This op-ed was co-authored with Jamie Lagarde, the president of Sedera. It originally appeared in the Alaska Journal of Commerce on October 14, 2020.
In a country that prides itself on checks and balances, freedom and independence, the health care industry seems to have self-selected a different path. Our current system prioritizes complexity, opacity and insider deals over direct care, transparency and competition — leaving consumers powerless to act in their own best interest.
In the U.S. health care debate today, much of the blame for our broken and overpriced system is pinned on the medical-industrial complex: big pharma, insurers and massively integrated hospital systems — many of which are tax-exempt while being extremely profitable. We keep trying to tackle this highly complex problem with one-size-fits-all policies like “Health care for all” or “Medicare for all.”
Yes, making sure everyone in America has access to quality health care and can live their lives without fear of medical bankruptcy, is no-doubt the right idea, but disabling consumer choice and customization is not. One size fits all approaches mean many of us are left with a solution that just doesn’t work.
We live in a free-market economy, and that economy has produced innovative products and services that have changed the world. This entrepreneurial spirit gave way to thousands of products and new ideas, so why does our health care system look relatively the same as it did decades ago? Where is the individuality, creativity, and passion that shapes most other major industries in our economy?
We deserve health care options that make sense for our individual needs based on our personal life experiences. Put in a different context: imagine we are all forced to only throw away items we no longer desired, eliminating different or varied options such as hosting a garage sale, or using a technology platform like eBay, DePop, Craigslist, or Amazon. That might work for some people, but many would prefer a different option. Lucky for us, this menu of ecommerce options exists, and competition has led to constant innovation, a variety of options, and transparency.
This, too, is the case with insurance. Consider you’re a father who needs medical treatment maybe once or twice a year. However, these treatments still don’t meet the annual deductible—and you are forced to pay out of pocket, with money that you don’t have, especially considering the high premiums you’ve already paid.
Or you are the owner of a small business and want an affordable option for your employees, but no one network comes close to meeting everyone’s needs. Or you have found that alternative, integrative forms of medicine work better for you, but your insurance plan does not cover them.
This is to say, insurance, as a health care solution, should not be a consumer’s only choice. Coverage does not guarantee care, and it certainly doesn’t guarantee affordable care.
There are many non-insurance options for people eager to play a bigger role in their health care decision making and engage in negotiating lower health care costs, such as direct primary care, or DPC, and medical cost sharing, or MCS.
Direct primary care allows patients unlimited access to their physician, without insurance, in exchange for an affordable monthly subscription payment.
By cutting out the middleman, direct primary care physicians can spend more time, effort and focus on treating patients without the heavy administrative burdens that plague the insurance system. DPC providers prioritize patient relationships and high-quality care. DPC also pairs well with medical cost-sharing organizations which provide an innovative, non-insurance approach to managing large health care costs.
Sedera and other medical cost-sharing groups promote transparency and autonomy in health decisions while encouraging mindfulness about the impact on the broader sharing community. Members of medical cost-sharing organizations are also cash-pay, which can help decrease the administrative burden on physicians.
Alaska needs to be fueling the fire of competition and making the incumbent systems work harder to provide solutions that are actually beneficial to the patient, like DPC and medical cost sharing, not mandating the purchase of a product that falls short.
Rejecting the current one-size-fits-all mandate is the only way we will achieve the efficient, affordable, and transparent care that we so desperately need. Our complex care system is explicitly sick, and the cure is more simple than most Americans realize.
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This op-ed was co-authored by Jamie Lagarde, the CEO of Sedera.