What Trump Has Done to Change Health Care and How It's Helped Battle COVID-19

www.nationalreview.com
6 min read
fairly difficult
Deregulation and market forces are making care more available at lower cost.
(DragonImages/Getty Images)



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 (see our assessment a year ago), 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.

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In pursuing its vision, the administration has aggressively pursued its options under current law. We now need Congress to make the revolution complete.

Virtual Medicine. The ability to deliver medical care remotely is growing by leaps and bounds. It promises to lower medical costs, increase quality, and reduce the time and travel cost of patient care. For example, most people in hospital emergency rooms don't really need to be there. With a phone or a computer and an app or two, many of them could be examined and triaged in their own homes.

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.

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Two things made radical change possible: COVID-19 and the Trump administration. Sweeping away the regulatory barriers to…
John C. Goodman, Marie Fishpaw
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