Conversation between host Josh Trent and guest Erica about medical cost sharing (Sedera) as an alternative to traditional insurance. Key points: cost sharing restores patient agency and an unfettered doctor–patient relationship, encourages transparency in pricing, reduces administrative waste, and fosters community-based mutual aid. The speakers use personal anecdotes (a member in North Carolina; Josh’s vision quest) to emphasize themes of awakening, choosing simpler community solutions, and moving from passive ('leaning back') to active ('leaning in') healthcare decision-making.
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What are some of the ways that Sedera really helps people? On a practical level, let's just go practical first.
Yeah, I know.
We'll get into the nuts and bolts of, you know, what's shareable, what's not shareable, answer some of the people's questions from the community. But on a practical level, just if someone's first learning about cost sharing, just unpack that a little bit. Cost sharing and the freedom and the flexibility of that.
Yeah, well, you know, I mean, I love what you just said because the big deal is how do we get back to basics? How do we have that freedom and flexibility? And a lot of it is really bringing the doctor and patient relationship back together. So if I were to say we bring anything to the table, it's that you get to be in charge of your health and you get to have an unfettered relationship with your provider, your doctor, which is really cool, right? Because if I'm going to my doctor and I don't know what things cost and I don't know kind of what all my options are, he's just, I'm in hand a card. I'm going to abdicate responsibility. He's going to run whatever labs he thinks and then I'm going to get whatever result I will. The difference is when I'm a cash pay patient, a medical cost sharing member, I'm going to sit down and I'm going to have really intentional conversation. It's going to be mutual. I talked to a member last week in North Carolina and he said he's probably late 40s. And he was like, I have had insurance most of my life and for the first time in the last year, as I've been a medical cost sharing member, I sat down with my doctor, they went line by line by everything because they knew I was a cash pay patient. We had had a mutual conversation. We worked out, yeah, you know what? I probably don't need that. Or let's wait, let's do that. Two months later, we made intentional decisions that were right for me. So beyond the freedom and flexibility, it's agency, it's engagement, it's being kind of from out from behind the. I don't really know what's going on into like, I'm empowered with all the insights and the knowledge and I get to make the best decision. So if we give anybody anything, it is that restored relationship, that unfettered opportunity to be directly in charge of your cost and choices and still experience, like what you said, the neighbor to neighbor, people to people experience which we are so hungry for everybody. And I think more than ever we're hungry to cut all the extra. If anything, last year taught us it's like, man, who are your people? How do you simplify what's on the table that doesn't need to be? I've talked to so many businesses and friends who had a kind of like awakening last year. Like, okay, what do I really want in my life? And I think what this allows you to do is to kind of choose those things and have a lot of agency in it.
I love that you talked about awakening because we're all making really, really hard choices depending on where we were in 2020, like finance, job, career. I think it was a beautiful gift. Now, I don't think sometimes gifts are easy to unwrap because last year was challenging fundamentally, I think to all human beings across the planet. Yet there is always something powerful and beautiful that comes from challenge and hardship. And really what I think has come from it is community and community based solutions where we're reconnecting to the nature of who we are. Just a quick story as we dig into the conversation more. I got back from a 10 day vision quest and four days of those vision quests, you're fasting in nature with no food. Like all you have, Erica, is water, no fire. Yeah.
So no coffee.
No coffee, no coffee, no food. So 100 hours of fasting in nature. And you know what the biggest part of this was for me? Because I've had a lot of anger, I've had a lot of resentment towards the insurance pyramid. Insurance, pharmaceutical. I mean, we're not here to paint the light of what people already know. People already know the absolute heinous activity and the pain that these industries cause. But you know what message came through? I was laying there and I was looking up at the sky and I just got this message like, less anger, more truth. Less anger and more truth.
I love that.
The truth is we're all community and the best thing we can do right now is exit systems that aren't necessarily serving us anymore or aren't directly serving us anymore and return back to this community based model. So. So why are costs out? You know what even makes that happen, Right?
