Senator Brian Schatz championed telehealth before the Covid-19 pandemic made it commonplace.
As this Congress ends, Democrat of Hawaii is pushing colleagues to take up legislation to extend the Department of Health and Human Services’ pandemic rules that allow Medicare beneficiaries to more easily have virtual appointments with their doctors. His CONNECT for the Health Act to strengthen access to telehealth has the support of more than 60 senators, but it is up to party leaders whether to bring it, or another bill, to a vote.
House passed the legislation from Rep. Liz Cheney (R-Wyo.) with similar goals in July.
Schatz is concerned that nonpartisan analysts at the Congressional Budget Office could make reaching a deal more difficult than it needs to be.
Schatz has promoted access to telehealth since the Obama administration to lower costs and help patients get easier access to care, especially in rural areas.
Ben spoke with Schatz about how the legislative process might play out. The interview has been edited for length and clarity.
What do you expect from telehealth legislation from this Congress?
We will be able to extend the authorities that have been used in the context of the pandemic.
Whether we can make it last forever or not remains to be seen. But there is less and less resistance to enabling Medicare to reimburse for telehealth services and opening up about the types of telehealth allowable.
Why are legislators more open?
There was a terrible parade called among people who resisted telehealth on both the fiscal side and the quality of care side. We now have years of real-life data to show that telehealth saves money, increases utilization, and improves quality of care.
Democrats tend to like it because it increases the availability of care, and Republicans like it because it saves money.
What is the biggest challenge for telehealth legislation moving forward?
Congressional Budget Office.
I am not trying to blame the professionals there, but they are simply not allowed to book possible future savings. In their analysis, they can only factor into their cost projections any potential cost increases.
There’s no real-world evidence that telehealth costs more, but the quirks of the CBO results sometimes make it seem like it’s an expensive proposition.
How have you seen the telehealth policy conversation evolve over the years?
Before the pandemic, telehealth was seen by many as a possibility for the future.
But everything has changed. Now isn’t just the future of healthcare, it’s what we’re doing now.
I had to spend a lot of time explaining what telehealth was when I first got to the Senate 10 years ago. My colleagues’ eyes glazed over or looked off into the distance. From then on, I can have a two-sentence conversation and they become a co-sponsor of our legislation.
Ten years ago, if you told someone they were going to interact with their doctor through their phone, they would have considered that poor service. Now if you can’t interact with your doctor through your phone, people get frustrated.
The thing that worries me the most is that some of the new innovations may expire and we may go back to the Stone Age.
Where do you see telehealth fitting into the future of healthcare?
Telehealth is the future of healthcare.
It is a fact that personal visits will never be completely replaced. But we can protect those who are medically fragile from having to mobilize to go to the doctor’s office. People can access mental health services without the stigma of going to a psychologist or psychiatrist’s office, and money and time can be saved.
This is the only space in health care that is completely bipartisan and has zero downside.
OUR PREDICTION: Extensions to the health TV rules could come during the lame duck session after the election if senators include them in must-pass government spending legislation.
But there is time. The rules for Medicare beneficiaries do not expire until five months after HHS ends the Covid-19 public health emergency. That’s scheduled to end in January — though HHS could extend it — so the telehealth rules won’t be finalized until June.
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A 94-year-old woman is giving new meaning to the bluebird… and no, it has nothing to do with Twitter. Rita Melone created a playful, animatronic bird that sits on walkers used by older adults and provides companionship … and a reminder to use a walker to avoid falls.
Today in ours Pulse control podcast, Erin Banco talks to Ben Leonard about the Biden administration’s new national security memo on biodefense and pandemic preparedness. Plus, Micky Tripathi, national coordinator for Health IT, talks about the HHS deadline this month requiring healthcare organizations to share all electronic healthcare records.
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Medical care that was avoided In the first months of the Covid-19 pandemic, it could never have been invented, a new study has revealed.
According to the report by health data company Trilliant, patients skipped tens of millions of visits in the second quarter of 2020, and have not made them, despite an increase in visits since then.
More than two in five American adults delayed health care appointments until the end of June 2020 as the pandemic spread, according to the data published in the CDC’s Morbidity and Mortality Weekly Report.
Consequences:
- Elderly patients at high risk of delayed or missed care had increased death rates in 2020, according to a study.
- CDC has reported data suggesting that childhood immunizations fell 14 percent in 2020 and 2021 compared to 2019, with measles vaccines down 20 percent.
Another attitude: Zocdoc, a New York City firm that offers a medical appointment booking service, reported large increases in appointments for mammograms, skin cancer screenings and HPV vaccines, among others, in the last year compared to the previous year.
The Covid-19 pandemic has not spurred the countries to open their wallets to fight old scourges like polio, AIDS and malaria.
And this despite evidence that infections pose new risks: Polio spread to New York last summer. HIV rates grew up in San Francisco during the pandemic for the first time in a decade.
The latest fundraising hurdle was yesterday’s promising event for the Global Polio Eradication Initiative.
The initiative, a partnership that includes the Centers for Disease Control and Prevention, the World Health Organization and other global organizations and foundations received $2.57 billion in commitments toward its polio eradication strategy over the next five years.
She was seeking $4.8 billion.
The US pledged $114 million, less than 10 percent of the $1.2 billion pledged by the Bill and Melinda Gates Foundation.
This overwhelming response follows a disappointing September fundraiser for the Global Fund to Fight AIDS, Tuberculosis and Malaria, which missed its three-year $18 billion target by more than 20 percent. It received pledges of $14.2 billion.
What is happening: Rich nations face the prospect of recession and they borrowed heavily to fight Covid-19. Domestic economic concerns outweigh the lessons learned about the importance of disease prevention on a global scale.
Masks hinder people’s ability to understand and share emotions, according to a new study by researchers at McGill University.
Psychologists at McGill tested standard masks, as well as ones you can see, and found that the transparent face coverings were no panacea.
While people could read each other’s emotions when wearing transparent masks, unlike opaque ones, the transparent versions did not restore the ability to empathize.
