Cutting out the Mickey Mouse Effect

Moving from Paralysis to Practically

Public Administration

November 9, 2020

Introduction

One of the most recognizable cartoon characters called Mickey Mouse. He typically wears red shorts, large yellow shoes, and white gloves and is characterized as a cheerful yet mischievous underdog, a strength that overcomes adversity. Mickey gradually gave his name to anything requiring considerable effort for slight results, like bureaucracy. (Shafritz, Russell, Borick, & Hyde, 2017). Red tape refers to excessive regulations that are redundant with administrative rules, causing delays and paralyzes decision making. President Trump said, “My Administration will continue pressing forward until we have made every last vestige of Washington fully, completely, and accountable to the citizens of the United States” (Shawn Lawn, 2020). “Bureaucratic approvals have damaged our cities, devastated our workers, drained our spirits, which has crippled our nation’s competitive edge. President Trump pledged to use the eraser instead of the ink to cut the red-tape, but within the rule of law” (Crews, 2020). Strict rules and regulations remain in force with barriers, and compliance restrictions must deregulate to liberate procedures. “President Trump aims to sunset and relax the regulatory abuse of power of federal agencies, which is a major reason for today’s proliferation of rules” (Crews, 2020). This paper discusses the current administration in action to liberate to stimulate and to build resiliency for the future by cutting the Mickey Mouse Red tape effect during the Covid-19 Pandemic associated with telehealth. Telehealth and telemedicine are used interchangeably in this context, but they may not always mean the same thing. (Crews, 2020)

Cutting Regulations

President Trump implies, “We fought to make sure that in America, health care is not just a privilege, but a right for every single American.” (Wallace, 2020) Over three years, the center of gravity of the Trump deregulatory program has been Executive Order 13,771, dubbed “Reducing Regulation and Controlling Regulatory Costs.” (Friedman, 2020) This directive requires significant rules. Agencies must eliminate at least two other laws. The aggregate net new federal regulatory costs may not be greater than zero (Friedman, 2020).

The Coronavirus (COVID) pandemic became an emergency threat. A million lives lost. Losing lives should not have been the ending factor. In countries like Korea, deaths leveled off because COVID testing was done with a ten-minute drive up with results in two to three days; however, US testing was nowhere near the national demands. If testing is unavailable, people will not know if they are infected, causing the disease’s spread. Increased exposure to COVID-19 may initially increase individual compliance and result in compliance decreases (Wang & Kapucu, 2008) and increased investments to address future crises (Zhang, Welch & Miao, 2018).

Without testing kits, we can’t correctly quarantine people. The government wanted complete control of America. The Centers for Disease Control and Prevention (2019) decided to develop a test, but it didn’t work. The government would not allow private labs to build a COVID testing kit. When labs attempted to create their test, they came up against a bureaucratic requirement that forces these labs to seek Food and Drug Administration (FDA) emergency approval that would take months or years to approve. Hundreds of machines are in the United States but not allow to test for the virus without FDA approvals. A practical action to take would immediately release the emergency equipment to save lives, but the government wanted control. The Trump administration finally waived the testing regulations, saying, “Do it! Ask permission later.” (Stossel, 2020) Telemedicine and telehealth are new efficient ways to evaluate patients. This process saves time and quick diagnosis of results given to patients. Another government concern is violating patient privacy by video visits, remote monitoring, scaping, and using a cellphone for advice, prescriptions, and diagnosis. Government approvals were delayed before the Patient’s Discretion Act was accepted. Telemedicine should have been legalized years ago.

Not enough doctors and nursing for the hundreds of sick patients in the world was a huge concern. Practicing from state to state was illegal; such violation is against state licensing rules. They were removing licensing barriers that stop nurses and doctors from providing services across state lines. Trump waived specific federal license requirements, so doctors from other states could provide services to the greatest needs. This regulation license waiver was critical. The impact of the COVID virus reports higher numbers in different states than others.

Under the Trump administration, laws have become relaxed and flexible to the people’s current needs during the pandemic. “The FDA has accelerated approval for coronavirus treatments as scientists develop them” (Marcoux, & Vogenberg, 2016). The FDA has lifted the regulations to streamline testing, the approval process for drugs, vaccines, diagnostic tests, and other medical equipment during the devastation.

Waiving regulations can take months or perhaps years, even when they are harmful. Trump’s new executive order is a start. It encourages agencies to use whatever emergency powers they need to hurry along the cleanup process.

Paralysis to Practicality

Moving from paralysis to practicality is how strict regulation would end. Federal and state policymakers have made it easier to access telehealth and or telemedicine during the pandemic to keep people home and safe. (Baker, & Stanley, 2018) This process has reflected tremendous and positive results. Telehealth offers a video visit as a virtual interactive appointment with the physician, and quick questions answered—communication of treatment given during the physician’s video visit—co-insurance expected with telehealth services. Board-certified doctors, including pediatricians, offers acute, non-urgent care through a national telemedicine network. According to the Centers for Medicare & Medicaid Services (2020), under the Trump administration, effective Jan. 1, 2020, there is no charge when you receive care through telemedicine.

