For Silicon Valley and the tech sector, the ground has dramatically shifted in the last seven days. In the months leading up to the election, the sector overwhelmingly contributed more money to Hillary Clinton than Donald Trump. There were persistent rumors that some of the Valley’s brightest minds, including Facebook COO Sheryl Sandberg, Apple CEO Tim Cook, and Microsoft founder Bill Gates, were being considered for top positions in a Clinton administration. And Clinton’s tech platform read so much like the industry’s wish list that some joked that it was a love letter to the Valley.
Under President-elect Trump, the sector is sure to have a much cooler relationship with the administration: Trump has expressed his opposition to net neutrality, has threatened to make Apple manufacture its products in the U.S., and has sided with law enforcement in the encryption debate. It seems to be a far cry from the Obama years, which have been marked by a Silicon Valley boom and a tech-savvy president whose first campaign was immeasurably helped via the data analytics employed by Google CEO Eric Schmidt and Facebook founder Chris Hughes and who liked to pal around with Airbnb’s Brian Chesky.
Yet since the five biggest American tech companies—Amazon, Apple, Facebook, Google, and Microsoft—are also the country’s biggest companies overall, they’re still going to have plenty of impact and influence.
On Monday, the Internet Association, an industry group that represents Google, Facebook, and Amazon, sent an open letter to Trump with its recommended policies and proposals for the new administration. They included protection of net neutrality, comprehensive immigration reform, stronger encryption, revamping law enforcement’s surveillance, and retaining liability regulations when it comes to copyrighted works.
“We look forward to working closely with the Trump administration, along with Republicans and Democrats in Congress, to implement policies that promote innovation and cement the internet’s role as a driver of economic and social progress for future generations,” Internet Association president and chief executive Michael Beckerman said in a statement accompanying the letter.
To find out what else Silicon Valley and the tech sector want from the new administration, Fast Company asked dozens of executives and entrepreneurs for their wish lists. Most of them included comprehensive immigration reform, STEM education, smarter regulations, and incentives to increase technology development and to spur innovation.
Craig Walker, CEO of Dialpad, cloud communications platform and Google’s first entrepreneur-in-residence
I’d love to see a policy that favors innovation, personal merit, hard work, and performance. I’d like a policy that rewards people who overcome obstacles, contribute to society, and improve their local neighborhoods. I’d like to see policies that are blind to privilege, affiliation, and social class. Meritocracy is the key and everybody should have the same opportunities to contribute.
Dr. Telle Whitney, CEO of the Anita Borg Institute (ABI), an international social enterprise organization committed to promoting the progress of women in technology
Dr. Telle Whitney
The president and U.S. administration can help focus on policies and approaches that advance the industry and the country broadly, and advances technology innovation. By addressing the industry’s continuing need for skilled technical workers through initiatives such as Computer Science for All and other efforts to include a more diverse array of participants in technical roles, the administration can help to develop a broader bench of talent and help drive innovation. The administration can also help to address how stereotypes often hold us back from achieving our full potential by hiring and featuring diverse technical leaders such as U.S. CTO Megan Smith and through initiatives such as the Tech Inclusion Pledge and Summits.”
Ben Goldberg, founder and CEO, and Claire Burke, cofounder, of Goby, toothbrush subscription service company
We do not favor the empowerment of some; we believe in the empowerment of all. No matter your gender, race, religion, age, or sexual orientation, you deserve to live a self-determined life (and to have access to great oral care). This simple yet firmly held belief drives our company culture and serves as the foundation of our wish list for the next presidential administration.
We hope the next administration prioritizes education, schools, teachers, and students, and ensures our country’s children are successful world leaders of the future. Improving women’s rights, including eliminating the wage gap, protecting a woman’s right to choose, and increasing the number of women in positions of power, are also important goals. We hope the next administration stands on the right side of history, embraces diversity and empowers those who often feel politically and personally discriminated against, specifically minorities and the LGBTQ community.
Raaja Nemani, cofounder and CEO of Bucketfeet, artist-designed footwear company
The U.S. is in danger of losing its identity as a place where anyone can come from anywhere and create opportunity for themselves and for others. This is not an option. The next White House must embrace all cultures, all religions, all backgrounds, all races, all genders, and all humans. We must stress inclusion in order to retain our identity in the world. Inclusion breeds innovation, because it allows for the best people with the best ideas to drive impact.
