The immediate costs of the coronavirus have already proven astronomical, with small businesses forced to shut down as increasingly workless workers must isolate themselves from a global pandemic. After a record period of growth, markets have fallen back into bear territory, and our economy is likely to contract in the next quarter by some estimates, perhaps by double digits.
But, when the dust settles, the virus abates, and the sun rises over the global economy, there may be one revolutionary transformation in the nation for the better: our healthcare.
For decades, HIPAA has strangled the healthcare system, preventing providers from communicating with patients and sharing health data with other experts. Although the initial rationale for HIPAA, to protect patient privacy, may have been well intended, it has also meant that, even as every other sector of the economy embraced the most advanced information technology, doctors have lagged behind. They are forced to use antiquated electronic medical record systems and to communicate with patients primarily in person.
Because of the coronavirus, that is all about to change, at least for the time being.
As a part of the White House's emergency measures to expedite coronavirus coverage, the Department of Health and Human Services has waved HIPAA to allow for expanded telemedicine. Rather than force potentially contagious patients to see doctors in person, the Trump administration's decision will allow patients to use the phone or FaceTime for virtual visits and keep their providers updated through online patient portals. Medicare coverage will be expanded to cover telehealth programs, and President Trump has asked private insurers to follow suit.
And, if such changes last after the coronavirus crisis comes to a close, our healthcare will likely become substantially cheaper and more immediately accessible.
Currently, a patient experiencing a bad sore throat has the choice to wait weeks to see his primary care physician or else pay a substantial amount to go to urgent care. He may be directed to an ear, nose, and throat specialist at an additional cost. But, with a widespread waving of HIPAA regulations over telemedicine, every patient in the country could be better served by either integrated managed care consortiums, such as Kaiser Permanente, or direct primary care models, such as One Medical.
Both of these models are capable of offering telemedicine visits, often administered by highly competent physician assistants or registered nurses, because they rely on patient membership more than on fee-for-service payments. Kaiser does so by serving as patients' internal insurance providers. Budget DPC models such as One Medical have a low annual membership fee with few costs for insured patients. In the past, only expensive boutique "concierge care" models didn't take insurance, but startups such as Forward cover uninsured patients for just $149 a month.
Kaiser and One Medical can do this because patients aren't paying to see their preferred physician. They're paying to get immediate, efficient care. You may wait weeks to see your private practice physician, who is financially incapable of circumventing the HIPAA stipulations that render telemedicine so difficult. But, with ample overhead and the cost-cutting of salaried (and often nonphysician) healthcare providers, Kaiser and concierge care models can offer a virtual visit with a perfectly qualified stranger in a matter of minutes.
With families quarantined, individuals isolated, and the economy on the brink of recession, it's hard to find any silver lining in this panic. But HHS's temporary deregulation could cut ample costs for consumers and slash wait times far more than any "Medicare for all" or "skinny" Obamacare repeal ever could. It might even give lawmakers and regulators ideas about what to do next.
