One of the most effective policy responses to COVID-19 thus far has not been a new government program or infusion of federal funding. Rather, it’s been the deliberate effort by the Trump administration to pare back regulations impeding access to health care.
That work must continue after the pandemic passes.
The dangers posed by heavy-handed government regulation were clear from the first days of the coronavirus crisis. One of the chief reasons it took weeks to ramp up testing is that federal regulations prevented private laboratories from assisting in the effort.
But after a slow start, the administration went on a deregulatory kick. Much of that deregulation has been in telehealth.
Telehealth systems enable patients to consult a doctor remotely using digital technologies like video conferencing. They’re crucial to mitigating the spread of COVID-19 during the height of the pandemic because they allow patients to get medical attention without exposing themselves or others to the virus.
Recognizing the value of these technologies, the administration expanded access to telehealth services by waiving a number of rules. First, it ensured that telehealth services were covered for all Medicare beneficiaries. Previously, only rural patients had coverage for remote care—and only after they had failed to get care from an in-person provider.
The Department of Health and Human Services also agreed not to enforce penalties under the Health Insurance Portability and Accountability Act for physicians who consult with patients through consumer apps such as Skype or FaceTime. Just as important, the administration waived licensing requirements so doctors could use telehealth systems to see out-of-state patients.
More recently, HHS rolled back the requirement that Medicare and Medicaid patients obtain a written request from a physician in order to be tested for COVID-19.
Each of these reforms eliminated rules that have never made much sense. At a time when video conferencing is now commonplace, there’s little reason to treat virtual consultations differently than face-to-face visits. Prohibitions on doctors practicing across state lines because of strict licensure regulations were nonsensical even before the days of telehealth.
But the administration didn’t just dismantle many of the regulatory barriers that reduce patients’ ability to access care. It has also streamlined the drug-development pipeline in order to accelerate the creation and distribution of potential COVID-19 therapies and vaccines.
For instance, the Food and Drug Administration recently eliminated some of the requirements governing distributors of prescription drugs so that medicines can reach their destinations more quickly and efficiently. The agency has also sped up the review process for clinical trial protocols for COVID-19 drugs, reviewing some protocols in as little as day.
Reforms like these have enabled drugmakers to respond to COVID-19 with unprecedented speed. Just a few months ago, nobody had heard of the disease. Today, dozens of clinical trials are underway for new treatments. A vaccine may be available later this year or early next.
In light of this success, it’s encouraging that the president has instructed federal agencies to review the regulations rescinded during this emergency to determine which rules should be eliminated permanently.
In the meantime, however, the administration should continue to look for regulations that deserve to go. It can start by relaxing the licensing and medical residency requirements that keep qualified doctors educated and trained abroad from practicing here in the United States.
States can loosen scope of practice regulations that restrict highly qualified healthcare personnel like nurse practitioners and physician assistants from delivering routine care or writing prescriptions without the supervision of a doctor. States can also give pharmacists full authority to administer routine vaccines.
The medical education establishment can pitch in, too, by shortening the length of medical school. Relaxing restrictions like these could drastically reduce the doctor shortage that is expected to reach as high as 121,000 by 2032.
For decades, red tape has frustrated the efforts of healthcare providers to deliver timely, high-quality care—and of patients to access the care they need. The pandemic has shown just how useless so many of those regulations were. Continuing that deregulatory drive will yield a more efficient, more responsive, and less wasteful health system that produces better health outcomes for all Americans.
Sally C. Pipes is president, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is False Premise, False Promise: The Disastrous Reality of Medicare for All, (Encounter 2020). Follow her on Twitter @sallypipes.