Editor: When Delegate Dave LaRock voted against Medicaid expansion for Virginians in 2018, no one knew that a health calamity—a pandemic—was just around the corner. Happily, the House of Delegates passed the legislation over his objection.
A positive legacy of COVID-19 has been the rise of telemedicine in Virginia. Both Medicare and Medicaid have supported telemedicine services in Virginia since 2001, but Medicare considered distance services as a distinct (and restricted) form of healthcare, while Medicaid simply covered services based on the patient’s travel costs to obtain care—which consequently most benefits the rural poor.
It is a child’s fever spiking in the middle of the night, an elder’s fall, an adolescent’s mental health crisis, and a need for physical rehabilitation that telemedicine under Medicaid serves. It can bring Meals-on-Wheels, provide medication adherence, and allow patients to remain in their own homes instead of occupying hospital beds. And it can enhance what EMT’s can do in that “golden hour” after a stroke. In these and other ways, telemedicine can improve outcomes, reduce costs, diminish hospital readmissions and thereby make health a more achievable goal for more people.
Telemedicine is still in its early development. With new monitoring devices—wearable, ingestible and implantable—and artificial intelligence to interpret the data of individuals, patient sectors (e.g. all diabetics) and entire communities, we can anticipate new businesses—perhaps seen as hospitals without walls—and new occupations, such as telepresenters as a type of medical assistants.
Dave LaRock is not the kind of leader who can deal with a clear and present health calamity, nor is he someone who can anticipate future needs of an aging population. His focus on the culture clash in politics makes us sicker, not better.
Terry Sharrer, Waterford