"If we're going to insure all Americans, which is a worthy and appropriate cause, then somebody has to pay for it," Bertolini said of the expected premium increases under Obamacare.
Bertolini said that insurance premiums could double in some places just on 
the basis of what types of policies people buy today. 
He also said that when Obamacare is fully implemented, it won't start the way 
people had hoped and it won't be cheaper. 
Over the longer run, the key to bringing down premiums will be controlling 
health care costs, he added. "It'll be fits and starts, but we'll get there," 
Bertolini said.
Higher premiums also will not necessarily mean higher margins for Aetna. "The 
people coming into the system will be sicker because they have not used 
services," Bertolini said. "So in the initial part of this program it will cost 
more to take care of people because they have been going without health care for 
so long."
The Aetna executive also weighed in on the debate over the country's fiscal 
situation. 
(Read More: Forget the 'Fiscal Cliff,' Look at These 
Cliffs)
Bertolini said a big deal would be the best deal for the country, but that 
it's looking increasingly unlikely that politicians do anything more than a 
short-term fix which won't be enough to restore confidence. 
And confidence is key to increasing business investment and spurring economic 
growth. "A grand bargain won't create a slow economy," Bertolini said. "It will 
restore confidence and we'll all invest."
He added, "Americans don't want Plan B, they don't want a short term fix. 
They want the very best we can come up with. They want Plan A."
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