A hybrid model of medical care would also be good for telecommunications

Health Care Spending In The US And Taiwan: A Response To <em>It’s The Prices, And A Tribute To Uwe Reinhardt</em> | Health Affairs: Uwe Reinhardt And Taiwan’s Single-Payer Health System

In 1989, as a high-level government adviser to Taiwan when it was planning to implement universal health insurance, Uwe boldly recommended a single-payer system. Taiwan’s government accepted this recommendation in 1990 and implemented its single-payer National Health Insurance (NHI) in 1995.
Uwe based his recommendation on three policy considerations. First, a single-payer system is effective in controlling cost; this was a major policy goal of the government as health spending in Taiwan was growing rapidly. Second, a single-payer system is equitable: coverage is universal and all insured are treated equally regardless of ability to pay or preexisting conditions. Third, a single payer system is administratively simple and easy for the public to understand. The NHI has achieved all three policy goals. Uwe also suggested that Taiwan retain its predominantly private delivery system. He believed that the private sector has an important role to play in a nation’s health care system. As long as financing and payment were within the purview of government, a mixed delivery system of private and public providers could work well within a single-payer framework. Taiwan’s experience has shown this to indeed be the case. (Emphasis added)

As with health care, the Americans pay more and get less value than other nations for telecommunications services. In a parallel with advanced telecom services, many Americans find needed medical care inaccessible or unaffordable. The late health care economist Uwe Reinhardt's prescription for Taiwan was putting the government in charge of the financial side of medical care while allowing the private sector to do what it does best: providing care.

The United States should do the same for another essential and high cost service: telecommunications. Let the telecom providers do what they do best -- planning, building and operating networks -- and relieve them of the burdens of infrastructure finance and ownership. Their weaknesses here have led to widespread infrastructure deficiencies, market failure and poor value service offerings. Hybrid models get around the winner take all, win-lose dynamics and allow providers and consumers to both benefit.

FCC chief touts hybrid fiber and next gen wireless delivery infrastructure as viable alternative to FTTP

U.S. Federal Communications Commission Chairman Ajit Pai said a hybrid infrastructure of next generation wireless backhauled by fiber offers an alternative delivery method for fixed premise advanced telecom service where the return on investment to connect premises directly to fiber isn't adequate.

Industry observers are skeptical of this scenario, noting next generation wireless service requires the construction of substantial new fiber infrastructure to support it, significantly weakening the investment case.

Pai disagrees, arguing that sufficient fiber infrastructure is already in place to move ahead with deployment. "Part of the reason is, in terms of the possibilities of fixed wireless, given the fiber penetration that some of your members have," he told the NTCA-The Rural Broadband Association in New Orleans earlier this week. Pai urged the group to "think broadly" about "how to extend this great fiber penetration you’ve got." 

Generation into IP telecom era, AT&T still has no durable, scalable premise service delivery infrastructure

AT&T Does a Flip Flop on Fixed 5G, Now Sees It “Unequivocably” a Landline Broadband Replacement - Telecompetitor: “As we look at 5G will you have enough capacity to have a good broadband product that serves as a streaming service for all of your DIRECTV NOW, your Netflix, et cetera?” asked Stephenson in a SeekingAlpha transcript of today’s earnings call. “I absolutely am convinced that we will have that capacity, particularly as we turn up millimeter wave spectrum. That’s where the capacity and the performance comes from and that’s where you’ll begin to see a broad – a true replacement opportunity for fixed line broadband. So I have little doubt that in the three to five year time horizon you’ll start to see substitution of wireless for fixed line broadband.”

The concerns that Stephens expressed last year related primarily to the cost of backhaul to support 5G fixed wireless. Stephens apparently also was envisioning fixed 5G wireless being deployed in the millimeter wave spectrum band. Millimeter wave spectrum will support the highest broadband speeds, but over relatively short distances. Hence there is a need for dense backhaul infrastructure.

It is unclear what has caused the company to have a change of heart about the prospects for an AT&T fixed 5G wireless offering. Interestingly, however, the company recently released a policy paper touting the potential of using its AirGig fixed broadband technology in combination with 5G. Although the paper doesn’t provide details, perhaps AT&T is looking at the possibility of using AirGig to provide backhaul for fixed 5G.

A generation into IP telecom era, AT&T has no proven durable premise service delivery infrastructure easily scalable throughout its service area as its 1990s DSL over copper outside plant goes obsolete. AirGig remains an experimental technology. And the millimeter wave frequencies used by 5G can't penetrate objects.

Texas Hill Country: Where the "rural broadband" descriptor and comparisons to electric power in 1930s fail

Broadband Communities – News & Views / GVTC Launches New Fiber Internet Tier Structure in Texas: SMITHSON VALLEY, TX — GVTC, a fiber communications provider internet, digital cable TV, phone and interactive home security monitoring to residential and business customers in far north San Antonio, the Texas Hill Country and South Central Texas, is simplifying its fiber-to-the-home offerings with a new fiber internet tier structure. GVTC launched brand new fiber internet plans that feature standard download speeds of 250 Mbps in its fiber-to-the-home areas. In addition, upgrades to 500 Mbps and 1 Gbps are offered, all three plans featuring 250 Mbps upload speeds as well. New plans are available to both new and existing customers.