Privacy Risk

“Telehealth visits protects patients’ privacy and personal health information. However, telemedicine does have intrinsic privacy and security risks that all providers must minimize to protect sensitive patient data” (Pennic, 2020). The same connectivity that makes telehealth possible also creates threats to patients. Protecting patient health information and providing remote services don’t fit together easily. (Pennic, 2020) Health Insurance Portability and Accountability Act (HIPAA) guidelines must be forced upon Medical professionals to comply with rigorous standards to be deemed compliant. Telemedicine HIPAA security rules should ensure only authorized users would have access to patient privacy information. Implement a secure communication system to protect the integrity of the patient’s health records. (Baker & Stanley, 2018) A monitoring communication system helps to prevent accidental or malicious breaches.

“Office for Civil Rights officials said the agency would exercise its enforcement discretion when providers use apps in good faith for any telehealth treatment or diagnostic purpose” (Landi, 2020).

Future Research

My thoughts on the preparation of post-COVID are researching our infrastructure to guarantee a healthy and robust workforce for the production of goods and services to determine the shortage of Personal Protective Equipment (PPE). This equipment should be produced locally and not depend on other countries to deliver. Consider a Physician Marketplace tool that allows all Physicians to volunteer where needed. This process would create more jobs in the public sector.

Conclusion

Telehealth and Telemedicine are likely here to stay, and there will always be a need for a personal visit, a remote consultant for convenience. Records reflect the Telemedicine is something that has been accepted by thousands.

“No administration in history has removed more red tape more quickly to rescue the economy and to protect the health of our people.” (Crews, 2020) Trump has ordered federal agencies to look for ways to make these healthcare reforms permanent by working closely with state, local, and leaders to streamline occupational licensing (Wallace, 2020).

Unfortunately, we were unprepared for this deadly disease that impacted all Americans. The COVID pandemic did spread a beam of light on our vulnerabilities and weaknesses worldwide. I feel we have become resilient and more robust Americans that will produce positive change in the future.

References

Baker, J. & Stanley, A(2018). American Academy of Allergy Asthma & Immunology: Security and HIPPA. Retrieved November 7, 2020 from https://www.aaaai.org/practice-resources/running-your-practice/practice-management-resources/Telemedicine/HIPAA

CMS. (2019) COVID-19 Resource | CMS.org. Retrieved November 8, 2020 from https://www.cms.org/covid-19/coronavirus-resources

Crews, C. (2020, July). Trump Administration Celebrates Red Tape Reduction, Promising More. Competitive Enterprise Institute. Retrieved September 2, 2020, from https://cei.org/blog/trump-administration-celebrates-red-tape-reduction-promising-more

Friedman, Z. (2020, August). Payroll Tax Cut Starts Today. Retrieved September 2, 2020, from https://www.forbes.com/sites/zackfriedman/2020/08/31/payroll-tax-cut-trump/#4bcee9f56e47

Landi, H. (2020, July). Fierce Healthcare. Trump administration opens up access to telehealth services during coronavirus outbreak. Retrieved November 7, 2020 from https://www.fiercehealthcare.com/payer/trump-administration-opens-up-access-to-telehealth-services-during-coronavirus-outbreak

Marcoux.R.M., & Vogenberg, F.R. (2016).Telehealth: Applications from a Legal and Regulatory Perspective. Pharmacy and Therapeutics (P&T). 41(9): 567–570. Retrieved November 7, 2020 from https://www.ncbi.nlm.nih.gov/pmc/articles/

PMC5010268/

Pennic, J. (2020, July). Telehealth and Cybersecurity: What You Should Know. Retrieved November 7, 2020, from https://hitconsultant.net/2020/07/22/telehealth-cybersecurity-what-you-should-know/#.X6cU1Ensa1s.

Shafritz, Jay M., Russell. E.W., Borick, C.P., & Hyde, A.C. (2017). Introducing Public Administration, 9^th ed. New York: Routledge.

Stossel, J. (2020, March). Red Tape Pandemic. Retrieved November 8, 2020 from https://triblive.com/opinion/john-stossel-red-tape-pandemic/

Wallace, C (2020, July) Transcript: Fox News Sunday Interview with President Trump. Retrieved September 2, 2020, from https://www.foxnews.com/politics/transcript-fox-news-sunday-interview-with-president-trump.

Wang, X., & Kapucu, N. (2008) Public Administration in the Time of COVID-19Journal of Public Administration Research and Theory.Volume 18, Issue (1), pp. 57-78.

Zhang. F., Welch, E. W., & Miao, Q. (2018) Journal of Public Administration Research and Theory. Volume 28, Issue (3), pp. 371-387.