Abstract
Nurses are the advocates of patients as they represent their best interests. To effectively conduct their duty, it is vital that they liaise with members of congress to suggest the issues pertinent to healthcare. The purpose of this paper is to write a letter to three congressional members of the United States committee on finance. Ranking member Mike Crapo is a lifelong Idaho Senator who supports the bipartisan bill. One of the legislations he supports and is relevant for this letter is protecting critical technologies. The letter is also addressed to the Chairman of Senate Finance, Ron Wyden, the senator for Oregon known for his innovations. He is a bipartisan bill supporter who focuses on solving problems and advocating for tax codes that help families. Senator Debbie Stabenow is who has been working tirelessly to provide grants to marginalized communities such as the Tribe of Chippewa. Although many issues affect the delivery of care, the selected congress members of senate finance should prioritize subsidizing telehealth for people with chronic illnesses.
Introduction
Hospitals across the United States have been experiencing staffing shortages. The onset of COVID-19 compounded the problem by causing an overwhelming demand for healthcare professionals. The aftermath was insufficient care for people with Chronic diseases leading to poor patient outcomes and satisfaction. The use of technology such as the telephone became an alternative way for healthcare providers to get in touch with their clients. Notably, a study shows that among the member counties of the Organization for Economic Cooperation and Development (OECD), demand for telehealth starts when there is a 50% accessibility to telecommunication, and the proportion of elders is more than 10% (Wang & Wang, 2021). The United States is among the leaders in terms of internet penetration yet is still struggling with the use of electronic health.
Challenges in the Implementation of Telehealth Services
The healthcare sector continues to experience a wide array of challenges. For instance, the financial state of many hospitals in the country is fragile, with a third of the $4.1 trillion expenditure on healthcare going to cash flows (Cornaggia et al., 2021). The cost of healthcare for individuals with chronic diseases is increasing as the government cannot provide free medical services to all people. The burden on the family and friends who care for their loved ones is high, causing them to develop stress. The use of telehealth promises relief to many people whose economy is being derailed due to suffering from or caring for a relative with chronic illness.
Despite the promises of telehealth, its adoption remains challenging due to low investment in the area. Particularly, a large survey shows that hospitals and individual nurses do not want to adopt the use of the electronic health delivery due to a lack of reimbursement (Cornaggia et al., 2021). The doctors can spend significant time helping patients through the telephone, but their work is not compensated. In 2015, only $17.6 million in Medicare reimbursement was given to telehealth medical providers (Luthi, 2017). Resultantly, there is a lack of motivation for healthcare providers to work extra hours offering virtual care. Unless there are proper mechanisms for compensating the doctors, the penetration and usability of telehealth will remain slow.
Worse still, there are significant differences in the delivery of telehealth between urban and rural hospitals. For instance, the only regions where Medicare covers telehealth are those that are federally categorized to be rural and with a shortage of health professionals (Luthi, 2017). Moreover, there are eight specific types of healthcare providers that are allowed to deliver healthcare services (Luthi, 2017). The efforts of other licensed professionals in the healthcare sector are not recognized. Congress can make an effort to review such policies since there is a high demand for telehealth provisions, yet the availability of nurses and doctors is low. As long as a legal, medical professional, a person should be allowed to provide telephone services to their patient and receive payment for their work.
The disparity in technological penetration remains a hindrance in serving people in remote regions, but there is a possibility for positive projection if there are a few legislative changes. For instance, the adoption of the telehealth parity laws resulted in an increase of 8.5 PBS bonds and a 27% increase in bonds between 2005 and 2019 (Cornaggia et al., 2021). An extension of similar policies is needed to increase the telehealth delivery in other rural places. There should be tax reduction on internet services for people using their telephone to seek medical care.
