Should Obama really use stimulus money to invest in broadband and online medical records?

Innovation, the Internet, gadgets, and more.
Feb. 9 2009 5:44 PM

Tech for America

Should Obama really use stimulus money to invest in broadband and online medical records?

Illustration by Mark Alan Stamaty. Click image to expand.

About 10 percent of Americans today don't have access to high-speed Internet service. The rest of us are pretty much stuck in the granny lane—on average, we get broadband speeds of less than 5 megabits per second, 10 to 20 times slower than what people in many other countries enjoy. Derek Turner, research director for the public policy group Free Press, dreams about America becoming a "broadband utopia." In Turner's paradise, you'd be able to order up a fast connection no matter where you lived. And not just that—several broadband providers would compete with one another to bring super-fast service to your door, a dynamic that would keep prices low and speeds very high (100 MBps downloads and uploads, a file-trading gamer's promised land).

In a policy paper that Free Press put out in December, Turner and his colleagues called on the Obama administration to spend $44 billion to realize this dream. The broadband advocates argue that the money would boost short-term economic activity—we'd need tens of thousands of people to produce and maintain fiber-optic cables, routers, and other equipment; to dig trenches and climb poles to install the new broadband lines; to staff customer service and billing centers; and to train everyone to use the new stuff. The long-run effects of a national broadband plan are even rosier. More than any other investment, Free Press argues, Internet lines would stimulate activity broadly across the American economy, fostering innovation and new jobs in education, health care, retail, and high-tech businesses.

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That sounds great—sign me up! But wait a second … here's Don Detmer, president of the American Medical Informatics Association. In an open letter to Obama shortly before the inauguration, Detmer called on the new administration to spend $10 billion a year for five years to create electronic medical records, a huge project that would require the training and hiring of tens of thousands of new health care and technology workers. Not only would the plan create new jobs, Detmer says, it would also reduce costs by making medicine more efficient. Plus, the investment would improve our health—electronic records would allow for more advanced medical research and significantly reduce errors. (Doctors' sloppy handwriting supposedly kills more than 7,000 patients a year.)

OK, now I'm confused. Should we spend stimulus money on building a broadband utopia or on transforming health care? Or both? Or maybe, as Thomas Friedman has argued, we ought to build advanced batteries, hybrid drivetrains, and other environmentally friendly technologies. That sounds great, too, right? But what about a completely redesigned "smart" electricity grid that would be able to handle a new generation of plug-in cars, fuel cells, and other as-yet-unimagined power-generation technologies—what some people have called the next Internet. Let's hear it, American taxpayers: Which of these things, if any, do we want to fund?

The two stimulus plans working through Congress outline far fewer funds for high-tech projects than their advocates would like. The House and the Senate are calling for around $6 billion or $7 billion to fund broadband infrastructure, with much of that money going to rural areas—a far cry from the $44 billion Free Press asked for. Congress seems to be settling on about $20 billion to $25 billion to improve health care technology—about half or a third of what estimates say a transition to e-health records would cost.

The problem with calling for any government funding of technology is that the future always sounds terrific. Who doesn't want cheap Internet everywhere, an end to medical errors, and an electric system that could change the way we drive? Sketched out like this—a series of plans that promises radical advancements after a relatively small investment of resources—it seems crazy not to sign up for every one of these ideas. After all, the U.S. government has played a huge role in the inception of nearly every modern innovation we enjoy today. Government research grants were present at the creation of microprocessors, databases, the graphical user interface, video games, the Internet, and the World Wide Web, among many other great things. (See this research report.)

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