On July 13 the Wall Street Journal ran an opinion column by Ateev Mehrotra and Barak Richman entitled, “A Cancer Patient’s Brutal Commute,” powerfully illustrating how state medical licensing laws that block telehealth across state lines can be cruel and inhumane.

The authors offered reform proposals, most of which worked within the existing regulatory framework. For example, they recommended states form interstate compacts that permit providers licensed in compact member states to provide telehealth services to patients living in member states.

To be fair, the authors did mention a 2019 Florida reform that permits Floridians to receive telehealth from providers licensed out of state, but implied it was a longshot to expect other states to follow suit. Maybe they were unaware, but a more comprehensive “universal telehealth” reform bill passed last May in Arizona.

They also failed to consider the idea of Congress defining the “locus of care” of telehealth to be the state in which the practitioner is licensed as opposed to the state in which the patient resides, as is currently how states define it.

I wrote a letter to the editor of the Wall Street Journal to commend the authors but also offer constructive criticism. Unfortunately, the editor decided against running it. So I am running it here:

Ateev Mehrotra and Barak Richman make a powerful case for removing the barriers that state licensing laws place in the way of providing telehealth services. (“A Cancer Patient’s Brutal Commute,” July 13). But they neglected to mention that, in May, Arizona enacted landmark universal telehealth allowing its residents to receive telehealth services–including audio-only services–from any health care practitioner with a license in good standing in any of the other 49 states and District of Columbia. This measure is broader than the reform adopted by Florida in 2019.

They also left out an important federal action for Congress to consider. As I said in my testimony before the Joint Economic Committee last September, “To the extent consistent with its authority to tear down barriers to interstate commerce under Article 1, Section 8 of the Constitution, Congress should define the ‘locus of care’ as the state in which the practitioner is located as opposed to the state in which the consumer of the service resides. While states have constitutional authority to regulate the practice of medicine for residents within their borders, crossing state lines to provide telemedicine or short‐​term in‐​person care can reasonably be classified as interstate commerce.”

In 2017 the Cato Institute published “Liberating Telemedicine: Options to Eliminate the State-Licensing Roadblock,” that offers these and other proposals to allow patients and health care practitioners to take full advantage of a technology that has long been underused.