1997 Partnerships for Networked Consumer Health Information Conference

Transcripts of Plenary Sessions and Breakout Sessions

"Implications of The 1996 Telecommunications Act"

Tuesday, April 15
2:00-2:30 PM

Speaker: The Honorable Reed Hundt, Chairman, Federal Communications Commission, Washington, DC

Thank you very, very much. Thank you for having me and special thanks to the Telehealth Task Force.

I would like to acknowledge the head of the Telehealth Advisory Committee, Greg Lawler, and also Jay Sanders. Both played key roles in telling us what to do in the intersection of telecommunications and telehealth.

Right now in telecommunications, we are trying to reset the rules. Sometimes the tasks seem daunting but we're encouraged by the fact that Congress has asked us to bring the Federal Communications Commission (FCC) into areas we have hoped we would see developed, but that the FCC has not been involved in before -- education and medicine, for instance.

As a result of the Telecommunications Act that passed last year, we need very specific help from all of you, which we have gotten from the Advisory Committee, regarding our policies. There has always been a discussion about universal service, but we need to take the discussion further. We still have gaps in service. Telephone service is still limited in some areas, and classrooms are still only 10 percent wired.

Particularly in the fields of education and in health, the Telecommunications Act is very important. It shows a revolutionary commitment by the United States. When it comes to telecommunications, we are the envy of the rest of the world. Everyone is trying to move from the Industrial to the Information Age -- determining how best to open up markets to competition. Everyone around the world is watching the United States to see how we pull this off. And they are watching the FCC to see if we meet all the goals Congress has set for us.

We will do what's necessary to provide universal service for all Americans, all classrooms, all libraries, and all health care providers. We will deliver a comprehensive system to connect all these groups to the information highway. I am confident we will do the right thing, because we are committed to meeting the goals.

The FCC's role in improving health care delivery is a new one. Last year, we adopted guidelines to measure the effects of wireless services on health. We provided the forum to see what the guidelines should look like. We also explored the impact of television on kids -- the mental health of kids -- and studied the V-chip. For a long time, the effects of television on children have been dealt with by the FCC, which has worked to develop industry standards.

Last fall, the liquor industry reversed a voluntary ban of hard liquor ads on television. They have been targeting programs with a large proportion of underage viewers. This is what you want an agency to be doing -- being open to receiving input and guidance from the public, making a report to the American people, writing the rules on issues that people think are important. This is how we approached the job of writing rules for telehealth. We opened up for comment, then formed the Advisory Committee. Now we are supposed to write the rules that make the report relevant.

How many undiagnosed problems are there in the unconnected parts of our society? We must make expedited information available to the population. The FCC has the high honor of developing the network that will provide that information.

One of the advantages of telehealth is that it will bring health care costs down. The FCC is working with numerous agencies to examine its costs and benefits. The money we spend to connect health agencies will probably prove to be money well spent. Congress has mandated that rural access be brought under our control. Modern communications services must be put into place.

Telehealth and telecommunications are investments in the future. We hope someday that every health care provider in the world will be able to learn from the great teaching institutions of the world. Secretary Shalala's healthfinder™ web site is a wonderful resource and will attract many, many visitors seeking reliable health information.

Senators Snowe, Exon, and Rockefeller probably deserve the most credit for ensuring that rural America has access to telecommunications equal to that of urban areas. We have received advice from several rural health projects and are in the midst of writing the rules.

The Telecommunications Act mandates the infrastructure to provide adequate health services. But who decides what is adequate? I would be inclined to say that the health care providers should be the ones to decide. Maybe there should be a fundamental bandwidth for telehealth.

What about long distance charges? A rural provider may have to pay a long distance charge that could run as high as $1400 a month, while in a city that same service might be $60. How do we compensate rural health care providers to bring down these costs? And the Internet? Many rural customers must pay a fee to connect over long distance. Should rural providers get a discount or should we help them pay the fees? It is in answering these questions and making the best possible policy that we will find out if we have done the right thing.

Your help will make sure that these problems are solved. Thank you.

Audience: It is not a good idea to pay long distance access charges to a company.

Audience: Could you explain how we will be paying for the services that will be provided under universal service?

Hundt: Not you, sir -- on a general level, we would take all of the telecommunications revenue and redistribute it to specific consortiums or companies that the school would choose as providers. These revenues are about $200 billion, and only a couple percent of that would provide for universal service.

Audience: There is one important group that you do not have on your list. Many public health and disease control agencies do not have access to the web, and need your assistance.

Hundt: In fact, rural public health agencies are specifically included in the 1996 act.

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