Steve Goodman, founder and CEO of Restless Bandit, analytics startup that helps automate the candidate-screening process
Our next president needs to focus on workforce diversity. Our country’s ability to compete and stay ahead of the world isn’t just informed by it—it depends on it.
Mike Grandinetti, CMO and corporate strategy officer of Reduxio, data storage technology company
After President Obama, who clearly gets the importance of innovation as fundamentally essential to a growing, vibrant, and competitive economy, we need a president who is dedicated to understanding and has interest in the key issues facing the tech industry. There are troubling studies that indicate new company formation has slowed dramatically in the U.S. Immigrants have always been a key factor in the startup economy. In fact, half of all startups that have scaled to $1billion valuations, those that create the most jobs and wealth, were started by immigrants. Today, the current limitations on H1-B visas send many of the world’s best and brightest elsewhere to commercialize their innovations. U.S. innovation leadership is not sustainable if something does not change.
Education is another foundational issue, from elementary school through university. Today, computer programming is a requirement in British elementary schools. As Marc Andreessen said, ‘software is eating the world.” We should follow suit. At the other end of the spectrum, most state universities have slashed their budgets dramatically on computers, labs, research, etc., putting STEM education at risk. Finally, a grasp of key issues is paramount. Technology is accelerating and public policy is not keeping pace. We need coherent national policy on driverless vehicles, drones, AI, robots, genetic engineering, and related issues that will have a huge societal impact from a political, legal, and ethical perspective. These issues were flatly ignored in both candidates’ campaigns or either party’s platforms.
Avi Flombaum, cofounder of coding bootcamp The Flatiron School
The current administration is simultaneously shutting down bad actors in education like Corinthian and ITT while encouraging innovative educators through programs like EQUIP. This an example of the delicate balance of accelerating the right kind of innovation while delivering on regulatory responsibility. Continuing this direction is absolutely crucial to seeing the promise of innovation improve our society.
Stephen Dash, founder of Credible, an online student loan refinance platform
Stephen Dash
The next president should focus on the need to better align incentives for students, schools, and lenders while rewarding innovation. The U.S. could learn from Australia’s system of financing higher education, which not only ties college costs to graduates’ expected earnings but bases monthly repayment of student loan debt on what they actually end up making.
The Consumer Financial Protection Bureau has done a good job documenting problems in student loan servicing, and the next administration can take steps to address them like simplifying income-driven repayment.
Carolyn Yashari Becher, cofounder and head of policy and people at HopSkipDrive, a ride service for families
It has been proven that companies that draw on a wide range of experiences, backgrounds, and worldviews for their workforce produce greater success. I would like to see the next administration focus on STEM education for underrepresented communities and female students. It is well accepted that African-American, Latino, and female engineers are underrepresented in the U.S. workforce. Graduation rates in computer science and engineering for such groups continue to rise, but they are far from aligned with their hiring rates at the nation’s largest and most successful technology companies. I’d like to see a robust, healthy conversation about that difference and how we can make meaningful change in that area.
Josh Udashkin, CEO and founder of Raden, smart luggage company
I’m a firm believer that young people should have the opportunity to take the risk of creating their own company or working for a new company, so I’d love to see policies and attitudes that encourage young entrepreneurs. Getting rid of student debt is key.
Mark Lewis, chairman and CEO of Formation, enterprise storage software company
Prioritizing education, especially higher education.
The next administration must focus on educating the workforce in order to keep quality jobs in the U.S. and to keep American companies on the leading edge of technology innovation. The U.S. is currently being outpaced internationally in higher education and the percentage of U.S.-based students that achieves a four-year college degree continues to slip. Unless the administration takes action and reverses this trend, the amount of technology innovation from U.S.-based companies will continue to erode, putting U.S.-based tech companies at a severe disadvantage from international competition. In order to continue to foster innovation and to encourage U.S.-based research and development, the next administration should allow U.S.-based companies return foreign profits into the U.S. with little or no added tax. This is the norm for most other countries and gives U.S. companies the ability to use this capital for local investments and hiring. R&D tax credits for U.S.-based companies should be expanded independent of any broader economic reforms.
The next administration must also prioritize deployment of new technology to modernize government infrastructure, especially as it relates to health care and education. This would serve to open up new opportunities for high-tech companies to deploy their products and services, while modernizing the infrastructure within health care and education to improve patient and student care while accelerating technology adoption within these sectors.
