For episode nine of our podcast, we were joined by Jenny Aghamalian, Vice President, Public Affairs and Strategy at Sedera. Jenny oversees the company’s legislative and regulatory strategy, policy development, and enterprise-wide communication. Jenny started her career as a policy analyst for a bi-partisan Texas legislative caucus, followed by roles in the Capitol offices of several Texas legislators. Her passion for healthcare policy stems from time spent as a lobbyist for more than 50,000 physician members of the Texas Medical Association.
Our hosts for this episode, Steven Cutbirth and Mark Camero, discuss several topics with Jenny, including what factors contribute to the complexity of healthcare, how healthcare sharing communities work, and why so many Americans have health insurance but still struggle with affording healthcare.
You can listen to the whole episode here or on Spotify, Apple Podcasts, or wherever else you listen to podcasts. If you’re short on time, we’ve included a few highlights from our conversation below:
Mark: “Can you just let us know, how did you go from a legislative aid in the Texas Capitol and how did you find this role in healthcare policy?”
Jenny: “It was a long process, a long journey to get to where I am today. And healthcare is not really the subject matter that I focused on when I was a staffer at the capitol. Obviously it's a major policy initiative, it's a huge budget driver for any state and at the federal level, but my principal area of focus and expertise when I was a staffer at the capitol was public education finance. School finance is, especially in the state of Texas, an incredibly complex topic. And I was really drawn to the question of, ‘do you get the education you can afford or is there a compelling public policy rationale for making sure that everyone has access to what we described in Texas as an equitable and excellent public education?’ There are a lot of ways that healthcare and public education were along those same themes. If you take that same logic and apply it to healthcare, ‘do you get the healthcare that you can afford, or is there a compelling public policy rationale for why we should have a healthcare system to elevate the health of the entire community?’ And so dealing with and wrapping my head around those types of questions, I was just always really fascinated by the outcomes. I'm a big proponent of the free market and I think that there is a lot of good that private industry can have in both the education space and the healthcare policy space.”
Steven: “I'm really interested to hear about your experience working with a large insurer and what you learned from that and how that informed the work that you're doing with Sedera.”
Jenny: “Healthcare has evolved tremendously in the last couple of decades and as it has grown in complexity. The desire for patients and employers, those of us who are the individual actors in this space, our desire to see it simplified and made easy has also grown. So the harder it gets to understand the more complex it feels, the more you feel like you're getting the run-around, the more you just want somebody to give you that super simple, easy button that's going to make it simple for you. I think when employers are shopping for care for their employees, they're looking for that easy button. But when you want something to be made easy, I think the temptation is that that takes away your incentive to understand it, to educate yourself about it, and to engage with it in ways that start to peel back the layers of the onion. So you want a one-stop-shop for your pharmaceutical needs, your employee wellness plan, your mental and behavioral health, your physical health, and you want it all at the place where you want to go, where you trust the doctor, and the hospital that you're going to get to. You want it all to be made really simple, easy, and packaged up nicely for you. And I think insurers have stepped up to the plate to try and do just that, to pull everything together, to bundle it all up, and to give you a single solution for everything under the sun. And while that might make it easy, at least from the outside looking in, it makes it crazy expensive. And that's where I think we are now in the situation where folks are like, ‘there's gotta be a better solution.’ But they don't know where to start because they've checked out of this process for so long. It's really hard to know which door to come through, to start to better understand how we got to where we are right now.
Mark: “Why is it just so hard to understand healthcare policy? Why does it just elude people and we wind up in these massive quagmires that we're in?”
Jenny: “So I might push back on you a little bit. I think that healthcare policy is not as hard as you think it is to understand if what you really are asking is, ‘Where are the dollars coming from and where are the dollars going?’ As soon as you can start to follow the flow of money, it starts to become a lot more comprehensible. I don't think that healthcare is complex because there is any one entity or a group of professionals out there who are intentionally trying to create complexity. I think that you have so many different players coming together to solve for a very complex problem, clearly health, and they're bringing their lens to how the problem should be. You just end up adding fix, on top of fix, on top of fix, on top of fix to the point where to unravel it means you have to ask every single participant in the system to let go of that thing that works for them and start from scratch. So everyone has their viewpoint on what's broken about the system, but they also have their viewpoint about what in the system works for them. And until all of the participants are either voluntarily willing to lay down the things that work for them in search for something that works for everyone or some other entity is able to force that to happen, you're just going to have everyone holding really tightly to their solution. We're all just coming from the place where we think what we're doing is virtuous and right and everybody else is who needs to make the change. Until you're willing to assess yourself and figure out what changes you also need to make, you're going to just keep running around in circles and pointing fingers.
To hear the whole conversation, click here for the full podcast episode. You can also hear more from Jenny by following her on Twitter at @atxjenny and @sederahealth. You can also check out the Sedera website to see the great work they’re doing in the healthcare sharing space.
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