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hello this is dr eric bricker and thank you for watching a healthcare z todays topic is six causes of employer health plan change and as we all know pain causes change so were gonna go through six sources of pain and the resulting health care change so first source of pain is regulation changes in regulation with obviously the biggest example being the affordable care act which caused tons of changes within employers back in 2010 when it was originally passed now looking forward this pain of regulation might occur again given the results of the upcoming presidential election we will see next pain point decreased top line revenue causes pain that leads to employee health plan change where does that come from that comes from recessions and where does that largely come from that largely comes from the business cycle which is highly influenced by the federal reserve and interest rates okay so isnt that interesting that believe it or not the federal reserve actually plays a fairly signif