Basic Health Access

It has become common to promote innovations as solutions without sufficient testing and without really considering the possibility that the intervention might not work as planned. After decades of failure to resolve cost, quality, and access woes across medical error focus, managed care, managed cost, EHR/HIT, PCMH, alternatives to physicians, insurance expansion, and numerous forms of Pay for Performance - the cost, quality, and access problems remain. Telehealth deserves to be critically examined as a solution for rural or underserved populations. First of all, telehealth will be priced in a way that supports expensive medical personnel, managers, CEOs, and investors. There is no intent for service for those low or no pay or with worst insurance. This will require payment. Medicare and Medicaid patients will play a major role as they are concentrated in places with lowest concentrations of physicians. Indeed this is a major reason for shortages. These are the places receivi...

The 2010s have been a time of great claims of value from numerous innovations. While it seems that much is being done to help to improve health access, there has actually been very little change. The new proposals can actually undermine health outcomes and undermine the local workforce that is most important for access to care. Resistance to Telehealth may be futile, but there will be consequences that we need to understand. When High Tech and High Touch Go Wrong Telehealth has much surface appeal. High tech with the appearance of high touch has appeal. It seems so simple. After all in the photos or descriptions it appears that all you have to do is just link up and someone magically appears to address your needs . For the purposes of discussion we can leave behind the discussions of laws, licensures, privacy requirements, payment uncertainties, certifications, and also controversies regarding the quality of telehealth. There are a number of reasons why telehealth is...