TCS Daily

Congress Decides: Telemedicine or Telemonopoly?

By David Charles - June 8, 2001 12:00 AM

When telephones made their debut in America more than 125 years ago, the first customers in every small town and big city were the physicians and pharmacists. The connection between health care delivery and communications technology has been in place ever since.

Today, with a little help from public policy, America's telecommunications networks have the potential to become an integrated health care delivery system. The technology of telemedicine could drive down the costs and increase the availability of affordable health care.

Just what is telemedicine? It is the use of voice, data and video connections to link patients with medical services and information they need, even if the providers of those services are hundreds or even thousands of miles away. Telemedicine blends the best of medical and communications technology.

A woman in a rural community too small to have a first-class breast cancer clinic could have her mammography results analyzed instantly by cancer experts at a National Cancer Institute facility over a high-speed Internet connection. Patients with chronic conditions --- which account for 79 percent of health care spending today --- could be monitored with digital connections that instantly alert their doctors to a problem.

Two-way multimedia connections will allow physicians to conduct the virtual equivalent of an office visit examination by monitoring a patient`s EKG, blood pressure and other vital signs and talking with the patient while the patient rests comfortably at home

To deliver the benefits of telemedicine to the vast majority of Americans, especially in rural areas, we need a competitive market for high-speed Internet services that will expand their availability and drive down the cost. And here's where public policy has to help, because the state of competition in that market is in what hospitals call guarded condition.

Five years after the Telecom Act of 1996 was passed to open up America's local phone services market to competition, 95 percent of American consumers still have no other choice than their regional Bell company (SBC, Verizon, Bell South, Qwest). The Bell companies' unwillingness to give potential competitors the access they need to the Bells' local networks is forcing independent providers of high-speed Internet service out of the market.

And legislation now pending in the House known as the Tauzin-Dingell Bill, HR 1542, would permit the Bells into the data long distance business without first opening up their local markets to competition, as the Telecom Act requires. This would perpetuate the monopoly in local phone service and almost guarantee a new monopoly in high-speed Internet services.

The absence of competition means the absence of high-speed Internet access for rural hospitals and clinics. "From a historical perspective, the Baby Bells have not shown a great interest in serving rural areas," says Adam Schwartz of the National Rural Telecommunication Cooperative. Physicians practicing in small towns in middle America have reason to wonder if they will ever realize the promise of telemedicine when the Chairman of local telephone giant Qwest is quoted as saying "Iowa is a great place, but I could probably live without it if we lost the whole damn place."

By soundly rejecting HR 1542, the U.S. Congress could stand behind the promise it made to America in 1996 that we would have a fully competitive telecom market. And that would go a long way towards delivering the benefits of telemedicine to families of rural America.

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