Scott McGohan is the CEO of McGohan Brabender, an insurance brokerage firm focusing on employee benefits. With the health care landscape changing constantly, McGohan helps his customers manage the change. He sat down with Dayton Magazine to discuss the challenges.

1. Tell us about your work with McGohan Brabender. I’ve been with McGohan Brabender for 27 years, starting as an assistant and working my way through sales and marketing before focusing on leadership. Currently, we have 1,200 clients and 250,000 “belly buttons:” individuals who we have helped insure. We manage $2 billion in health care spending.

2. What problems are today’s health care system facing? Health care today is built on other people’s money, either the employer’s or the government’s. We tend to forget it was our money to begin with, and we’ve built a system we can’t afford.

3. Why is health care so expensive? Fifty percent of health care spending today is from self-created disease due to lifestyle factors. It’s easy to blame other parties, like the government, for rising health care costs, but we created much of this.

4. Other countries don’t spend as much as the U.S. does on health care; why is this? This country has 5 percent of the world’s population, but we account for 50 percent of the world’s spending on prescriptions. We want that instant gratification instead of putting in the work to be healthier.

5. How can we begin to address these problems? Addressing this problem is about meeting people where they are. Some people are ready to change, and some are not. It’s important to have conversations with people about how to improve their health. People want a message of hope.

6. What solutions are on the market to help? For example, look at the population with diabetes and pre-diabetes. About 70 percent of those who should be testing their blood glucose don’t do so regularly. We now have a product called ActiveCare, which is a glucometer that acts like a cell phone, transmitting results to a doctor or a caregiver who can monitor whether the person is testing regularly.

6. Why is health care so difficult to “fix?” Disease is like poverty; there’s a lot of money in it. Most organizations want diseases “fixed,” but they want the system to be fair. That’s hard to do.

7. What role should employers play in managing health care costs? For example, health insurance should be more like car insurance; if you drive recklessly and get a lot of tickets, you expect to pay more than a cautious driver would. Health insurance is the same; those who are proactive about their health should receive the rewards for doing so, while the others should expect to pay more. The real payer is the employer; employers pay 70 to 80 percent of health care expenses. They should be able to have a conversation with their employees about this.

8. Are there tools to help manage health care costs from the patient side? Transparency is a big deal, and employers are yelling for transparency tools. One such tool has been released by United Health Care. It’s an app that lets you put in a diagnostic code and see the price, quality and location of your local providers as an incentive to look for value.

9. What is the best way to communicate with employees about health care? People respond to stories, and the best stories are the ones people see in front of them. At McGohan Brabender, we collectively lost 2,000 pounds as part of a challenge to improve our health. That’s a powerful example.