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EMILY COVINGTON, SRNA

THE UNI VERSI TY OF KANSAS



Telecommunication
&
Telemedicine
Health care spending in the US is twice as much as other
industrialized nations

The US health expenditures approximated $2.6 trillion in
2010

US citizens do not reap the benefit of increased spending

The US is the worlds leader in producing and consuming
medical technology
Define the Problem
Although the United States holds more Nobel Prizes in medicine and
economics than any other country, our health care system is less efficient,
in terms of health per dollar spent, than those of other high-income
countries
Health telematics is a composite term for health-related
activities, services and systems, carried out over a distance
by means of information and communications
technologies, for the purposes of global health promotion,
disease control and health care, as well as education,
management, and research for health.

Universal terms
telemedicine
telehealth
e-Health


Health telematics
Telegraphy dates back to 1753

The 1
st
electric telegraph was developed in the
1830s

Samuel Morse unveiled the 1
st
one-wire
telegraphic system in 1987

Telegraphy has allowed for numerous
advancements in healthcare, furthermore it has
established the foundation for telemedicine
History of Telemedicine
NASAs Project Mercury crew was monitored via telemetry

Jay H. Sanders established the first statewide telemedicine
system
Recognized as the Father of Telemedicine

Kenneth Bird introduced the term telemedicine and
defined it as healing from a distance
History of Telemedicine
Airline Deregulation Act of 1978
deemed to be a controversial act
many believe airline passengers have saved an annual $19.4 billion
others believe this caused thousands to lose their jobs

Telecommunication Act 1996
estimated to save customers $550 billion
estimated to increase job market with 1.5 million jobs
However, it decreased the economy by $2 trillion


The History of Deregulation
Provides reimbursement when telecommunication
technology is used for services including: office visits,
individual psychotherapy, and pharmacological
management
Kansas Medicaid
Mixed and dissimilar opinions regarding this bill
Optimistic
Increased concern

eliminates regulation provided by the Kansas Corporation
Commission
Kansas State Legislature enacted the
House Bill No. 2201
State legislatures give public utility commissions the
authority to develop and enforce rules about the
way in which telecommunications companies
behave, including whether they must file retail-
pricing information with the commission (tariffs),
whether they must meet certain quality-of-service
standards, whether they must provide basic service
to operate as carriers of last resort, and whether
they are eligible for high-cost or Lifeline support.
Alternative #1
make NO changes to the HB 2201
Alternative #2
ABOLISH the HB 2201 completely
ABOLISHING may prevent the free-market from deserting the
average customer
keeping will promote advancement in technology (especially
telemedicine)
Alternative #3
REVISE the HB 2201
Complete deregulation may jeopardize customer safety
Complete regulation may limit competitive prices



Construct the Alternatives
Bardach (2012) affirms an absence of efficiency
consideration for policy decisions frequently overlooks the
welfare of the little guy.

He then states, The little guy may be little, but in a proper
efficiency analysis, he at least shows up to be counted
(Bardach, 2013, p. 33).
Select the Criteria
Vilfredo Federico Damaso Pareto
An early 20
th
century Italian economist and sociologist
He studied economic efficiency

Pareto efficiency says that an allocation is efficient
if an action makes some individual better off and
no individual worse off
Select the Criteria
The need for increased health care technology,
telecommunications, and telemedicine create a
dual-sided argument when examining the
efficiency of this matter.

Many individuals view health care innovation as a
major contributor to the USs increased health care
cost. However, these advancements may also be
perceived as the best hope to effectively meet
daunting cost and quality challenges
Kansass telecommunication deregulation bill
may allow these firms to abandon the less
profitable rural customer, or what Bardach
(2012) defines as the little guy.


Deregulation of telecommunication may
discontinue service delivery in the hard-to-reach
geographical locations.

If their services are not discontinued,
telecommunication companies could potentially
mitigate landline availability, or significantly
increase prices in rural areas due to supply and
demand.
Select the Criteria
Option #1Keep the bill
improve access to care for the rural community (via telemedicine)
pose threats to the rural and elderly population
Option #2Get rid of the bill
telecommunications companies will not be responsible for
maintaining services that offer safety standards
Option #3Simple revision
create an equal balance between regulation and deregulation
Project the Outcomes

In order to have credibility when removing unnecessary or
outmoded regulations, those of us who adhere to a
market-based philosophy must be willing to acknowledge
an important fact: There are times when regulators may
need to step inwhen the marketplace does not allow for
sufficient competition to a former monopoly, when the
market needs to be open to new entrants and
technologies, or when larger societal goals such as
ensuring the needs to public safety, fall outside the
markets scope.
Option #3
With option #1
The HB 2201 minimizes the Kansas Universal Fund, which will abolish extra
funding for telecommunication services in rural areas.
This bill may be inhumane to citizens of the rural community, in that
telemedicine has been presented as an effort to improve access to
care for the rural population .
With option #2
Increase drawbacks and costs associated with complete regulation.
regulators generally do not have the latest technological information,
regulated firms may be able to use the regulatory setup to create
barriers to entry, the regulatory setup is bureaucratic, there is significant
rent-seeking activity, it is difficult to regulate new and evolving products.
Confront the Trade-Offs
With option #3
put in place the appropriate regulatory framework that achieves
the twin goals of spurring investment and establishing open platforms
to deliver choice and innovation to consumers
Confront the Trade-Offs
Decision
After completing an extensive amount of research on
telemedicine, I found telecommunication to be the
foundation of this innovation.
I believe revising the Kansas State Legislatures HB 2201
would be both beneficial for the market, and the
consumer.
Complete deregulation of telecommunication generates
potential risks for the consumer.
Conversely, rigorous government regulation will create a
precarious environment for the provider.
Balancing deregulation while focusing attention on the
customers welfare appears to be the most acceptable
alternative to the HB 2201.

Thank you for your attention
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