Benefits of Telehealth
Many people can benefit from telehealth services, including those in regions with low internet penetration if audio is used as the medium for passing the information. The cost of transport is automatically reduced by using virtual services for people who need regular check-ups. Cutting down on healthcare expenses is a significant move in ensuring the sustainability of healthcare services. Noteworthy, there was a 50% increase in health expenditure from 2007 to 2017 (Snoswell et al., 2020). Using telehealth will help to reduce the high cost of medical care while at the same time making the service accessible to many people. Telehealth enjoys economies of scale and shifts some elements of care from the physician to the technologies such as monitoring devices.
In addition, telehealth offers an opportunity to develop services that are culturally appropriate and patient-centered. It reduces the mismatch in demand and supply of patients and providers. The healthcare professionals can work for more hours while at home and save time while caring for more people. Video conferencing is a better alternative in telehealth as studies show that although it is time-consuming, it provides more accurate diagnosis, fewer medical errors, and efficient treatment decisions compared to teleconferencing (Luthi, 2017). However, some patients may be uncomfortable with face-to-face meetings and instead have preferences for audios only. The healthcare providers can focus on value-based care and ensure that they choose a telehealth model that offers the most value to the clients.
Telehealth enhances emergency preparedness and coordination to save lives in critical moments. One of the lessons from the COVID-19 pandemic was that clinicians use telehealth from unaffected regions to meet the surge in healthcare demands in the most affected places. The telephone portal gives the public an avenue to report critical needs. For example, during hurricanes Ima and Harvey, a group of virtual first responders identified victims and coordinated with services such as ambulances to ensure they received prompt care.
Legislative Recommendations on Senate Finance Committee
The first recommendation is to provide tax relief to people who need a constant supply of internet access to manage their conditions virtually. For example, individuals using biomedical devices for monitoring their blood sugar levels or heart rate can have subsidized prices on their mobile internet and credit charges. The aim is to ensure that telehealth is used conveniently for the people who need it the most. Moreover, subsidizing the charges and offering tax relief may help relieve the burden on family caregivers. As a practicing nurse who was part of the COVID-19 first responder and works with patients who have chronic illnesses, I understand that diseases can cause a huge financial strain on people. Supporting the tax relief on telehealth will lead to improved funding which is a core wish of many nurses (“From patient, 2010). Therefore, the Senate Finance Committee can budget and strategize on ways to provide some tax relief for the people using telehealth services.
The next recommendation is to work with the telephone and internet providers to selectively improve accessibility in the remote regions. The people in rural areas, especially the elderly, are marginalized in terms of medical care because most graduates prefer working in urban areas where there are many opportunities (Sklar & Robertson, 2020). The Senate committee on finance can narrow the marginalization by offering more assistance to the people in terms of purposeful telephone penetration. Furthermore, by working closely with the providers, congress can bargain for a discount or pay over an extended period.
Furthermore, the Senate finance committee needs to allow more healthcare professionals to offer services to their patients and receive compensation for their services. Notably, the hospitals are currently spending 62.5% more on travel nurses than in 2020 (Harms et al., 2022). The implication is that there is a high demand for such professionals, yet Medicare does not allow them to provide their services using electronic channels. Instead of traveling, the nurses can offer their services through video conferencing at a lower rate and reach more people struggling to meet their cost of healthcare. Reimbursing the health workers for their telehealth services will motivate them to utilize the service more effectively and reduce overcrowding in hospitals.
Conclusion
Conclusively, telehealth has proven to have many benefits due to the increased healthcare demands. It ensures that the healthcare providers serve many people, especially those with chronic conditions that need continuous attention. However, there are many impediments to the delivery of such services due to the marginalization of rural areas, Medicare restrictions on reimbursement, and expenses of mobile and internet charges. The Senate can improve telehealth through tax waivers for tele-medical services, including more nurses in compensation for virtual assistance and increasing telephone penetration. Therefore, congress can consider including all the suggestions to promote healthcare delivery in the United States.
References
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From patient advocacy to political activism: AACN’s guide to understanding healthcare policy and politics. (2010). Washington, D.C: American Association of Colleges of Nursing.
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Luthi. (2017). Lawmakers Eye CHIP, Debt Bill, Other Vehicles to Repeal ACA’s Taxes. JSTOR, 20(32), 10-11.
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