Peter Arvai, CEO and cofounder of Prezi, presentation software company
With the new administration, we would like to see education remain a priority—and see expanded programs beyond ConnectED* that bring technology to even more students. We should turn our schools into places of exploration and creativity. By learning the principles of design and how to use visuals and other forms of media, students will be better equipped for the future. In world where low-skilled tasks will be automated away, schools will have to fundamentally rethink their role in society. Creative and critical thinking, plus the communication of these ideas, will be a key skill for our children. In 2014, Prezi joined other major high technology companies (including Apple, Microsoft, AT&T, Sprint, Verizon, Autodesk, and Adobe), to support President Obama’s ConnectED Initiative. Since then, Prezi has donated over $60 million worth of Prezi licenses to Title I schools—and we continue to work with our partners to bring technology to schools that otherwise would not have access.
Gary Steele, CEO of Proofpoint, a next-generation security and compliance company
We need a national defense strategy to match the sophistication and tactics of today’s cybercriminals. I understand the challenge in putting together a policy. Cybersecurity is a complex issue with its origins in IT departments. In the past, internet security was very much a technical issue and was not addressed at the board level let alone a presidential level. But the world has changed and cybersecurity has become a critical piece of business risk management for companies as well as a national security risk for countries. Further, cybersecurity is not something we can fix with one solution—or even solve completely once and for all. As threats and attack techniques grow more sophisticated, we need to keep investing. You can’t spend once or fix it once, and hope that it is over. Admittedly, it’s hard to develop a policy on an ever-changing threat.
With all that being said, the next U.S. administration needs to focus on developing an effective cybersecurity policy. I have some ideas of how to do this—it needs to be a people-focused, national cybersecurity policy. We need to redefine what needs to be protected, invest in and build a modern defense backed by legislation, we need to think globally, act locally, and empower individually. IT security has only recently become part of the national stage because people and their devices are the targets. Companies and government agencies must shift their focus and spend to protect their people, data, and public trust. That means protecting the way business and government agencies work today across email, social media, and mobile devices—and protecting employees everywhere they work.
Eyal Goldwerger, CEO of BioCatch, cybersecurity company that uses behavioral biometrics
Eyal Goldwerger
From the regulatory perspective, there seems to be an onslaught of existing and proposed regulations that make it hard for industry to follow, and drains resources on compliance. Businesses and enterprises end up being focused on checking the boxes as opposed to figuring out what is the best way to protect their users and data. In addition, many of the regulations are very vague and seem to call for the development of guidelines, reporting, and information sharing that solve (December 03, 2016)’s problems. The next administration would do a great service to think more broadly about solving a variety of cyber threats, such as social engineering and account takeovers, and not just traditional fraud prevention and authentication.
This is the first time since World War II that trade with other nations has declined during a period of economic growth. There are many reasons why, but the fact is, the world is moving away from physical goods in favor of ongoing services. In this new “subscription economy” people and businesses are increasingly opting for outcomes over assets: rides over automobiles, streams over compact discs, cloud computing and storage over on-premise servers, etc. In 2013 The Economist found that 80% of customers are demanding new consumption models and moving away from traditional ownership. The digital services sector of the economy needs urgent attention from the next administration, because right now it’s the only one that’s growing—not just here, but around the world. Sure, governments will always be haggling over coffee and oranges, but these days the real comparative values that countries are looking to gain from one another are not related physical goods.
Today the new values reside in innovation, intellectual property, talent, and business models. With the global economy at a virtual standstill, we need the next administration to bring together governments so they can start constructively haggling over ones and zeros, not car parts and kitchen appliances. Silicon Valley, where I live and work, owes much of its success to “clustering”—local companies here are constantly swapping (and haggling over) talent, innovation, and business models. The next administration has the potential to let the entire country take advantage of this effect, but it needs to take its trade policies into the future of the subscription economy.
