For three months, I’ve constantly washed my hands, practiced social distancing and worked from home.
In this remote corner of mountainous southwestern Virginia where my wife and I are still weathering the coronavirus storm, our wireless 4G connection has more bandwidth than the only available wired internet service, so we’ve been leaning on mobile broadband for internet access.
Strong and reliable, it has enabled us to work and keep abreast of the latest news. We’ve also developed a new appreciation for the rich and varied content offered by the streaming services, which, up until now, we haven’t had much time for.
I’m lucky to have a broadband connection that has allowed me to maintain some semblance of normal life. Approximately one-half of the residents of this county are not so fortunate. They live beyond the reach of wired broadband or even a strong cell signal. During a time when internet access has never been more crucial, they are digital have-nots.
While the virus spreads more easily in densely packed urban areas, it has no regard for whether it infects a financier or a farmer. COVID-19 doesn’t care whether someone lives in the middle of Manhattan, New York, or outside Manhattan, Kansas.
In the national effort to continue stemming the spread of the virus, including provision of the healthcare necessary to treat and contain it, unique and major challenges confronting rural areas must be taken into account.
Rural Americans face a chronic shortage of doctors and hospitals. There are about five doctors for every 10,000 people in rural areas, compared to eight in urban areas, according to an analysis from the Rural Health Information Hub.
Put another way, fewer than 10% of U.S. physicians practice in rural communities, where 25% of Americans live. What’s more, hospitals in rural areas are closing at an alarming rate, with a record 19 rural hospitals closing in 2019 and 12 more this year to date. Since 2005, more than 170 rural hospitals have closed, three in my former congressional district alone. But that’s not the only problem rural residents in search of healthcare face.
When we get sick, patients are being encouraged to turn to telemedicine as the coronavirus has swamped certain weakening rural healthcare systems and threatens to overwhelm more. Telemedicine’s efficiency enables doctors to see more patients. It reduces the risk of patient infection by reducing the number of clinic visits. It’s a key way to ameliorate the shortage of rural hospitals and healthcare providers. It’s making a major difference with COVID-19 for those fortunate enough to have the broadband access sufficient to support it.
As promising as telemedicine is for rural medicine, obtaining a high-speed internet connection for telehealth is an impossibility for tens of millions of rural residents who are on the wrong side of a seemingly intractable digital divide.
Often, less than half of Americans living in the most mountainous regions have internet access due to the difficulty of deploying broadband lines or even offering reliable cell service when the mountains get in the way. And a recent study shows that only 38.6% of the people who live more than a 70-minute drive from a primary care physician subscribe to an internet connection capable of handling telehealth services.
In this time of a protracted national healthcare crisis, the need for Congress to fund rural broadband deployment has never been more apparent. Telemedicine can pick up much of the slack, but not until more rural Americans have the basic communications infrastructure to benefit from it. A response commensurate with the size of the problem is urgently needed.
The solution begins with an overhaul of the Federal Communications Commission's (FCC’s) national broadband map, which fails to identify vast parts of rural America that lack broadband availability. Congress has directed the FCC to improve its broadband coverage map. Now it should fund that effort, which is estimated to cost approximately $65 million.
Next, Congress should provide the tens of billions of dollars that will be needed to connect rural America with funds distributed in unserved areas as depicted with greater granularity on improved broadband coverage maps. The funds should be awarded on a competitive basis through the FCC’s time-tested reverse auction process. That way, we’ll get the most deployment for the dollars expended.
We shouldn’t be thinking about this connectivity need only in times of national emergency. Americans everywhere—whether they live downtown or on the farm—deserve modern communications technologies and the healthcare that it can help provide. It shouldn’t take a nationwide health emergency to make this clear, but now that it has, it’s time for Congress to act.
Rick Boucher was a member of the U.S. House for 28 years and chaired the House Energy and Commerce Committee's Subcommittee on Communications and the Internet. He is honorary chairman of the Internet Innovation Alliance and an attorney in the Washington, D.C., office of law firm Sidley Austin.