What is Sedera Health?
August 1, 2014
The Chinese language uses a wonderfully complex character system in its written form, rather than a phonetic alphabet. This picture language brings together some fascinating concepts. The character for “Crisis” is made up of the picture language for “danger” and “opportunity.” This is the exact situation facing health care in the United States.
The passage of the Affordable Care Act in 2010 represents the biggest change to the American health care model since the sweeping social legislation of the 1960’s introduced the country to Medicare and Medicaid. In the time since then, the expansion of these social welfare programs, and the general acceptance of the roll of government in helping with the needs of the elderly and the poor, has led to an ever increasing role for regulatory and government oversight of health care.
As happens in all situations when there is reduced personal responsibility for choices made, prices escalate when someone else is willing to foot the bills!
Small wonder that in the country with the most medical innovation, and with by far the highest Gross National Product, that medical prices began to escalate. And increase they have, at a rate far higher than the rate of inflation, producing the situation that we all now live in where medical pricing and government welfare in other forms is driving the nation to the edge of bankruptcy.
Enter the Affordable Care Act.
Whatever the goals and motivation behind the Act, the net result has been neither “Affordable” nor improved access to “Care.” On the contrary, it appears that what is emerging is a government sponsored grouping involving government, insurance companies and the American Medical Association seeking to work together to the exclusion of the very innovation that has made America a dominant economic powerhouse.
However, it is this very crisis that is producing the opportunity. When everything is working relatively well, and people and the companies that they work for can handle the cost of health care, there is little pressure for change. But now that everyone can see that the health care ecosystem is unsustainable, innovation is bound to pop up everywhere.
Sedera Health is an expression of this innovation.
In an economic model that has been dominated for 70 years by insurance companies or government, out of the public gaze another form of medical payment approach was developing. This approach is generally known (if it has even been heard of by most people!) as Health Care Sharing (HCS).
As far back as Biblical times, it is recorded that “No one claimed that any of their possessions were their own, but they shared everything they had. There was no needy among them. For from time to time those who owned house or land sold them, and brought the money and laid it at the apostles feet.” (Acts 4) This concept led to the early benevolence schemes of the churches, and philosophically also led to early fraternals, labor movements, and even to the communist manifesto.
Left and right have borrowed heavily from these early Christian ideas.
In the late 1980’s and early ‘90’s, some modern day Christian groups began looking at rising health care costs, and compared the escalating costs with the simple but effective manner in which older Christian groups, such as the Amish, handled their property and casualty needs. We have all heard of the proverbial Amish “Barn Raising.” There is no need to insure the “barn” because the community will come together for a “barn raising” if it should burn down.
And so modern health care sharing was born.
Now fast forward to 2010 and the Affordable Care Act (ACA). The impressive growth of the Christian health care sharing movement had, by now, led to hundreds of thousands of individuals and families not using an insurance model, but rather trusting to the sharing of needs as administered by these health care sharing groups. So the ACA, in recognizing the effectiveness of these groups, enshrined their legitimacy in law by granting an exemption to the law’s penalties for those who were a part of these recognizable groups.
Yet again, crisis becomes the seed bed of opportunity.
Although the exemption of the law only applies to a few qualified health care sharing groups and their members, the methodology of health care sharing has been shown to be both legitimate and effective. As long as one can find other ways of fulfilling the law’s requirements, the health care sharing methodology can teach us much.
And this is where Sedera Health was born as a concept.
Medium to large businesses need a group health insurance solution that will fulfill the requirements of the Employer mandate of the ACA. This can be found within the Minimum Essential Coverage (MEC) as defined within the law. Using this insurance model for handling preventative care needs, the minimum requirement of the law is fulfilled.
But, what about actually handling the escalating costs of illness? This is where the health care sharing model can be applied. But now it is applied within the corporate context, not just for people of faith, but for groups of employers and employees who choose to share common health related goals.
Now you are beginning to understand Sedera Health!
Thoughts from an Old World doctor on New World Healthcare