OPINION: Telemedicine: A Preventive Measure Against Single Payer

New York State legislators ended this latest session without passing what may possibly be the most detrimental bill in state history. The New York Health Act (https://legislation.nysenate.gov/pdf/bills/2021/S5474) would have crushed small businesses, middle-class families, and a myriad of jobs within the health care and insurance industries. 

With a Democrat supermajority in the state legislature, certainly the votes are there to pass the first-of-its-kind universal, single-payer health-care system. This proposal has been at the forefront of the state Democrats’ agenda for decades and has passed the state Assembly five previous times. So, what has changed? Perhaps legislators have finally come to their senses. Could it be that unions and insurance carriers have lobbied the sense right into them? In a NY Now article, Assembly Health Committee Chair Richard Gottfried (D) said, “I think the public sector unions in particular are the main group that we need to work out issues with. I believe that if we and they can sit down at a table, roll up our sleeves, there are ways we can modify the language in the bill that can guarantee them that their concerns will be more than satisfied.”

That sounds like a carve-out for labor unions, to me. Meanwhile, the bill would hand the rest of the state’s population and out-of-state commuters a large payroll-tax bill to cover the extraordinary costs of managing a health-care system of this magnitude. This could be, in my estimation, the largest health-insurance disruption we have ever seen as it calls for the elimination of all health-insurance plans within the state including Medicare, Medicaid, employer group coverage, and individual coverage. Federal waivers are needed to allow for all of this. The uninsured population in New York state is less than 5 percent of the population, which is a historically low rate. No one has ever said that the system isn’t broken. We can and should work to do better and I think there are many other options available to assist in lowering the exorbitant cost of health insurance in New York state. The answer is not a one-size-fits-all, state-run health-care system. We have witnessed the runaway costs of Medicaid in this state and should expect no different result here. 

As an advocate and user of telemedicine, I have often believed that there are better methods for the delivery of health care while also making it more affordable and accessible to all. Telehealth is one way to achieve this objective. The COVID-19 pandemic, as burdensome as it was, thrust market alternatives into deliverables from practitioner to patient. Few business models skirted business interruption during the pandemic and 16 months of shutdowns. The crisis, however, created a forced opportunity to go through a process of business analysis to determine how to continue to compete, be profitable, and still provide excellent consumer experiences. Emerging technologies and development by health-care service providers have sped up growth in this market space. Telemedicine programs have become more widely used than ever before. As mobile devices, tablets, and laptops have become common personal items, the infrastructure for these types of services is more readily accessible. A tremendous growth opportunity is still present as usage increases and software development becomes savvier. Insurance carriers and medical programs like Medicare expanded the telemedicine opportunities to their subscribers at a time during the pandemic when people were hesitant to visit the doctor’s office. As a result, patients learned how to utilize and appreciate the service, whereas before COVID, they would have preferred to have face-to-face interactions with their physicians. Telehealth will not fully replace in-person care, but it presents an exciting opportunity to help lower costs and manage usage, especially unnecessary emergency or urgent-care visits for nonserious illnesses. Moreover, as we address the needs and care of all people in New York, telehealth should not just be thought of as a service for the insured. MDLive, Teledoc, and other web-based platforms are growing in popularity among both the insured and uninsured. Anyone with a mobile device can access these platforms, enter a few personal details, and receive medical care almost instantaneously in the privacy and comfort of their own home at a reasonable price. No insurance is needed. In an era where consumers, especially younger generations, want quick responses from their mobile devices, telehealth companies are delivering.

The question we must ask now is how can government work to help these networks bridge the gap between providers and the uninsured? Mandating higher payroll taxes and unsettling the entire industry is not the answer. However, I believe government can work with the industry to allow for innovative ways in providing access to care. Telehealth now has increased momentum pushing it forward into additional health-care areas for virtual services. Additional investment will be needed as health-care service developers fight for market share in this field. If focus and incentives can be given to expand these technologies and deliverables to consumers, while creating a competitive marketplace and retaining personal choice, rather than uprooting an entire system, this could be a win-win. In doing so, we provide better, more affordable care to New Yorkers instead of continuing the course of outmigration due to continually higher taxation. Let’s hope our legislators lead this initiative.              

Angi Renna is president of Sterling Financial Group, LLC, a Central New York financial planning and wealth-management firm. She is the host of a local podcast, called “CNY Matters.” Renna (R) was also a candidate for the NYS Senate seat in the 50th District in November 2020, losing to John Mannion (D) by about 5 percentage points.