Masha Zager

Current levels of broadband deployment subsidies should be maintained or increased over the next five years, but policymakers will need to change the way these subsidies are distributed. The base for the Universal Service Fund needs to be broadened and made sustainable. Except in the most remote areas, the standard for publicly subsidized broadband networks should be set at 1 Gbps symmetrical or higher to ensure that public investments will be usable for a generation or longer.

Access to health care is a critical problem in many rural areas of the United States. Few physicians choose to practice in rural counties, according to the National Rural Health Association, yet the rural population is, on average, older and more in need of medical care. Census Bureau data show that 18 percent of the rural population is age 65 or older, compared with 13 percent in urban areas. Rural clinics and hospitals are consolidating or closing, leaving people to drive long distances to see doctors. Policymakers are counting on telemedicine to fill in the gaps.

In eastern Kentucky, the collapse of the coal industry, long a major employer, created severe economic hardship. Though a successor to coal hasn’t yet emerged, government agencies and economic development organizations at all levels are aware that the region needs to participate more fully in the digital economy. Efforts are underway to retrain miners and other displaced workers as computer programmers and homebased call center agents.