Healthcare Access: Telehealth and Health Disparities in Urban Areas

This report summarizes and critiques a paper by Agate (2017) focusing on the importance of telehealth in the United States for improving access to care and reducing health inequalities, particularly for chronic diseases in underserved populations like those in rural areas, ethnic minorities, and older adults. The report highlights issues such as uninsured populations, language barriers, and cybersecurity concerns that hinder telehealth implementation. It references other studies supporting the relevance and economic benefits of telehealth, while also acknowledging its implementation costs and the need for government support. The analysis extends to Christian worldview, ethical considerations, and legal aspects, advocating for telehealth as a means to achieve equitable healthcare access and reduce the financial burden of healthcare, referencing Mississippi SB 2064 as an example. The paper concludes that implementing telehealth will reduce health inequalities and the burden of chronic diseases.

Running Head: HEALTHCARE
Overall Summary
The main healthcare issue highlighted in the paper Agate (2017) is the importance of the
application of the tele-health in the United States to increase the access of care and reducing the
health inequalities in the domain of managing chronic diseases like diabetes, obesity and the high
blood pressure. The Agate (2017) are of the opinion that people residing in the rural areas or
people who are from the ethnic minority background are regarded as undeserved population in
healthcare sectors as they have limited access to healthcare services. This lead to an increase in
the rate of occurrence of the chronic disease. Agate (2017) also stated that older adults residing
in the urban and suburban areas also experience problem traveling to their doctors’ chambers for
frequent checkups.
The article highlighted that the main victims of the lack of proper access to healthcare in
the U.S are the Hispanics and the Latino population. Another important problem highlighted in
the article of Agate (2017) is increased amount of uninsured people in the U.S creating health-
related disparity. The Affordable Care Act (ACC) was implemented to close the uninsured gap.
However, the majority of the Latinos still lack adequate access to healthcare insurance.
Language is highlighted as another barrier inadequate access to healthcare service.
Lack of proper access to healthcare and inability to implement tele-health in the
healthcare sectors due to issues with cyber-security and digitalization increase the healthcare
barrier further among the Latinos. Page (2014) stated that increased healthcare barrier hampers
economic and social factors of the country (public). The providers are also affected as
introduction to new tele-health services require rigorous training of the healthcare providers
increasing the economy investment of the healthcare sectors (Page 2014). Moreover, under social

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context more work-force from diverse culture is recruited to manage the language barrier in tele-
health and this further increases the cost of managing diverse work-force (Page 2014). Agate
(2017) recommended active government support for conducting telehealth pilot programs for
comprehensive implementation and widespread success of telehealth.
Critique
The issue is extremely relevant to the present day healthcare system. The study conducted
by Bhutta, Sommerfeld, Lassi, Salam and Das (2014) stated that lack of proper access to
healthcare in the rural areas has increased the global burden of health both in the domain of
infectious and non-infectious diseases. Vassilev et al. (2015) stated that implementation of tele-
health for self-management of the disease is not effective over the indigenous population like
Latinos due to lack of proper adaptation of the digital language. However, Dorsey and Topol
(2016) stated that though tele-health has wide-spread advantage in the healthcare sectors, its cost
of implementation is high.
Under the economic issue, it can be stated that application of tele-health can save U.S
economy by $3.61 billion per year. Under worldwide basis, the application of telehealth will
ensure remote patient monitoring for chronic diseases saving $197 billion Agate (2017). The
economic implication presented by Agate (2017) is relevant as it coincides with the data
highlighted in the study of Henderson et al. (2013). Henderson et al. (2013) stated that telehealth
is cost-effective for patients with long-term conditions and is helpful for the overall states
economy. Under social and political perspective, Agate (2017) stated that in order to implement
tele-health in wide social sectors and to bring change in the social healthcare awareness, the
government and federal agencies must come forward with proper funding for conducting pilot

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projects. This social and the political perspective of the paper is relevant under the current
practice as Van Dyk (2014) stated that political agenda of promoting social health can be done
only when the political parties and the ruling government issue funding for the implementation
of the pilot projects.
The presentation is not biased as it uplifted balanced argument behind the reasons behind
health-inequalities among the racial and the ethnic minorities or the older adults, the role of the
government in the healthcare practice, the current scenario of the Affordable Care Act and the
barriers behind comprehensive implementation of tele-health. Agate (2017) article was never
biased as it never hold government to be solely responsible for the health-equality. It highlighted
all the poor socio-economic determinants of health in order to validate his argument.
Options
In the domain of cost and the cost-related benefits, two pros include, implementation of
the comprehensive tele-health service will help to improve the economy nation-wide by
decreasing the cost of care, unwanted hospital visits and creating provision for remote
monitoring. It will also decrease the prevailing health-inequality leading to improvement under
the economic status of the race (Agate, 2017). However, cons are, implementation of tele-health
will required training of the health-service providers in telehealth service and thereby increasing
overall expenditure (training cost) of the healthcare organization. Another pros under the
political backdrop is, the author recommended Medicare coverage for telehealth services in order
to decrease the healthcare cost further. However, this approach is useful for the people hailing
from the ethnic minority, it will increase the overall burden over the administrative body. This is
because, the government will once again need to calculate the premium and then set the bar of

