State Governments Erect Barriers to Pandemic Fixes

Democratic candidates continue debate massive overhauls of the American health care system like a public option or single-payer health care as COVID-19, popularly known as coronavirus, spreads across the country. Yet telemedicine, a major transformation to the health care industry that couldtruly help the industry address COVID-19 and future pandemics, while saving consumers time, money, and effort, is absent from these conversations.

Telemedicine, or connecting patients remotely with medical professionals, is not a new concept, but continuing innovations in medical and video conferencing technology has made it more viable.

Telemedicine offers significant benefits to consumers, particularly those without easy access to a physical medical practice. Over 79 million Americans have been identified by the Department of Health and Human Services as living in an area lacking easy access to medical professionals, many of whom suffer from chronic conditions and are uninsured.

Telemedicine can ameliorate some of these issues by limiting the need for physical office visits, allowing patients to access inexpensive medical care with no more than an internet connection and a camera. That can help prevent more serious issues down the line, while also helping consumers save money on hospital stays and emergency room visits.

It has the potential to be an important tool for combating COVID-19. Telemedicine could aid disease spread prevention efforts by enabling Americans who believe they may be infected to easily access medical advice. A fear with coronavirus is that some Americans infected with a mild case may pass their symptoms off as the flu or a bad cold, allowing the disease to spread further — patients that decide to avoid the hassle and expense of a doctor’s visit for mild to moderate symptoms may still be willing to make a quick remote video conference with a doctor.

This has clear benefits for medical professionals, as well. More than 3,300 healthcare workerstreating patients suffering from the virus have been infected by the virus themselves already. Yet if it was the standard for patients dealing with flu-like symptoms to check them first remotely via video conference, medical workers and fellow patients could avoid infection from emergency room patients who arrive thinking they have a bad case of the seasonal flu. Telemedicine also ensures that hospitals are not clogged, saving space and capacity for high-risk populations who need urgent care.

So what’s stopping the more widespread adoption of telemedicine in our healthcare system? Layers upon layers of red tape, piled on by state governments and licensing boards.

The most significant barrier is the lack of medical license reciprocity. A medical license enables a doctor to practice in that state, and that state alone. Technically, a doctor who video conferences with a patient is practicing medicine in the patient's state, not their own - meaning that the doctor must have a license for every state that patients call from.  Given that telemedicine is generally used for very basic functions like renewing prescriptions or diagnosis of common ailments, this barrier makes little sense.

Obtaining a medical license in all 50 states is impractical to say the least. While 29 states have made efforts to increase medical license reciprocity through the Interstate Medical Licensure Compact(IMLC), it’s not a perfect solution. License fees for each state in the compact would cost over $16,000 — a significant cost just to become licensed in a bare majority of states.

The telehealth industry faces other barriers, as well. Payment parity for equal service from government insurers is only the law of the land in 28 states, medical professionals could face additional malpractice insurance costs from their exposure to a far greater number of jurisdictions, and telemedicine practices could face greater privacy law compliance costs due to being required to comply with many states’ privacy standards, rather than just one.

Telemedicine has the potential to be a far more useful resource in combating major pandemics, as well as in providing day-to-day healthcare, than it currently is. But that can’t happen until state government bureaucrats get out of the way.