The free-market system has produced some of the most innovative products and services the world has seen in almost every corner of the economy. How is it that aspects of the American health care system remain such a glaring exception to this phenomenon?
That question nagged at Tony Dale, a former physician from Great Britain, after a disquieting encounter with the American health care system following surgery in the mid-1990s. It spurred him to create Sedera, an Austin, Texas-based medical cost-sharing community that has grown by more than 2,000 percent over the past three years.
Medical cost-sharing is often misconstrued as a type of health insurance, but it’s not. Medical cost-sharing organizations, like Sedera, offer an innovative approach to managing large health care costs through direct member-to-member sharing.
“Sedera is not an insurer or in the business of insurance, and this is intentional,” says CEO Jamie Lagarde. “Our health care system is overcomplicated, with skyrocketing costs, a lack of pricing transparency, and few options.” Citing a Harvard study that found more than two-thirds of personal bankruptcies are tied to medical issues, he adds that “it is clear that coverage does not equal care.”
LEVERAGING THE SHARING ECONOMY
Sedera’s platform allows members to share medical costs. Uniting like-minded people in a shared sense of purpose powers Sedera’s business model, Lagarde explains. Sedera is at the forefront of this new frontier, building a health care sharing economy that uses technology to allow health care consumers to find affordable, quality, and meaningful care. “The first generation of the sharing economy was about sharing assets like cars, homes, and other consumables. Sedera is proving that the next generation is about people coming together to share their bills,” he says.
Sedera’s model brings together engaged consumers unified by shared, ethically based principles and values rather than religious tenets. “To fulfill our vision of creating a new normal in health care, we focus on what unites our members: a commitment to transparency, education, community-mindedness, and a desire to help one another,” Lagarde says.
OVERCOMING OBSTACLES THROUGH TRANSPARENCY
When it launched in 2014, Sedera was a new startup in a little-known industry that sits adjacent to a highly political and regulated space. The company consistently bumped up against barriers when it came to education and misconceptions about its model. In response, Sedera embraced transparency, service diversification, and a commitment to industry best practices.
Looking to the future, Sedera teamed up this year with an FDIC-insured fintech partner to establish a platform that creates secure, individualized medical cost-sharing accounts. “This relieves members from handling complex medical calculations and frees them up to focus on their health needs,” Lagarde says. “Upending the status quo is no easy task.”