Sergey Gribov, a partner at Palo Alto-based venture capital firm Flint Capital
The most important issues for the next White House as far as innovation is concerned are related to immigration. The U.S. is currently the best country in which to build high-tech company, but the world is getting flatter, and unless the U.S. uses this advantage to bring in as much of the tech talent from around the world as possible, it will lose this position. In order to maintain an advantage, the next White House will need to finally push the StartUp Visa Act through Congress, so that anyone who wants to bring his/her company to the U.S. can do so. Also, there should be no cap on H1 visas, or at least it should be significantly higher, to ensure that there is enough of a talent pool to fuel innovation. Generally speaking, I think the U.S. government should allow anybody who graduated from a U.S. university with a technical specialization to stay and work in the U.S.
To summarize, next White House should make sure that a) any high-tech company who wants to move to U.S. can easily do so and b) any U.S. company that needs to hire highly skilled workers can easily source them from around the globe.
Michael Jones, founder and CEO of Science Inc.
In today’s technology-driven environment, the lifestyle choices of tomorrow’s generation will be vastly different from today’s. There will be much more flexibility around the pursuit of personal and professional dreams as individuals begin to challenge conventional norms and institutions, such as long-term employment and marriage.
I’d like to see encouragement and support for diversification and these non-traditional lifestyles. I love living in a country with the highest class of creative and innovative minds that tackle some of society’s biggest problems, but I’d also like to see an uptick in international business and workforce diversity. We should open our borders to acquire the best talent available and, as a country, our government must recognize foreign talent in order to continue growing technology and driving innovation in our economy.
Owen Tripp, cofounder and CEO of Grand Rounds, health care startup
More “do” less “say” on innovation around drug pricing. Though the federal government has no power to set prices, CMS can make innovation grants to sponsor affordable innovation in new therapeutics.
Tom Lee, founder and CEO of One Medical, primary care startup
A stable health care policy environment that enables entrepreneurs to help fix our health care system.
Sean Duffy, CEO of Omada Health, digital behavioral medicine company
Sean Duffy
The next administration must be prepared to tackle some of the country’s most pressing health care challenges: how to ensure the system is rewarding prevention and value, how to address the epidemic of chronic disease, and how to integrate new health care technology that is accessible, evidence-based, and proven effective. It will require the appointment of forward-thinking individuals to key positions at the Department of Health and Human Services, and the openness to rethinking how health care can be delivered in the 21st century.
Gene Saragnese, chairman and CEO of MedyMatch Technology
In President Barack Obama’s State of the Union address of January 2016 he announced the establishment of the Cancer Moonshot to accelerate cancer research in the United States. This is a significant first step in making more therapies available to more patients, while also improving the nation’s ability to prevent cancer and detect it at an early stage. However, this is only a first step.
Today, in health care, there is an unprecedented opportunity to turn science fiction into a reality. The advancements made by health care-focused artificial intelligence technologies have created a unique opportunity to address the escalating cost of care. Physician and patient access to artificially intelligent patient specific decision support technologies can make it possible for improved care, thereby making medical professionals life-saving experts every time. The new administration must create capacity in health care through the investment in new technologies that bring a new precision and personalization to health care, which will in turn broaden access to affordable health care for all Americans.
Gil Hecht, founder and CEO of Continuity Software, IT operations analytics provider
The Obama administration took some important steps to recognize the role that technology plays not only in our economy, but in the day-to-day lives of every American. The next administration will need to take an even stronger approach. It’s time that we treat our IT infrastructure with the same rigor that we apply to every critical utility—power, gas, water, telecommunication, etc. One obvious reason is that each of these utilities is controlled by computers, software, and networks. Any disruption in these underlying IT components can bring these services to a halt—we’ve already seen numerous power and communication outages caused by IT failures.
But it goes beyond the obvious. Just in the past few months we’ve seen IT outages causing the cancellation of thousands of flights leaving hundreds of thousands of passengers stranded for days; we’ve seen small business that could not get payment processed; and we’ve seen people unable to access their money, causing severe hardship for those that live paycheck to paycheck (one person even tweeted he could not buy food). These are just a few examples of the critical role IT infrastructure plays in our everyday lives. More regulations are not always the answer, but just like utilities have requirements to guarantee a level of service to their customers, other critical service providers should also step up to the plate to ensure customers’ lives are not severely disrupted. The next administration should work together with the business sector and consumer advocates to come up with standards, requirements, and measures to address this issue.
