Health and Media

Fewer than 10% of US physicians practice in rural communities, where 25% of Americans live. Yet, rural Americans may need more health care as they become increasingly older and sicker relative to their urban counterparts. Telemedicine has been proposed as a solution to improve access to care. Federal and state policymakers have enacted policies to expand telemedicine use among publicly and commercially insured beneficiaries. However, whether Americans with the poorest access to care have the necessary broadband Internet capability to fully benefit from telemedicine is unknown.

With this Order, the Federal Communications Commission takes necessary steps to provide full funding for all eligible services requested from the Rural Health Care universal service support mechanism (RHC Program) for the 2018 funding year (FY). In FY 2018, multi-year and upfront payment funding requests filed during the window sought support exceeding the $150 million funding cap for those payments. FCC rules would require the Universal Service Administrative Company (USAC) to prorate requested support received by eligible health care providers.

The job of VA’s Office of Rural Health (ORH) is to increase access to care for the nearly three million Veterans living in rural communities who rely on VA for health care. “Telehealth is a game-changer for rural Veterans,” said Dr. Thomas Klobucar, ORH Executive Director. “It breaks through the barriers of cost, time, and distance. Bringing rehabilitation services to the Veteran’s living room can connect patients with the care they might otherwise struggle to receive.”

The Benton Foundation unequivocally opposes any proposals from the Federal Communications Commission that would allow the FCC to shirk its responsibilities to meet its Congressionally-mandated mission. The FCC is supposed to ensure:

South Carolina is expanding access to telemedicine — or, put broadly, health care done via the internet. This virtual way of seeing a doctor or managing health is seen as a solution to deteriorating health care services in rural parts of the state. SC’s government has spent $68 million in one-time commitments since 2013 on telemedicine. But it’s no secret that progress is stunted if people don’t have internet access. Some 537,000 people in South Carolina don’t have an adequate internet connection at home — about 11 percent of the state’s population, and 26 percent of the rural population.

The funding year (FY) 2019 application filing window for the Rural Health Care Universal Service Support Mechanism (RHC Program) opened on February 1, 2019 and will run through May 31, 2019. To assist eligible health care providers participating in the RHC Telecom Program as they compile their applications for FY2019, this Public Notice provides guidance on complying with program rules, including the FCC’s rules for determining rural rates.

The question we face in the digital age is not how to have it all, but how to maintain valuable activity at a societal price on which we can agree. Just as we have made laws about tolerable levels of waste and pollution, we can make rules, establish norms, and set expectations for technology.  Perhaps the online world will be less instantaneous, convenient, and entertaining. There could be fewer cheap services. We might begin to add friction to some transactions rather than relentlessly subtracting it. But these constraints would not destroy innovation.

Two years ago I wrote that community broadband builders have two options for network deployment: they could use the problem-solving approach or the creation orientation approach. The problem-solving approach is typical when people deal with the government. The goal is often to make something go away.

A bill in the North Dakota Senate would require patients to do a video or in-person examination for their initial visit with a telemedicine provider. In 2017, the North Dakota Board of Medicine drafted a rule that would require a video exam or face-to-face visit for the patient's first telemedicine appointment. But the rule was shot down by the state legislature's Administrative Rules Committee in March. Committee members stated that the rule was "arbitrary and capricious," according to meeting minutes.