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.