Bashshur R L, Neuberger N, Worsham S
Department of Health Management and Policy, University of Michigan, Ann Arbor, USA.
Telemed J. 1995 Fall;1(3):249-55. doi: 10.1089/tmj.1.1995.1.249.
The new federalism is now taking hold in Washington, with far-reaching implications for the role of the federal government in health, education, and welfare programs; financial support for such programs; and the shift of control to the states. For telemedicine, the implications of these changes include having to make do with less external financial support and a need to establish partnerships between state and local governments, public sector developers and vendors, third-party payers, and community-based telemedicine programs. The long-term challenge for telemedicine programs, particularly in rural, medically underserved areas, is likely to be their sustainability in an adverse financial environment. The problem is further compounded by the lack of reimbursement for teleconsultations.
新联邦主义如今正在华盛顿落地生根，这对联邦政府在医疗、教育及福利项目中所扮演的角色、此类项目的财政支持以及控制权向各州的转移都有着深远影响。对于远程医疗而言，这些变化的影响包括不得不依赖更少的外部财政支持，以及需要在州和地方政府、公共部门开发者与供应商、第三方支付方以及社区远程医疗项目之间建立伙伴关系。远程医疗项目面临的长期挑战，尤其是在农村医疗服务欠缺地区，很可能是在不利的财政环境下维持其可持续性。远程会诊报销的缺失使问题更加复杂。