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coverage for the telehealth service. Thus the overall premium of the Medicaid service will be
increased leading to financial burden and hampering the fairness of the implementation of the
new healthcare policy (Markus, Andres, West, Garro & Pellegrini, 2013).
Christian worldview, legal and ethical considerations
According to the Christian Worldwide View, god or Jesus determines what is right and
what is wrong and what God decides, the Christians are ought to follow-it. Christianity values
charity. Charity here means love. God is love (1 John 4:8). All the humans are commanded to
love neighbors as they love themselves (Mark 12:31) (Lewis, 2001). Under this context, it can be
said that the African-Americans, Non-Hispanic population and the Latinos are the immediate
neighbors of the main race of the American population. Thus, their health and well-being can
never be discriminated or neglected. It is the duty of the government of loom after the health of
the Latinos and frame healthcare reforms targeting their health just they do for any other
Americans. The literature of Agate (2017) emphasizes equitable healthcare support for all by
introducing comprehensive implementation of tele-health, overcoming all the barriers.
The main ethical pillar of Christianity that is highlighted in the article is the ethics of
Justice that is equal Justice for all. Justice in healthcare means treatment or the healthcare service
is being made available to all societal group of people equally (Beauchamp & Childress, 2001).
The article of Agate (2017) mainly highlights the Christians view to equal justice for by
introducing the concept of tele-health in the wide-spread healthcare sectors. Agate (2017) stated
that implementation of tele-health will help to reduce the prevailing health-inequalities in the
rural population or ethnic minority people by generating provision for equitable and easy access
of healthcare for all irrespective of social background and financial status.

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The legislator must support this bill as it promises to reduce the prevailing health
inequalities along with the reduction of the chronic, non-communicable diseases by
implementing tele-health in healthcare. This technological revolution in healthcare is expected to
reduce the overall healthcare cost and thereby helping to decrease the escalating financial burden
of healthcare over nationwide economy. Under the provision of the Mississippi SB 2064
proposed Bill it can be stated that implementation of the tele-heath upheld the concept of
distance learning and delivery of healthcare in remote locations. It also helps to ensure minimum
healthcare standards and can prove to be helpful in implementing healthcare awareness in remote
schools (Reynolds & Maughan, 2015).

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References
Agate, S. (2017). Unlocking the Power of Telehealth: Increasing Access and Services in
Underserved, Urban Areas. Harvard Journal of Hispanic Policy, 29, 85. Retrieved from:
https://search.proquest.com/openview/4e8d71e1128fd127de681be579cef77c/1?pq-
origsite=gscholar&cbl=30599
Beauchamp, T.L., Childress, J.F. (2001). Principles of biomedical ethics. 5th. New York:
Oxford University Press.
Bhutta, Z. A., Sommerfeld, J., Lassi, Z. S., Salam, R. A., & Das, J. K. (2014). Global burden,
distribution, and interventions for infectious diseases of poverty. Infectious diseases of
poverty, 3(1), 21. https://doi.org/10.1186/2049-9957-3-21
Dorsey, E. R., & Topol, E. J. (2016). State of telehealth. New England Journal of
Medicine, 375(2), 154-161. DOI: 10.1056/NEJMra1601705
Henderson, C., Knapp, M., Fernández, J. L., Beecham, J., Hirani, S. P., Cartwright, M., ... &
Doll, H. (2013). Cost effectiveness of telehealth for patients with long term conditions
(Whole Systems Demonstrator telehealth questionnaire study): nested economic
evaluation in a pragmatic, cluster randomised controlled trial. Bmj, 346, f1035.
Lewis, C. S. (2001). Mere Christianity. New York, NY: HarperCollins.
Markus, A. R., Andres, E., West, K. D., Garro, N., & Pellegrini, C. (2013). Medicaid covered
births, 2008 through 2010, in the context of the implementation of health
reform. Women's Health Issues, 23(5), e273-e280.
https://doi.org/10.1016/j.whi.2013.06.006

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Page, T. (2014). Notions of innovation in healthcare services and products. Loughbourough
University. Retrieved from: https://dspace.lboro.ac.uk/dspace-jspui/handle/2134/17185
Reynolds, C. A., & Maughan, E. D. (2015). Telehealth in the school setting: An integrative
review. The Journal of School Nursing, 31(1), 44-53.
https://doi.org/10.1177/1059840514540534
Van Dyk, L. (2014). A review of telehealth service implementation frameworks. International
journal of environmental research and public health, 11(2), 1279-1298.
https://doi.org/10.3390/ijerph110201279
Vassilev, I., Rowsell, A., Pope, C., Kennedy, A., O’Cathain, A., Salisbury, C., & Rogers, A.
(2015). Assessing the implementability of telehealth interventions for self-management
support: a realist review. Implementation Science, 10(1), 59.
https://doi.org/10.1186/s13012-015-0238-9