Yeah, you are leading straight into that totally. Well, one of the things you were saying about community earlier and I just wanted to hit on was you brought forth this idea that, hey, we take care of ourselves and we take care of one another. It's a both and right. You can't go to a community like, hey, what am I going to get that's not community. And you don't also, like, we have to prioritize taking care of ourselves. And I think that mutuality is so, so important and community allows us to have that and kind of this year allowed us to kind of get back to that in some fresh ways. But yeah, when you're talking about why are we here, a lot of it is, is that we have a price transparency problem that is everywhere in the news right now. No, I didn't say anything shocking. But it. When there's not transparency when it comes to your costs, when you actually do not know what you are paying for, you don't know the end cost. Like, I might, if I am, I might go and say, hey, I need this surgery. But if I don't actually know what that cause is, there's no accountability and there's so much room for waste to get built in. No one knows. So, like, there's these amazing surgery centers that are popping up across the country. I'm looking at potentially needing a surgery soon. So I've been like digging in deep. I've known about them for years, but what's so cool about them is rather than go to my doctor and be like, oh my gosh, I need this surgery. And they're like, okay, give me your card. Then I get my card and I have no idea what's gonna happen from. I think my deductible is X. But then I still might get all these bills that weren't covered, you know, so there's a lot of mystery. Which makes my decision making even around where I go get my surgery really muddled. I'm not able to really look at the reviews and navigate, okay, is this the best cost for this value? I don't know what it really costs, but when you know what things really cost, when there is pricing transparency, I'm able to look at. So now I'm looking at these different surgery centers. I'm saying, hey, I want your real cost for this. I'm like, okay, this one's this thousand. This thousand, this thousand. This one has the best reviews and the best price. And my friend said she went there. Great. I'm doing that. That's what shopping should be about. We're making real decisions. So we have this huge problem because there's so much administrative waste built in and no one really knows what things cost. That's a simple way to get into it, obviously, just like you were saying. And valid room for anger is pharmaceuticals. Insurers and hospitals benefit from keeping their Prices secret. So whoever can flex the largest muscle wins. And you know, all these contracts are moving around but like, who really knows? So when I would call, like if I had insurance, I would call. And there's some really cool videos about this on the Internet, like of people actually practicing this. They're calling, they're like, hey, I need to get the surgery. How much is it going to cost? And they'll be like, hey, I don't know. Hold on. You don't know how much it costs? What do you mean you don't know how much?
You forget that a hospital is a business. It's a for profit entity.
Yeah, yeah, yeah.
It's not us sitting around the fire anymore.
Right. So why costs are out of control. We've got incredible amount of waste. We've got a system that's built on waste and we've got patients and consumers who need to get back engaged. We're used to leaning back as opposed to leaning in. We're used to saying, oh, here's my car, whatever. I don't really know. I don't have any control. Someone else is telling me me where to go. I mean we have people who are members for the first time. And I remember feeling like this. I was like, oh no, they're not going to give me a list of where to go. And it was like. But then as you get into it, you're like, oh my gosh, how cool. I'm going to like get on the Internet like I would about getting a haircut. I need a haircut right now. It's been way too long. And I'm going to. I've asked all my friends, I've gone on the Internet, I've looked at reviews. I'm probably going to look at cost a little bit, but might invest a little bit more because it's been Covid. Right. I'm going to make a choice that's right for me based on what I see. So we need patients to get and members to get back involved, kind of take back that agency to make decisions and enjoy that freedom and flexibility.
I love you. Talking about leaning back versus leaning in. That's another beautiful metaphor. As we contrast the first metaphor which is, hey, if everyone puts a house on their shoulders, a community can move single houses at a time. Yes. And those single houses represent a broken leg, an emergency event. Like all these things that like you say when people enter the system that currently is that the majority of people engage in. There's so much price hiding and really price gouging. Every industry have this. It's not. It's not just exclusive to health care.
No way.
A lot of industries. And you guys would be so shocked. This totally relates. Erica. My buddy used to be in the Navy, and he told me that sometimes they would charge for, like, a little washer on a boat, and they would charge $500 for a basic silver washer. That exact same gouging exists because there is a backdoor relationship with the people that make the products and the people that buy the products and the engagement of the really broken system that we're all playing in. So outside of that system, here we are, back around the fire.
