01 September 2020
Telehealth is an American idea that seems to have been accepted by everyone during the coronavirus pandemic. It involves talking to a doctor on a computer or smartphone.
Medicare is America's government-paid healthcare for older Americans and the disabled. It changed its rules to permit doctors to use telehealth to see patients. Now there is a push to make telemedicine available to everyone in the future.
Talking to a doctor on a computer or phone increased a lot when communities shut down in early spring because of the virus. Telehealth visits decreased as things slowly reopened, but they are still far more common than before.
Expanding telehealth will involve creating a balance between cost and quality. Some are worried about privacy or fraud.
"I don't think it is ever going to replace in-person visits, because sometimes a doctor needs to put hands on a patient," said Seema Verma. She is the head of the Centers for Medicare and Medicaid and the Trump administration's leader in the movement for increased telehealth.
"It's fair to say that telemedicine...it's come of age this year," said Murray Aitken of the data company IQVIA. It studies the use of telemedicine.
During of the coronavirus shutdown, telehealth made up more than 40 percent of basic care visits for patients with traditional Medicare. Before coronavirus, it was only 0.1 percent of care.
As the government's main health care program, Medicare covers more than 60 million people.
A recent poll of older Americans by the University of Michigan Institute for Healthcare Policy & Innovation found that more than 70 percent of people are interested in using telehealth for follow-ups with their doctor.
Privacy, however, was an issue, mostly for those who had not experienced telemedicine. The poll found 27 percent of older Americans who had not had a telemedicine visit were worried about privacy. Among those who had tried telemedicine, only 17 percent were worried about privacy.
Many others who tried telemedicine did have some worries. About 80 percent were concerned the doctor could not physically examine them, and 64 percent worried the quality was not as good.
For Medicare user Jean Grady of Westford, Vermont, telemedicine was very effective. She was required to see a doctor by Medicare to continue receiving insulin for her wearable pump. She worried about possible exposure to COVID-19 at a doctor's office.
So, she talked to her doctor's technology expert and downloaded the suggested teleconference software.
She said she would do some future visits by video, but not all because, for example, she will need blood tests that are done in the office.
Many private insurance plans offer some telemedicine coverage.
In the past, traditional Medicare had restricted telemedicine to those who live far out in the country and had to travel long distances to see a doctor.
When the coronavirus hit the U.S., officials changed the restrictions so Medicare users could use telemedicine. Making such changes permanent would require legislation from Congress.
Senator Lamar Alexander is chairman of the Senate Health, Education, Labor and Pensions Committee. He says he would like to see greater use of telemedicine while keeping costs down.
The goal, he said, should be "better outcomes and better patient experiences, at a lower cost."
One of the big questions is: Should doctors be paid the same for a telemedicine meeting as they are for an in-person meeting with a patient?
While Congress wants to quickly pass new legislation, "I think it is worth taking a little more time," said Juliette Cubanski. She is a Medicare expert with the nonpartisan Kaiser Family Foundation. She, and others in the healthcare industry, are worried about fraud.
Andrew VanLandingham is a lawyer with the Department of Health and Human Services. He called telehealth "experimental." He worries about the unknown risks.
But many see the opportunities, especially in the areas of mental health and the treatment of chronic conditions.
I'm Susan Shand.
The Associated Press reported this story. Susan Shand adapted it for Learning English. Mario Ritter, Jr. was the editor.
Words in This Story
pandemic–n. the fast spread of an infectious disease over a very wide geographic area
fraud–n. the crime of using dishonest methods to take something valuable
data–n. information used to study or plan something
poll–n. a study in which people are asked what their opinion is and is meant to find out what the public thinks about an issue
insulin–n. a substance created by the body that helps turn sugar into energy
nonpartisan–adj. not linked to any political party
chronic–adj. something that happens again and a again over a long period of time