by Mitch Kokai
Senior Political Analyst, John Locke Foundation
Our health-care system is experiencing rapid, powerful change, far more consequential than is generally recognized. Although these changes are welcomed by many in the health-policy community, … even those who applaud them have been surprised at their speed and impact.
What follows is a brief overview of what the Trump administration has done to reform the health-care system — in some cases, with the compliant help of Congress. The vision behind the Trump reforms can be found in Reforming America’s Healthcare System Through Choice and Competition. This 124-page Health and Human Services document from 2018 argues that the most serious problems in health care arise because of government failure, not market failure.
In pursuing its vision, the administration has aggressively pursued its options under current law. We now need Congress to make the revolution complete. …
… The benefits of telehealth have been known for a long time. Yet as we entered 2020, it was illegal (by act of Congress) for Medicare doctors to consult with their patients by phone or email, except in rare circumstances. Even non-Medicare patients were constrained. For example, it wasn’t clear if visual communication by Zoom or FaceTime satisfied the federal government’s privacy regulations. While some state governments were clearing away barriers, progress was incremental and uneven.
Two things made radical change possible: COVID-19 and the Trump administration. Sweeping away the regulatory barriers to telehealth was not a simple act. …
… The take-up by doctors and patients has been nothing short of breathtaking. According to CMS, between mid-March and mid-June of this year, more than 9 million Medicare beneficiaries alone received a telehealth service — including more than one in five beneficiaries who live in rural areas and almost one in three beneficiaries who live in cities.