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[Commentary] It is time to fix the pitifully slow, expensive Internet access in the United States: It is ridiculous that 19 million Americans can’t subscribe to high-speed Internet access because they live in areas that private companies believe are too expensive to serve. It’s even more ridiculous that one of the most technologically savvy countries in the world can’t offer reasonable prices compared to other places.

We used to say that the Internet allows everyone to be a publisher; now, with equal upload to download capacity over gigabit connections reaching homes through Google Fiber, that will actually be true in Austin. But I don’t want Google serving the whole country, because we still need policies that lower the barriers to entry for competitors. Without competition the incumbents won’t invest in offering better service. Yet … there is something very valuable about the news that Google Fiber is coming to Austin. It makes clear that America’s current backward status when it comes to high-speed internet access isn’t inevitable. It makes companies like AT&T want to act (sort of). And most importantly, it makes people get why high-speed access matters. This is a different phase, not an incremental improvement. The difference between the standard Internet access that shapes our imagination and a fiber-to-the-home connection is as great as the difference between no electricity and an electrified life. But only if we see this difference, only if we understand what’s possible, can we change our expectations. And that’s the most important thing about the Google Fiber efforts.

[Crawford is a professor at the Cardozo School of Law and an adjunct professor at the School of International and Public Affairs at Columbia University.]

[Commentary] Just as the light bulb replaced the kerosene lamp and steam engines replaced sails, IP-based networks that carry video, voice phone calls, and data are taking over for the voice-only phone lines of the past century. Copper phones lines, organized into the Public Switched Telephone Network (PSTN) met the challenges of the 20th century; and fiber technology and IP-based networks are needed for the 21st century. The only question is whether this change, which is complex and will affect every American in some way, will be haphazard or carefully managed — in a fact-based and data-driven process to ensure that consumers are better off and that nobody is left behind.

A smart, managed transition means best-in-the-world broadband services for all consumers. It means continued private investment of tens of billions annually for the next three years by AT&T, Verizon, Sprint and T-Mobile alone) and the jobs that come with it. For people of color and other minority communities, a well-managed transition promises expanded opportunity for high-quality and affordable Internet service so they can fully experience the benefits – in health care, education, jobs, and civic empowerment – that are possible in the digital age. While African Americans and Latinos have been early and enthusiastic adopters of mobile technologies, they run far behind whites in home-based broadband. African Americans trail whites by about 16 percentage points and Latinos trail whites by about 19 points, in large part because many African Americans and Latinos can’t afford broadband at home. Managed properly, in a process that includes affordability, pricing, and adoption rates in its analysis, a move to all-IP networks should provide additional competitive choices and affordable options for advanced home-based and mobile broadband.

Sens John Thune (R-SD), Lamar Alexander (R-TN), Pat Roberts (R-KS), Richard Burr (R-NC), Tom Coburn (R-OK), and Mike Enzi (R-WY) released a white paper, “REBOOT: Re-examining the Strategies Needed to Successfully Adopt Health IT,” outlining concerns with current federal health information technology (health IT) policy, including increased health care costs, lack of momentum toward interoperability, potential waste and abuse, patient privacy, and long-term sustainability. The 2009 Obama stimulus bill included the Health Information Technology and Economic and Clinical Health (HITECH) Act which aimed to promote the adoption and meaningful use of health IT. Now, nearly four years after the enactment of the HITECH Act, and after hundreds of pages of regulations implementing the program, we see evidence that the program is at risk of not achieving its goals and that $35 billion in taxpayer money is being spent ineffectively in the process.

Findings from the senators’ white paper include:

• Increased Costs. Despite previous estimates that the HITECH Act would save money due to the efficiencies in storing and sharing records and ordering and coordinating patient care, early reports raise concerns that health IT may have actually accelerated the ordering of unnecessary care as well as increased billing.
• Lack of Clear Path Toward Interoperability. The HITECH Act federal incentive payments are being made to hospitals and physicians without clear evidence that providers can achieve “meaningful use,” or the ability to use the health IT program internally, and without an adequate plan to ensure unaffiliated providers can share information with each other through an interoperable network.
• Lack of Oversight. Reports from the HHS Inspector General (IG), the Government Accountability Office, and stakeholders have revealed that the administration does not have adequate mechanisms in place to prevent waste and fraud in its health IT programs. Taxpayer dollars are being paid to providers who cannot or do not have to demonstrate that the health IT technology is actually used as prescribed, because the administration relies on provider “self-attestation” in many cases to determine eligibility for payments.
• Patient Privacy at Risk. The HHS IG found that the security policies and procedures at the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology – two federal entities which oversee the administration of the health IT program – are lax and may jeopardize sensitive patient data.
• Program Sustainability. It is unclear for providers that have accepted grants and incentive payments how much it will cost to maintain their health IT systems after the initial grant money and incentive payments run out. In 2015, incentive payments in most scenarios cease, and providers face reduced Medicare or Medicaid reimbursements if they do not comply with federal requirements, which may impact small providers that may not have economies of scale to make health IT cost-effective.

The Texas Tribune will refine its model for sustainable local journalism and hire business analysts to explore new revenue models with $1.5 million in support from the John S. and James L. Knight Foundation.

Since its founding in 2009, the Tribune, a nonprofit online news organization, has built a sound financial base, going beyond philanthropic support to gain revenue from corporate sponsorships and its signature events. Building on this success, one-third of the Knight grant, or $500,000, will allow the Tribune to hire two fellows who will examine the creation of premium content for specific audiences and explore new revenue streams. The Tribune team will then write about their experiences and the successes of similar ventures on a new web site, sharing lessons and best business practices with nonprofit news organizations and other media observers. The balance of the grant, $1 million, will go to shoring up the Tribune’s working capital to ensure its long-term sustainability.