Not So Fast Washington, DC – Don’t Just Do Something, Stand There! by Robert Nelson, MD

Labtop.stethoscope.iStock_000017019201MediumTelehealth? Absolutely!  –  AND it should be under the control of the real stakeholders – Patients and Doctors! And the participation and consumption of telehealth should be tied to REAL market signals which allow price transparency, thus determination of value to the end users.

Washington, DC-initiated, top down control masquerading under a cool sounding name like “Connected Care”?  –  Not so much!  

Introducing the newest catch phrase – “Connected Care” – and the latest attempt at bureaucratic mismanagement of a potentially great thing: Telemedicine. While it sounds benign on the surface, even something we can/should get behind, let’s not forget the other misnomer produced by the oxymoronic “Affordable Care Act”; that is neither affordable or has anything to do with real care. But I digress.  

Check out the the title of this article and the newest Washington-hijacked parlance:  Connected healthcare is our future, if Washington acts | TheHill. -By Former Sens. Tom Daschle (D-S.D.), Trent Lott (R-Miss.) and John Breaux (D-La.)

Call me paranoid (I prefer astute reader of between-the-line messages), but here we go again with the ” government must act” rhetoric.  Just like any good magician’s act,  misdirection political-speak tactics start with some facts and/or positive attributes about something that needs to be advanced (The Pledge).  It then goes on to point out the unfortunate circumstances getting in the way or how “unfair” it is that “everyone” doesn’t get to reap the benefits (The Turn).   The final part of the act is where we get fooled with “magic” that convinces us that only government action can solve, improve or otherwise look after us to make sure things get done for our benefit (The Prestige).

OK, let’s review the magic act in slow motion to see if we can find the slight of hand “trick”.  Former Senators Tom Daschle, Trent Lott and John Breaux are co-chairmen of the Connected Care Alliance (Alliance for Connected Care ), a diverse coalition of companies dedicated to patient access to care through advanced technology.  – Yeah, that sounds like a real grass-roots, organic movement doesn’t it? The mission of the Alliance for Connected Care should tell us all we really need to know about where this is headed. Here is the quote from their website regarding the “Overall Goal”, ostensibly,  of ACC:

“…formed to create a statutory and regulatory environment in which every medical provider in America is permitted to deliver, and be adequately compensated for, providing safe, high-quality care using Connected Care at his or her discretion, regardless of care delivery location or technological modality…”

Translation: The elites must be in charge of protocols, standardization, regulation, reimbursement guidelines, and of course making sure only the “right companies” pass muster to participate in product offerings.  Do you think just maybe the former Senators and their business associates might stand to benefit from a certain “statutory and regulatory environment” with regards to telemedicine?  Do the terms “conflict of interest” or “crony capitalism” come to mind?

The “regardless of care delivery location” clause is also a potential backdoor to Federal licensure of physicians, but that is for another discussion.  Back on point.  

So my paranoia is creeping back in again, right?  OK so I am paranoid, but for good reason; and so should you be.  Be afraid, be very afraid of this kind of political speak in all its nefarious forms.  

The Alliance’s position implies that there are these huge impediments to telehealth because providers are not “permitted” or not “compensated” for “high quality health care “using connected care at his or her discretion”. “Horse Hockey” is all I can say to that trail of smelly tidbits. This is nonsense and should be rejected outright. Have we not learned anything from the debacle of managed care that is fueled & propagated by government-private collusion? Let’s not make the same mistakes we made 40 years ago when the medical profession, with the aid of politicians, allowed the encroachment of third parties.

Telehealth IS being done successfully (albeit some growing pains) right now in many innovative ways on many fronts and for many uses. It is evolving and innovating because of the talents and creativity of thinkers, problem solvers and entrepreneurs. It is organic and has a healthy tie to a real market, and thus far not distorted, stifled and regulated by a corrupt government-private collusion operating under the pretense of nice sounding words like “access – delivery – quality  or safety”.

Guess what? Providers ARE getting compensated for Telehealth by the only stakeholders that really matter: The patient. They are paying a fair price for lifestyle friendly, convenient access that was heretofore not available because of the restrictive contracts and complicated revenue cycle brought to us by third-party networks.

And guess what else? It is being done without insurance at a affordable price. Imagine that?!

It should not be hard to see how the “formula” proposed by the Connected Care group will mess that up; similar to how third-party networks & Medicare, and the regulatory controls that come with it, messed up the Healthcare economy of for three generations of Americans. What it gave us was a economically perverse, inflationary, impersonal, inflexible, non-value based system that should be left on the dust heap of history.

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Telemedicine Survey