Jonathan Ofir, founder and CEO of Leaf, a cannabis tech company
The next U.S. administration must stop pretending that cannabis legalization isn’t happening. Twenty-five states and the District of Columbia currently have laws legalizing marijuana in some form. On November 8th an additional 9 states will vote on cannabis reform, most importantly California and Florida, the largest and third largest states in the U.S.. A recent Gallup poll found that a whopping 60% of Americans support full cannabis legalization. Our neighbors to the North, Canada, have already moved to legalize the herb federally. All this begs the question, why does the U.S. federal government maintain that cannabis is illegal, has no acceptable medical use, and is classified in the same category as heroin?
The change is happening and at this point it is irresponsible of the White House to stay silent. For example, the legal cannabis industry is currently worth billions, but state law abiding businesses do not have access to bank accounts or credit card processing due to federal banking regulations. At a bare minimum I’d like to see that the next administration solves this immediately. Instead of ignoring cannabis, the next administration should embrace it. It’s had an overwhelmingly positive effect on the health, well-being, and economy of the communities where it has been legalized.
Aaron Hirschhorn, founder and CEO of DogVacay, which matches traveling dog owners with host families
I’d love to see some attention given to policy around the quickly rising peer-to-peer economy. The U.S. Department of Commerce released a report on it earlier this summer, so clearly it’s gone mainstream enough to have government attention. We need a better, modernized employee classification system, because in this new digital economy, W2 and 1099 don’t cut it anymore. We need a third classification that fits with the new way work happens.
We also need more centralized consistent regulations for the sharing economy across the country. When rules and nuances vary widely from county to county, it’s confusing for people to keep up with what’s legal and what’s not. You can move a few blocks away, and all the rules change.
Chris O’Neill, CEO of Evernote, the note-taking and productivity startup
Chris O’Neill
We expect the next White House to establish a leadership role in the global economy that allows us to make productivity tools available to a user in Mumbai as easily as one in Cincinnati. We have no idea where the next great invention, creation, or business will come from, but companies like Evernote can help bring those advancements to fruition faster by sharing what we know about organization and productivity. With more than 75% of our users outside of the U.S., we hear about our users making advancements in everything, from scientists in a research lab in St. Louis, to a Latin American composer in the studio. The next White House needs to be a champion for U.S. businesses to accelerate these advancements.
Greg Albrecht, cofounder and CTO of Orion Labs, wearable tech manufacturer
I believe wireless internet access should be like water—free, clean, readily available and accessible to all. Currently, we have a number of legacy license holders who have veritable monopoly on high-speed internet, split into archaic fiefdoms that are both underutilized and poorly allocated. The next administration needs to continue to push for the reuse of our available wireless spectrum in intelligent beneficial ways.
Greg Cohn, cofounder and CEO of Burner, a disposable phone number app
I hope the next administration will build on the work the current one has done to keep the monopolistic tendencies of telecom and cable carriers in check, ensure fair access to the internet, and protect consumer privacy. While the “net neutrality” discussion rightly got a lot of attention (and a great outcome), the FCC in particular under the leadership of both Obama appointees has taken a number of steps to maintain open and fair access for businesses and consumers, ranging from opening up new spectrum to promoting competition, opposing dominant-carrier consolidation, and introducing new consumer protections for ISPs. As even more merger proposals are lining up, a fair, well-lit playing field in this arena is vital for companies like ours to be able to compete, and of course important for consumer privacy, which is core to our mission.
Rod Favaron, president and CEO of Spredfast, social software company
Unfortunately, as with most policy issues during this election season, a debate by the candidates about tech policy has been notably absent. I’d be interested in seeing an investment in STEM education and other programs that promote diversity in technology, and it will be important for the next administration to foster a more startup-friendly business environment. We compete globally, and an overhaul of workplace and tax regulation would be welcomed. And finally, I’d like to see the modernization of government services online. An administration that embraces the opportunities that tech innovation provides will not only be more efficient, but also more transparent.
Scott McFarlane, cofounder and CEO of Avalara, cloud software company
Today, businesses of all sizes struggle to comply with a patchwork of confusing, ever-changing sales tax regulations for their online, inter-state sales. Although Congress and the courts have tried many times to resolve this issue, it’s actually gotten worse. Individual states have taken measures into their own hands to reclaim sales tax revenues, and the result for business has been even more complexity, more confusion, and more tax compliance burdens. No seller can possibly know how to respond to all the different states’ sales tax challenges. For example, are the so-called “Amazon laws” constitutional? Is an “economic nexus” in place, and if so, how many sales must a business make to trip that threshold? I would love to see the next resident of the Oval Office drive Congress to finally enact legislation that levels the playing field and supports businesses who just want to do the right thing.
