In short, during his wide-ranging and highly engaging keynote presentation that touched on everything from politics to deficits to Medicare, Will didn't neatly connect the dots in a roadmap of future trends that would directly affect the benefits community. Instead, he did what he does best, namely paint an overarching picture of the background against which corporate benefits decisions will be made in the coming years.

Consider the deficit. There is a permanent powerful incentive for the political class to run deficits, he explained. "What we are doing is something new in American history… We are now borrowing from the future not for the future but to finance our own current consumption of goods and services."

Meanwhile, our IOUs in the form of entitlements are stacking up. Low interest rates will keep the worst at bay, but how long can rates stay low, Will asked. "We get away with 'so far so good'" only for so long.

"The biggest problem and unknown is modern healthcare, and while longevity is a great social achievement, as is competent medicine, it is tremendously expensive," he said.

In the 1900s, he says, medicine was so small a part of the American economy that if we had statistics, it wouldn't even have been measured. "Now healthcare is a massive employer," he said. "If you look at Cleveland, the largest employer is a healthcare clinic. If you look at Houston, you think energy capital, but the largest employer there is Texas hospitals."

He noted that in 1900, 33% of all deaths were from infectious diseases. "Before COVID-19, only 2% were from it. This is a tremendous achievement, but terrifically expensive."

Every day between now and 2030, 10,000 more baby boomers retire into the Medicare, Medicaid and social security systems, he noted. "The average health care cost for an 85-year-old is five times higher than the average cost for a 55-year-old. Longevity is a great social achievement but it is also tremendously expensive."

Another key turning point in the last century was the linkage between employment and health insurance, he said. In the 1940-1941 huge labor shortage, Congress passed wage and price controls, he explained. Businesses couldn't compete by increasing labor so they offered healthcare with untaxed compensation. Fast forward to today when you go to the doctor and he or she wants to give you a certain test. Most people never ask how much it will cost. "Partly because they don't care and partly because the doctor himself or herself doesn't know. We don't have a particularly functioning market."

Will believes in a profit system because it concentrates the mind. "The idea of a healthcare system without pricing makes an irrational system more so." However the internet, Will said, provides glimmers of a viable alternative. "There are more visits to webMD these days than there are visits to doctors. People are using this information and there should be ways to structure healthcare around this by giving people an incentive to not use the healthcare system so much."

These are thorny issues Will touches on and most of the legislative and administrative attempts to address them have ultimately failed. For benefits administrators hoping that Washington, now united under the Democrats, will finally be able to provide some relief, Will has some unpleasant news. Until there are term limits, legislators will not think of the next generation, he said. "Sooner or later and this is what I fear, interest rates are going to rise. Interest rates today are essentially negative. And when they rise, we will spend more on debt service than we are spending on education. More than we are spending on defense. The debt is stored up and waiting for us."

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