Net Neutrality and Rural Health
Though the National Rural Health Association does not currently have official policy on the issue of Net Neutrality, the rising need to understand the driving factors behind health IT and broadband as it relates to the delivery of health services in rural America warrants at a minimum its initial discussion. For a little background, Net Neutrality advocates argue that every similar piece of information transferred via the internet should be available to each consumer at the same price and speed. Their argument suggests that the larger companies tailor individual internet products to various markets, and could ultimately lead to blocking content at their own discretion. The broadband providers, however, would argue that changes in service patterns make it necessary to adjust bandwidth accordingly to account for peaks and valleys in use, and that more government regulation of the net would ultimately lead to less innovation. Thus, giving completely equal treatment to all internet traffic means they would not have the ability -- the same ability afforded to most other industries -- to tailor their product to shifts in consumer patterns or demands. With a great deal of recent and future emphasis placed on the health IT needs of hospitals and other health providers, it is important to recognize broadband capacity as a key component to full adoption of electronic health records. Ensuring broadband providers act in customers' best interest -- and that they do not block legal internet content from users -- is necessary, but it is also important to recognize a system in which various market fluctuations can be accounted for and subsequently addressed. Should a telecom company, for instance, be required (emphasis on "required") to offer the same bandwidth to a hospital in an area with limited broadband capacity transferring large medical image files, as it offers to an individual in that same area who wants to share his entire mp3 library an unlimited amount of people on the web? The FCC's Role Integral to this discussion is the role of the Federal Communications Commission (FCC). A ruling earlier this year by the U.S. Court of Appeals for the District of Columbia stated that the FCC did not have the authority to require that broadband providers give equal treatment to all internet traffic. The FCC essentially disagrees, but at the same time also recently released a plan accounting for arguments on both sides. The plan, announced on December 1st by FCC Chairman Julius Genachowski, would formally ban broadband providers from blocking legal content, but also allow them to charge different rates for different levels of service. The NRHA applauds the FCC efforts to pursue a fair compromise on these net neutrality regulations. Overall, this fight over internet access pales in comparison to that of the FCC's recent rural health broadband proposed rule, which has the potential to produce actual beneficial health outcomes. Developing a timely alternative that works to both sides' of net neutrality debate's concerns will ensure its ability address issues truly important to its scope of work. In rural America, innovation, investment in critical infrastructure, and lowering costs is the key to addressing barriers to obtaining quality health care. The NRHA believes the FCC's most recent plan to address the issue of net neutrality will provide the market with enough checks and balances while fostering innovation. From social to economic to medical benefits, broadband access is the key to moving our society forward. Underserved and unserved communities cannot bear extreme regulations and do not deserve to be further excluded from the advantages that broadband Internet access brings. As this issue, as well as official NRHA policy, develops, we encourage input and debate amongst potentially affected providers and consumers.