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September 19, 2020 12:00 AM

Act now to build on painful lessons learned during the pandemic

Sen. Lamar Alexander
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    Sen. Lamar Alexander

    In this social-media age, attention spans are short. Even with an event as devastating as COVID-19, memories fade and our attention moves quickly to the next crisis. That makes it imperative that Congress act this year, while we have our eye on the ball, to take advantage of the most important lessons learned so far during this pandemic.

    Make telehealth changes permanent. The COVID-19 pandemic has forced the industry and federal and state governments to cram 10 years’ worth of telehealth experience into a few months, resulting in one of the most dramatic developments ever in the delivery of medical services.

    I recently heard from a psychiatric nurse practitioner in Nashville who has been seeing patients virtually during the COVID-19 pandemic using telehealth. She told me about an elderly patient who, before COVID, got to her medical appointments by walking from her apartment to catch a bus and then walking from the bus stop to the clinic.

    When the patient arrived at the clinic she had to wait for her appointment, and when the visit was over, she had to take all of these steps in reverse. Because of telehealth, this nurse said her patient was in tears of appreciation because now she could have appointments without leaving home.

    Sen. Lamar Alexander (R-Tenn.)

    SERVED SINCE: 2003, now in his third term; he is not seeking reelection and retiring at the end of this year.

    HEALTHCARE-RELATED COMMITTEES: Chair of the Senate Health, Education, Labor and Pensions Committee. Also serves on the Senate Appropriations Committee’s Labor, Health and Human Services, Education, and Related Agencies Subcommittee.

    When the patient arrived at the clinic she had to wait for her appointment, and when the visit was over, she had to take all of these steps in reverse. Because of telehealth, this nurse said her patient was in tears of appreciation because now she could have appointments without leaving home.

    In 2016, there were almost 884 million visits nationwide between patients and physicians, according to the Centers for Disease Control and Prevention.

    The CEO of Ascension St. Thomas Health—which has nine hospitals in middle Tennessee and employs over 800 physicians—recently predicted to me that 15% to 20% of the system’s visits between patients and physicians will be conducted through telehealth in the future. If that holds true across the nation because of telehealth expansion during COVID-19, it would annually produce hundreds of millions of new telehealth visits.

    Congress and the Trump administration reacted to the pandemic by creating a regulatory environment that made the current telehealth boom possible by allowing, among other flexibilities: in-home virtual visits; telehealth for patients in rural areas; telehealth from physical therapists, speech language pathologists and other providers; telehealth for many more services including emergency department visits; and allowing Medicare hospice and home dialysis patients to start their care with a virtual visit.

    We need to make these extraordinary gains permanent.

    Preparing for future pandemics. We must also use this time to take the necessary steps to prepare our country for the next public health crisis. Legislation I have introduced takes steps to prepare us for the inevitable next threat by boosting the nation’s response capacity in three main areas:

    • Onshore manufacturing: New sustained funding—$5 billion over 10 years—to maintain sufficient manufacturing for tests, treatments and vaccines so that when a new virus emerges, the U.S. has facilities ready to manufacture those products as quickly as possible.
    • State stockpiles: New sustained funding—$10 billion over 10 years—so states can create and maintain their own stockpiles of supplies such as masks and ventilators with help from the federal government.
    • Federal stockpiles: We must boost the federal Strategic National Stockpile by allowing the federal government to work with companies to maintain additional supplies and manufacturing capacity.

    There is also broad agreement about additional steps Congress needs to take. These include improving disease surveillance, enhancing coordination of pandemic response, and restoring support for our state and public health systems, which former HHS Secretary Mike Leavitt describes as being badly underfunded for the last 30 to 40 years.

    Congress should take all of these steps now to make permanent the extraordinary progress we have made in such a short time on telehealth, to keep vaccine manufacturing on our shores and to maintain our stockpiles. We can’t afford to lose our focus.

    The 116th Congress: Policymaking Amid the Pandemic

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