Despite the availability of fiber to the premise advanced telecom service in these areas, there is a continued misleading and overly broad description of America's telecom infrastructure deficiencies as a "rural broadband" issue. They've also been inaccurately compared to the lack of electric power infrastructure in the early 20th century when these same areas were completely unwired and left in the dark. Electric power infrastructure was truly a rural problem then because it didn't exist outside urbanized areas. Advanced telecom infrastructure by contrast is deployed in a far more granular manner by investor owned providers that cherry pick nominally rural neighborhoods where they believe they can earn the fastest return on investment and redline the rest.

Oregon opens broadband office to connect rural residents

Oregon opens broadband office to connect rural residents: Spokesmen from the governor’s office told StateScoop the office would essentially serve as a policy and planning hub, responsible for coordinating a statewide strategy and securing funding to ensure everyone in the state has access to high-speed internet. In Oregon, some communities in urban areas have less broadband access than others, but the issue primarily affects rural communities outside of the state’s more populous western cities.

Given the above mission statement, the office would have to include a major federal lobbying function to secure the billions needed to achieve universal advanced telecom service. And especially considering the state's budget allocates just $5 million for infrastructure projects, an amount that won't go very far statewide.

CenturyLink Down, Not Working? Nationwide Outages Reported By Users

 

CenturyLink Down, Not Working? Nationwide Outages Reported By Users

When the Internet was created in the 1960s by the U.S. Defense Department's Advanced Research Project Agency, it was designed to be "self healing." That means if one part of the network is taken out (in DARPA's scenario, a nuclear strike on one or more American cities), the network routes around the damaged areas and keeps functioning as a "network of networks."

As legacy telephone and cable companies became Internet Service Providers using the Internet protocol technology to deliver voice, video and data telecommunications, the survivability and redundancy built into the Internet has weakened. Too much of their network operations functions are centralized, rendering their entire national networks vulnerable to a single hardware or software glitch as shown by today's most recent outage taking down much of CenturyLink's network.

The lesson here for policymakers and regulators is the United States needs to ensure the advanced telecommunications services the Internet transports must be designed and managed to build on the original resilient design of the Internet. That could mean reducing the role of private sector, investor owned players like CenturyLink that are naturally inclined to limit network operational capabilities in order to avoid the expense of managing multiple and redundant network assets.

While technically more complex, given their vital role advanced telecommunications should be as solid and reliable as basic analog voice telephone service that preceded it.

USDA ReConnect Rural Broadband Pilot Rules Released, Allocates $600M in Loans and Grants - Telecompetitor

USDA ReConnect Rural Broadband Pilot Rules Released, Allocates $600M in Loans and Grants - Telecompetitor: To be eligible for a 100% loan or 50% loan / 50% grant, the service area must be in a rural area where 90% of the households do not have sufficient broadband access. To be eligible for a 100% grant, the service area must be rural and 100% of the households must lack sufficient broadband access.

These funds are apparently targeted to truly rural America where they'll make only a slight dent in advanced telecom infrastructure deficits. They won't help in much of the United States and particularly exurban and metro edge communities where redlining by investor owned ISPs is commonplace.

California policymakers should consider creating public utility to serve Northern California delivering electric power -- and advanced telecommunications.

Northern California’s electric utility Pacific Gas & Electric’s future as a going concern is in doubt in the aftermath of enormous wildfires in the region the past several years, most recently the disastrous Camp Fire that incinerated the town of Paradise. The investor-owned utility is potentially facing liability claims running into the many billions of dollars from deaths, injuries, property damage and fire suppression costs that it will be hard pressed to pay. This circumstance is raising the question of whether the public interest of reliable and safe electric power would be better served by a publicly owned utility.

The question presents at a pivotal time as regulators prepare to reassess PG&E’s organizational structure going forward, the Legislature begins a new biennial session and new administration is about to take office. Veteran Sacramento columnist Dan Walters suggests they explore whether California’s electric utilities should become governmental entities – regional versions of municipally owned utilities already operating in the state. “All of them have markedly lower rates than the three big private utilities, and have governing structures that are much more transparent and accountable, not only to ratepayers but to voters.”

Policymakers would be wise and forward looking to also consider expanding the scope of a publicly owned regional utility to include advanced telecommunications. Consumers would likely get a better deal there as well. Much of PG&E’s service area lacks adequate landline telecommunications infrastructure, nominally served by investor owned corporations like PG&E. A publicly owned utility would operate without the need to generate profits and could concentrate on providing the highest possible level of service and value to all – and not just some premises. Particularly when advanced telecommunications service is increasingly seen as essential as electricity.

New methods of installing fiber optic cable on poles owned by PG&E show promise to lower construction costs compared to the traditional strand and lash method of utilizing a separate metal suspension cable hung in the middle part of the pole leased by telephone and cable companies. These include lighter weight all-dielectric self-supporting cable and aerial conduit used in conjunction with smart grid technology. Smart grid technology could also improve safety management of the electric infrastructure, reducing wildfire risk.