Losing Net Neutrality Could Be Bad For Your Health: Here’s Why

The US Federal Communication Commission’s reversal of Obama-era net neutrality regulations sets the stage for broadband internet service providers (ISPs) to slow or block certain content from reaching their customer’s screens. This is likely to have a significant and potentially negative impact on a healthcare system poised to go fully virtual in the coming years.

Healthcare consumers already depend heavily on internet search results for advice when making healthcare purchases. Coupling preferred content with existing search engine optimization strategies will undoubtably steer consumer behavior. What will be the result? The American healthcare market is unique, both in its expense (higher than any other nation), and its shocking lack of value. Some of this is due to misinformed consumers swayed by direct-to-consumer marketing. Arguably, repealing net neutrality may amplify the problem.

Even more troubling is the prospect of an ISP partnering with a health delivery system. Telehealth – the use of electronic communication technology for healthcare delivery – will become standard of care in the coming years. National telehealth have already managed to get a foothold in today’s highly competitive healthcare market, supplying a disruptive and potentially cost-containing force in the healthcare market. With the elimination of net neutrality, larger, more well-established healthcare delivery systems, seeking to defend or expand their marketshare, can now partner with ISPs to preserve internet “fast lanes” for realtime video doctor’s visits. Smaller, possibly disruptive companies, unable to make these same financial commitment to ISPs, may be marginalized or lost.

Lastly is the idea that healthcare, including telehealth, should be thought of differently than the more conventional goods and services now bought and sold on the internet. Our current approach to healthcare – a combination of free market principles and government regulation – recognizes this difference and has long been considered acceptable. Why? Because the price of market failures, namely avoidable pain, suffering and death, is generally seen as unconscionable.

To be sure, internet deregulation may provide the financial incentive needed to more fully develop a robust and consumer-responsive telehealth infrastructure. Indeed, the rapid consolidation of the healthcare industry, combined with the growth potential of telehealth, will continue to attract the healthcare industry’s attention. The repeal of net neutrality will likely profit both healthcare companies and ISPs alike.

There is no guarantee that the new partnerships and financial gains brought on by the repeal of net neutrality will increase the value of America’s healthcare spending. Within healthcare industry, the results of the FCC’s repeal, combined with an already complex and inefficient healthcare marketplace, will be unpredictable at best. What seems most likely is an increase in corporate profits. It may be American healthcare consumer, however, who ultimately pays the price.

John McDougall, MD is a postdoctoral fellow with the National Clinician Scholars Program at Yale. 


5 replies »

  1. “There should be dozens of ISPs, dozens of “edge providers” to choose from, and thousands of media/content generators to layer on top…. that’s the only way to make sure citizens benefit from these services.”

    That can only happen with unlimited delivery pipes which citizens can choose from – not very realistic, or even practical. I’m sure though that Bernie would have done it for us.

  2. Already we see that drug companies are affecting CDS alerts and warnings to favor their products when they purchase the drug coding companies and CDS creators/companies. And this is only directed at physicians. With the ability for drug companies and others to affect speed of access to information on healthcare (a major use of the net) the biasing of information to lay people will be horrific. People will be directed toward this or that drug or treatment or hospital — on the basis of profits or corporate connections. The web is already full of dangerous and insane healthcare advice (in addition to legit info). Without net neutrality, the highest bidder or the ones with the most connections and power will control effective access to information.

  3. I am ambivalent about the details here, but one thing is for sure: Corporations (will) benefit and people (will) pay the price, with or without net neutrality. The difference between the two is which particular grouping of corporations will benefit most, and frankly, I don’t give a damn….

    There should be dozens of ISPs, dozens of “edge providers” to choose from, and thousands of media/content generators to layer on top…. that’s the only way to make sure citizens benefit from these services. Bickering about which monopoly gets the upper hand may be intellectually satisfying, but won’t make any difference in ultimate outcomes.

  4. I don’t think this is overblown

    Another important issue to consider —

    New barriers to entry for smaller healthcare start ups. If providers can start charging per download and giving priority to their largest customers, it is going to become increasingly difficult for small newcomers to compete with established players.

    I just don’t get the logic.

    WTF? There wasn’t enough innovation on the internet for them?

    You lost me at “the Future is going to look like cable.”

  5. At now another level, among many, the legitimate and predictable safety of the internet use for healthcare will increasingly become doubtful. It makes one think about a national healthcare INTRAnet becoming economically feasible that is not connected to the military originated internet. Its likely that in some respects, this phenomena already exists for business. There are large fiber optic cable networks all over the nation that would be capable of this, e.g., LEVEL 3 . It represents another possible source of expense to our nation’s healthcare industry that we are already unable to afford.