March 30, 2020
Originally published in Deseret News.
My daughter recently had an appointment with a child psychologist at the pediatric clinic where we go for our kids’ healthcare. Due to concerns about spreading the novel coronavirus from one adult or child to another while waiting to be called back for an appointment, the clinic asked patients and their companions to wait in the parking lot for the clinic to send a text saying the psychologist was ready to see them. When my daughter was called, she was taken directly through the waiting area to the child psychologist.
My initial thought upon hearing this was a sense of relief that the clinic was taking steps to limit the spread of disease. My next thought was: “Why haven’t they done this before?”
This question in turn led me to a hopeful thought: What other kinds of innovations in the market for medical care are being inspired by the coronavirus pandemic that may improve healthcare for decades to come?
Pandemics have a history of changing the way we care for the sick. The 1918 Spanish flu pandemic, for instance, increased the national reporting of disease in the United States and led to more centralized systems of healthcare in many countries. So a pertinent question for today is: How will pandemic-induced medical care innovations change the future of healthcare?
To understand the importance of motivation in medical innovation, you have to recognize that the innovation of my pediatrician’s office has likely been feasible for a long time. For example, for many years commercial airlines — with a market in the hundreds of billions of dollars — have had texting services to notify passengers of flight delays or cancellations, so that they can avoid at least some unnecessary waiting at the airport. What healthcare — with a market in the trillions of dollars — has lacked was an external motivation and incentive pushing providers to offer such a service to patients. The coronavirus pandemic supplied that.
In addition to pushing my kids’ doctor to put everyday technology to use for the benefit of the patient experience, the pandemic has:
- Incentivized home delivery of prescription drugs, with two major pharmacy chains waiving fees for home delivery of medications.
- Prompted federal government officials to expand coverage for telemedicine services in the Medicare program, so fewer elderly patients have to risk getting COVID-19 by going into a doctor’s office.
- Revealed a need for expanded telemedicine capacity generally.
- Generated drive-up testing stations that allow patients to quickly and conveniently get tested for disease without being around other people.
What does this mean for the future of Utah and American medical care?
While the future is impossible to predict, you can envision a future in which the medical treatment norm is not to require sick people to congregate in a doctor’s office waiting area, but to diagnose and treat a sick person with as little exposure to healthy people as possible. A typical experience of medical care for basic illnesses could involve a video chat with your doctor (i.e. telemedicine), a trip to the drive-up testing center, if needed, and a delivery of a prescription a few hours later to your home. Innovation in medical care can have the dual impacts of protecting public health while maximizing the convenience and positive experience of the patient — a classic example of what a free market can deliver.
And that leads to one of the more important considerations of the future of medical care post-COVID-19. If the pandemic leads states and the federal government to embrace more market-driven healthcare policies — removing barriers to telemedicine, encouraging drive-up testing and home delivery of prescription drugs where such delivery is reasonable — then innovations can be better for everyone. Doctors and nurses can be exposed to less disease, on average, and multiservice hospitals can become less expensive to administer by using telemedicine. Patients can be put at less risk for spreading or contracting disease through telemedicine, drive-up testing and at-home prescription delivery.
On the other hand, if our response to this pandemic is to further centralize authority over healthcare in the hands of government — through Medicare-for-all schemes, for example — then we will further subject public health and patient well-being to the whims of politics and partisanship. Given the ways in which centralized government authority has exacerbated the coronavirus pandemic already — the communist Chinese government suppressing facts and information about COVID-19 at the very time a pandemic could have been prevented, and U.S. federal government decisions that limited coronavirus testing when broader testing would have helped limit its spread — the proper path forward is clear: Market-driven healthcare policy is the way to ensure both effective medical care and improved patient well-being (medical, emotional and financial).
Caring for children and families in vulnerable situations is an undoubted public priority, and everyone willing to provide good-faith help is needed.
The year 2021 has started fast and furious in the political space. Rioting at the U.S. Capitol and the banning of our president from certain big tech platforms like Facebook and Twitter have continued the national discussion about speech and ideas.
Ensuring that Utah civics education is adequate will take a statewide commitment from more than just the Legislature (and it’s usually better when it comes from more local decisionmakers), and it will demand that we avoid simplistic solutions about teachers or schools simply needing to “do better.”