On the Wall Street Journal’s Bold Names podcast, David Cordani, chairman and CEO of The Cigna Group, discussed what’s driving rising health care costs in the U.S. and what it will take to fix the system.

Cordani pointed to two main pressures: growing demand for care – particularly mental health services – and the rapid introduction of lifesaving, and increasingly expensive drugs and treatments. He outlined the role health insurers can play in making care more affordable, including improving care coordination, using data to guide better decision-making, and addressing inefficiencies like unnecessary utilization and administrative burden.

The Cigna Group’s CEO also explained why employer-sponsored coverage remains central to reform, weighed in on the role employers and policy makers can play in driving meaningful change and shared optimism about the future of American health care despite ongoing challenges.

Watch the full episode above or read through some of Cordani’s quotes below.

On why health care costs are increasing

“First, on the demand side, we’re demanding and consuming more services, driven in part by an aging population. That’s a global phenomenon, but it’s especially true in the U.S. Consumption increases as people age, and more than 50% of Americans are now dealing with chronic health conditions. We’ve seen an explosion in chronic care issues in this country. On the supply side, new pharmaceuticals – while in many cases life‑improving – are coming to market at higher and higher costs every year.”

On mental health and whole‑person care

“The physical health and mental health aspect of a human being are inextricably linked. For all too long, our society separated those – you have a physical ailment, go see a medical doctor; you have a mental ailment, go see a mental health professional. But they are inextricably linked. So, guided by our mission, we lean into that meaningfully.”

On the role of insurers and the patient experience

“We need to do a better job creating a seamless experience for the benefit of the patient. Full stop. We made a commitment as an organization in the first quarter of last year to do just that. So, we can do better, we are doing better, and we need to do better.”

On what needs to change in the health care system

“The U.S. spends most of its resources fixing sickness after it occurs. We need to spend more resources on helping individuals maintain their health.”

On optimism and positive change ahead

“The United States is about to celebrate our 250th birthday anniversary. Our company is a 230‑year‑old company. We’re one of the oldest companies that has been in service almost as long as this country, and it is going through, just like the country, many rebirths over time. You look back to look forward. You have two choices. You could either start every day with pessimism or optimism. I choose to start every day with optimism.”

*Quotes have been lightly edited for clarity and brevity