[ Text Version ]

Remarks of
Chairman Reed Hundt, by video

Transatlantic Telemedicine Summit
May 20, 1997

Greetings to the participants in the Transatlantic Telemedicine Summit. I am sorry not to be able to be with you in person. Your goal of increasing the development of telemedicine is one that is enthusiastically shared by the FCC and the United States.

Less than two weeks ago, on May 8, the FCC issued rules that put into place the single most important policy for encouraging the growth of telemedicine in the U.S. -- universal service.

I'd like to give you a sense of what universal service policy will mean to health care providers and patients in the United States -- and how this and other FCC policies will encourage the world-wide use of telemedicine.

Universal Service & Health Care

The goal of universal service policy is to make affordable telecommunications service accessible to all Americans. Universal service funds are collected from a broad-based group of interstate telecommunications carriers in all areas of the country. The Telecommunications Act of 1996 directed the FCC to develop a new plan for universal service policy based on a series of principles. Among these principles are quality service at "just, reasonable and affordable rates," services for rural, insular and high-cost area consumers at rates "reasonably comparable to those in urban areas," affordable access to telecommunications services for schools and classrooms and libraries, and rates for public and non-profit rural health care providers that are reasonably comparable to those paid in urban areas.

This is the first time universal service benefits have ever been specifically targeted to rural health care providers. Congress recognized that rural health care often suffers because of distance -- distance that can be overcome by telemedicine. About one quarter of the US population, over 60 million people, live in rural areas. The FCC's rules will directly link the 12,000 non-profit and public health care providers who serve rural Americans to specialists who would otherwise be hours or days away.

Universal service policy will save lives by saving time. In rural areas, trauma injuries are 4 times more likely to result in death than in urban areas due to distance and lack of information. Through universal service, rural health care providers will get support for telecommunications links that could reduce 50-fold the time needed to transmit an x-ray in an emergency situation and cut the charge as much as 10 times.

Congress saw that a big impediment to the use of telemedicine in rural areas was the very high cost of telecommunications services -- often several times the cost of similar services in urban areas. So it asked the FCC to figure out how to give public and non-profit rural health care providers access to advanced telecommunications services at rates comparable to those paid by their urban counterparts. Based on recommendations from our Advisory Committee on Telecommunications and Health Care, which were supported by a federal/state board of communications policy-makers, the FCC voted in favor of the following:

I urge you to spread the word on this new support for telemedicine. If rural health care providers don't use it, they'll lose it. Universal service is among the most important policies in the US for increasing the availability of good health care for all Americans. To find out more about the FCC's universal service benefits for telemedicine, visit our health care web site at www.fcc.gov/healthnet/.


As you know, the FCC's universal service policy will directly support only health care providers in the United States. But it can be seen as a model for other countries that want to encourage the use of telemedicine to improve their health care.

The power of telemedicine is its ability to extend beyond geographical boundaries. By increasing the use of telemedicine in the US, we are increasing the quality of telemedicine available to any health care provider who has access to the Internet and other international information networks.

An example that many of you are familiar with of the potential of international collaboration in telemedicine is the work being done at Mass General Hospital. A magnetic resonance imaging scan of a patient in Saudi Arabia suspected of having a brain tumor can be scanned into a digitizer, compressed, and sent via telephone lines to Massachusetts. A radiologist at MGH reviews the image, and consults with a surgeon in Saudi Arabia.

Such exchanges save not only time and money but lives. The best thing the US can do to increase the growth of telemedicine throughout the world is to encourage the growth of competition in telecommunications.

We need competition in services between countries and between continents. Ultimately, we need competition in every country. Otherwise, monopolists will at minimum reduce the efficiency of the global network. At worst, when they are from large markets, they can leverage their monopoly at home into anticompetitive behavior in world markets.

The same principles of competition and deregulation that guided our own telecommunications reform legislation a year ago should guide the rest of the world in opening their telecommunications markets as we have. Over the past three years, we have worked to create the framework for a Global Information Infrastructure that will foster economic development for all countries of the world.

The FCC is preparing to play our appropriate role in implementing the World Trade Organization agreement that overthrows the monopoly paradigm in favor of the competition model in 69 countries around the world. The agreement is the best possible news for the world economy, and for the improvement of health care through telemedicine on a global scale.

I look forward to working with international leaders such as yourselves, in both the public and private sectors, to eliminate barriers to the spread of telemedicine. Among the most powerful contributions of this age of communications is the opportunity to improve the level of health care around the world.