, residents of the region and relatives said t he dead men were mostly laborers or fisherman making $500 a trip.
Law enforcement officials and experts echoed those findings, saying the smugglers captured by the Coast Guard are hired for little money to ferry drugs from point A to point B.
“They are hardly kingpins,” said Kendra McSweeney, an Ohio State University geographer who has spent years researching U.S. drug policies.
Trump administration officials recently promoted big seizures
In April, months before Trump launched his military campaign, his attorney general, Pam Bondi, traveled to South Florida to welcome home the Coast Guard cutter James from its latest antinarcotics patrol. It had seized 20 tons of cocaine worth more than $500 million.
Flanked by FBI Director Kash Patel, she praised a “prosecutor-led, intelligence driven approach to stopping these criminal enterprises in their tracks.”
“This is not a drop in the bucket,” said Bondi, standing in front of the vessel loaded with colorful, plastic-wrapped bales of narcotics stacked several feet high. “Behind you is half a billion dollars of pure, uncut cocaine.”
Five students at U.S. military academies and three each from Yale University, Harvard University and the Massachusetts Institute of Technology are among the 32 American winners named Sunday as 2026 Rhodes scholars.
The group includes students focused on housing, health outcomes, sustainability and prison reentry programs. They include:
Alice L. Hall of Philadelphia, a varsity basketball player at MIT who also serves as student body president. Hall, who has collaborated with a women’s collective in Ghana on sustainability tools, plans to study engineering.
Sydney E. Barta of Arlington, Virginia, a Paralympian and member of the track team at Stanford University, who studies bioengineering and sings in the Stanford acapella group “Counterpoint.” Barta plans to study musculoskeletal sciences.
Anirvin Puttur of Gilbert, Arizona, a senior at the U.S. Air Force Academy who serves as an instructor pilot and flight commander. Puttur, who is studying aeronautical engineering and applied mathematics, also has a deep interest in linguistics and is proficient in four languages.
The students will attend the University of Oxford as part of the Rhodes scholar program, which awards more than 100 scholarships worldwide each year for students to pursue two to three years of graduate studies.
Named after British imperialist and benefactor Cecil John Rhodes, the scholarship was established at Oxford in 1903. The program has more than 8,000 alumni, many of whom have pursued careers in government, education, the arts and social justice.
Politics8 years ago