Managed Competition In Us Telecommunications

The Telecommunications Act of 1996 envisioned a competitive free-for-all in the U.S. telecommunications industry with removal of barriers to entry in local telecommunications markets and the lifting of the artificial restrictions that kept the Regional Bell Operating Companies (RBOCs) out of the interLATA long-distance market. After close to 5 years, only one RBOC has been granted permission (controversially) to enter the interLATA market, and local competition has yet to provide most consumers with meaningful choices. In addition, the wave of mergers across the industry has raised the specter of putting the former Bell System back together again. Policymakers now openly question whether the Act can deliver what it promised. Three principal themes are developed in this book. First, there has been a coordination failure between Congress and the FCC in translating the principles embodied in the Act into practice. The authors provide evidence for this by analyzing stock market reactions to legislative and regulatory actions. This coordination failure was largely predictable, given the ambiguity in the Act, as well as conflicting jurisdictions between the FCC and the states. Second, the Act calls for wholesale prices to be `based on cost.' Regulators adopted a costing standard (TELRIC) that provides a means to subsidize competitive entry in local telephone service markets. The ready adoption of the TELRIC standard by regulators is shown to be tied to the third theme: price cap regulation provides regulators with `insurance' against the adverse effects of competition in local telephone markets. Statistical analysis reveals that regulators in price cap states set uniformly lower unbundled network element prices (lower barriers to entry) in comparison with regulators in rate-of-return and earnings sharing states. The result is a triumph of regulatory processes over market processes - the antithesis of the purpose of the Act.

The authors analyze regulatory reform and the emergence of competitionin network industries using the state-of-the-art theoretical tools ofindustrial organization, political economy, and the economics ofincentives.

"Commercial satellites are used by the U.S. government to provide a variety of fixed satellite services, such as military communications. However, the number of satellite operators providing such service has declined since 2000. Further, until recently, three vendors, known as satellite service providers, had sole authority to contract with the Department of Defense (DOD) under its primary satellite contract.Among other things, GAO was asked to describe (1) changes that have occurred in the fixed satellite services industry since 2000 and the effects these changes could have on the relationship between satellite operators and service providers; (2) the technological, regulatory, and other factors that affect competition in the fixed satellite services industry; and (3) how costs for DOD to acquire fixed satellite services have changed since 2000 and contracting officials' views on the effects of changes in the industry and contracts on costs. To address these objectives, GAO reviewed demand and capacity data, economic literature, and international regulations; analyzed DOD commercial satellite procurement data; and interviewed satellite industry stakeholders.The Federal Communications Commission, DOD, General Services Administration, and the Departments of Justice and State reviewed a draft of this report. The agencies provided technical comments that GAO incorporated into the report asAgency Commentsand Our EvaluationWe believe the guidance reflected in OMB's August 2011 memorandumis a positive step in reaffirming the importance of the role of CIOs inimproving agency IT management and toward addressing the concernsthat are the basis for our first recommendation. It highlights theresponsibilities of CIOs in the four areas of IT governance, programmanagement, commodity services, and information security. Theseresponsibilities are consistent with requirements in law and bestpractices. Further, OMB's planned use of the councils for agencyreporting..."

In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.