Jake Levine, founder and CEO of Electric Objects, a startup that makes picture frame-like computers that can display high-resolution artwork from the internet
I’d like to see the next president continue to hold the technology industry accountable for our obligations to the public sphere. There’s a troubling trend in our industry of recusing ourselves from politics, relying instead on whatever product we’re hawking to serve as our contribution to humanity; and claiming a certain neutrality innate to software development, as if software isn’t an extension of the world views of those who write it.
The embarrassment that is the 2016 election is in many ways a reflection of media and technology industries that have effectively abdicated any responsibility to the public good, relying more and more on ratings and page views to drive coverage and algorithmic visibility.
The next president will be in a unique position to call attention to the influence that software has on our world, to encourage technology executives to reckon with the influence that our tech and media systems have had on our politics, and to prioritize investment in areas that have always been the drivers of real change: access, the environment, public health, civic engagement.
Sallie Krawcheck, the cofounder and CEO of Ellevest, a digital investment platform for women
Sallie Krawcheck
My wish is that we get a mandated parental leave in the next administration. While most of us know the U.S. is the only developed country in the world without such a leave, fewer of us know that parental leave represents an investment, not an expense. That’s because research has shown that leave for mothers pays for itself in the first year; that’s because women are more likely to return to work after a leave. This saves companies the expense of replacing them and of training their replacements. And reversing the decline in female participation in workforce also grows the economy and goes some ways towards closing the retirement savings gap.
Jeff Dachis, founder and CEO of One Drop, a diabetes management app
Integrity and Honesty—I want to see Kardashianization of our political discourse to disappear and have a return to a honest and integrity-filled discussion about the real issues and real solutions for the near term and the long term to truly enable everyone to be healthy, to be happy, and to prosper. I want to see the administration exclusively focus on the issues by taking a path of honest action including:
A functioning non-partisan Congress that continues efforts to solve some of the real problems we have.
Health care – universal, modern, mobile technology-enabled care systems that empower, motivate, and keep people mindful to make healthy choices and the simultaneous elimination of waste, fraud, and costs plaguing the system today
Education – Focus on universal pre-K, STEAM, entrepreneurial studies, and the retraining of out-of-work workers
Tax reform – The wealthy need to pay a little more, everyone else needs things to be simple, and corporate tax rates need to come down significantly
Infrastructure – I’d like to see the builders and doers in this country refurbish and rebuild our infrastructure
Climate Change – Commitment to not only move to renewable energy, but to lead the way on renewable energy sources, sustainable industrial production, and breakthroughs in production, storage, and transmission of energy
I’d also like to see a renewed commitment to the literal moon shots of space exploration, biotechnology, and AI
Last, I’d wish for sanity to return to the Supreme Court through the nomination and approval of modern, future-forward, sane justices that guarantee a woman’s right to choose and that look to protect the rights and voices of all Americans.
Stephanie Tilenius, CEO of Vida Health, a virtual care platform and health expert marketplace
Stephanie Tilenius[Photo: Kevin Moloney/Fortune Brainstorm TECH]
Focus on Jobs[/b]—the most important thing to address inequality and economic gaps in the country.
Reform health care[/b], take Obamacare to the next level—let’s offer public catastrophic care plus private insurance plans and create true market-based pricing aligning consumer incentives with employers, payers, and providers who are paying. Get rid of the hairball of perverse incentives that distort decision-making and drive an extra $1T of spend that is unnecessary. With one public system you would have interoperability of data too. We have to rip off the band-aid, we are heading to 20% of GDP and it’s crippling our economy. 50% of families can’t afford their out- of-pocket deductible.
Campaign finance reform:[/b] We waste too much money getting folks elected and should redirect that money to health care and education.
Offer the 50 states incentives to roll out computer science in elementary schools. It should be taught just like math, English, science. It should be required.
If we could change the ERISA laws such that employees could buy health care directly and then choose a plan, you would see a market mechanism and transparency and innovation. Health care premiums have grown 3x since 2000 for employer-based health insurance while wages are flat. It’s time to have the consumer take control and buy their own insurance and be accountable for managing their health care costs.
