Changing the Conversation on Health Insurance

While politicians in Congress wrangle over how to repeal and replace Obamacare, some Catholics and Evangelical Christians have already found an alternative to health care insurance. Surprisingly, it has been around for 30 years. They call it “health care sharing,” and it’s based on the biblical principle of believers sharing each other’s needs. In this case, the “sharing” applies to medical costs.

New model

Jamie Lagarde, a member of Legatus’ Austin Chapter, was so convinced about the merits of health care sharing that in 2015 he helped found Sedera, a health care sharing organization.

“Sedera is in the business of sharing health care costs,” Lagarde explained. “We have 2,000 members in 30 states, and we have doubled in size in the last six months. What we have found is that there are spiritual and economic benefits to applying biblical principles. Who said that insurance was the only way to deal with medical costs? We want to do what Uber did for transportation and what Airbnb did for hospitality.”

Surprisingly, health care sharing is one of the few types of organizations that is exempt from Obamacare requirements.

In health care sharing, people sign up as “members” and share each other’s medical costs. The monthly cost of membership is lower than insurance rates. Each member is considered a “self-pay” patient, and their bills are negotiated down as such. Sedera members can go to any doctor they want.

“For example, we had one couple who had a premature baby,” said Lagarde. “Their baby had to stay in the NICU. Ordinarily, this would cost $199,000. We were able to negotiate the bill down to $30,000 because the couple was considered ‘self-pay.’ We have advocates especially dedicated to negotiating down all of our members’ bills.”

All medical bills over $500 are subject to negotiation. Everything is done behind the scenes with little involvement from the member.

“Getting fair prices for medical services is critical to keeping rates down for the health care sharing community,” said Lagarde.

Bringing costs down

Another example Lagarde gives, closer to home, was when his wife recently went to a dermatologist. The doctor prescribed a cream which cost $600. Through Sedera, they were able to negotiate the price of the cream down to $50.

“We save our members 40 to 60% off their health care costs,” he said.

Lagarde co-founded Sedera with Dr. Tony Dale, a British evangelical Christian. Dale worked as a family medicine practitioner in Britain before moving Stateside in 1987. After having knee surgery in the U.S. in 1996, Dale became interested in medical economics. The cost of his knee surgery was staggering compared to what it would have cost in Britain. He was determined to find a way for individuals to have access to quality and affordable health care.

Dale and his wife Felicity were also involved in medical missionary work in developing countries. Both had a passion for bringing health care to individuals and groups who could not otherwise afford it.

“I was impressed by Dr. Dale when I met him because he is a man of God,” Lagarde explained. “He takes his faith very seriously and incorporates it into his work. Up until then, for me, Sunday Mass did not directly translate into my work on Monday. But Dr. Dale taught me that faith in the workforce does exist and can be an incredibly powerful thing. At Sedera, we are practicing what we believe.”

After meeting Dale, Lagarde remembers one day waking up and telling his wife that he needed to stop what he was doing and join forces with his new friend.

“I felt called to do this. I loved Dr. Dale’s vision of health care in America,” said Lagarde.

Lagarde and Dale began to work on the Sedera concept in 2014 and officially opened in 2015.

“It’s nice now to work for a company where I can share who I am,” Lagarde said. “This is the best and most fulfilling job I have ever had.”

Because of the cost savings which Sedera is able to achieve, the organization is able to help companies get out of the red and into the black.

“I’ve met CEOs of companies who told me that they had stopped offering group health insurance at one point because it was too expensive. With Sedera, these same companies can now help their employees. They save $1,000 to $3,000 per employee per year,” he said.

Faith-based model

Though Sedera doesn’t ask members questions about their faith — as most health care sharing ministries do — the company is clear about the fact that it won’t share the costs of abortion, sterilizations, in-vitro fertilizations, surrogacy or abortifacients.

“I think this is the next big thing,” said Lagarde. “Insurance is a great thing for cars and homes. You offset a highly unlikely event with insurance. But with health care, all of us need it. We all have health care costs. This is about managing expectations and unexpected costs. With more transparency, you get to become more involved in your health costs. This is the way health care should be done.”

Another person who has become convinced about the merits of health care sharing is Mike O’Dea, co-founder and director of the Christ Medicus Foundation. O’Dea has been working for 20 years on the issue of protecting conscience rights for those in health care. He regularly works hand-in-hand with evangelical Christians in lobbying the federal government.

“What has come out of all this work was that we saw a need in the Catholic world for health care sharing,” said O’Dea. “We didn’t have the exemption that evangelical Christian organizations had.”

O’Dea and his team looked into health care sharing plans for Christ Medicus employees and realized that it was a great opportunity. They chose Samaritan Ministries, one of the oldest health care sharing ministries in the country.

“The best part is that people of faith can share each other’s burdens and pray for each other,” he explained. “This goes back to biblical times. We have many testimonies of people and how good they feel to be supported by this network, and the design of the plans is right in line with Catholic teaching.”

SABRINA ARENA FERRISI is Legatus magazine’s senior staff writer.

For more information:
sedera.com
christmedicus.org