A remarkable demographic change is happening among elderly Americans. It's a trend that the U.S. Census Bureau recently called, "a gray revolution in living arrangements" and the implications for health care access are huge.
There are now almost 27 million households headed by someone 65 and older, a 24% increase over the past decade, according to Census. For women over 75, living alone has overtaken staying with relatives as the most common living scenario.
As a result, the need for dramatic improvements in health care delivery, especially in rural America, is becoming a crucial national issue. As The Journal put it, "Aging in place is proving difficult in places where the population is growing older, supportive services are scarce, houses are in disrepair and younger people who can assist have moved away."
The seniors profiled in that article - many living alone in rural areas - show the need for expanded telehealth and mHealthpractices. Telehealth and mHealth are vital to expanding access to diagnoses and monitoring services that would otherwise only be available after a long car ride.
But while Federal and State officials increasingly recognize the importance of telehealth and mHealth, the inevitable question is - how can we make this happen? Larry Irving, co-chair of the Internet Innovation Alliance, has an excellent idea: expand the federal Lifeline Program to include broadband Internet service.
Irving, who has been writing for decades about the need to expand broadband Internet service, envisions a scenario in which consumers in need receive direct subsidies to purchase broadband. This, in turn, stimulates competition for broadband deployment. Administration of the new program would rest with an appropriate Federal agency.
Perhaps the most important aspect of Irving's insightful idea is that Federal benefits will go directly to those most in need. As Irving correctly notes, the tens of millions of Americans still not connected to broadband "tend to be older, poorer, sicker or live in rural communities."
The Lifeline program today is focused solely on telephone service. To be sure, phone service remains vital. Yet in today's society, phone service without broadband is incomplete - like a car whose tires are almost, but not quite, flat. Modernizing the Federal Lifeline program would address this problem efficiently and effectively.
American society is changing and so are our health care needs. Modernizing the Federal Lifeline program is an important step forward to address those needs.
This summer, The New York Times offered a front-page view of the future of medical care. It was a vision of better health care access, more convenience and the potential for large cost savings. "The same forces that have made instant messaging and video calls part of daily life," said The Times, "Are now shaking up basic medical care."
The rise of online health care access is one of the most important social benefits of the decade. Approximately100,000 mHealth apps are now available to help patients monitor their health and connect with their doctors more easily.
After watching my mother endure years of serious chronic medical conditions and then serving as the primary caregiver of my father, I am especially appreciative that health care providers are increasingly utilizing broadband as an effective way to deliver healthcare services and improve quality of life for their patients.
That's why the recent news about an unexpected plunge in broadband investment is so worrisome. For only the second time since 2003, investment in U.S. Internet services declined in comparison with the previous year. In every other year, broadband investment has moved higher, generating faster Internet service and economic benefits like better health care.
Worse, that other decline, which took place in 2009, could be explained by the Great Recession. But not this one, as our growing economy should, by all rights, mean higher investment.
While many things may have contributed to this bad news, there shouldn't be much doubt on the main culprit: last February's decision by the Federal Communications Commission (FCC) to begin micromanaging the Internet with Title II regulations from the 1930s.
That FCC action was as unprecedented as it was unnecessary. The constant upgrades fueled by demand for HD video had created an Internet that was unprecedented in its openness.
Unfortunately, this recent news is only the latest sobering development following the FCC's Title II action. Last May, FCC Commissioner Ajit Pai, who opposed the Title II overreach, released a list of several mostly rural communities in the South and West that lost opportunities for better Internet service because of the higher costs and legal uncertainty caused by the FCC's action.
The FCC took the Internet in the wrong direction this year when it voted to treat our sprawling, rapidly evolving service like a public utility. The implications for social benefits are significant - nowhere more than with improved health care.
Loss of investment means less deployment of faster services that are necessary to expanding access to the latest in mHealth. If the FCC won't reverse course, then it's up to Congress to set a better course.