Bridging the Digital Divide

BERKELEY, CALIF. (03/05/2000) - With health care moving online, a group of academic, business and government leaders met Thursday to work on ways to keep the poor from falling through the digital safety net. "It's important that if we're going to have social justice as it pertains to health, that this digital divide as it pertains to health be bridged," said Robert Berdahl, chancellor of the University of California at Berkeley, which hosted the e-Health Summit.

Concerns over the so-called health digital divide in the U.S. mirrors the debate over access by low-income people to the Internet Economy. But if the discussions at Berkeley Thursday were any indication, the breach in health care will be harder to close.

Participants in the summit say that's not surprising, given a health care system that leaves some 55 million people uninsured. Giving the poor access to online medical care is complicated by the government's role in paying for their health care through Medicare and other programs. "We're dealing with two huge cultures, health and government.

These are the two systems that have invested the least and are the most ignorant about what technology can do," said Molly Coye, the former director of the California Department of Health Services and now a senior VP at the Lewin Group, a health consulting firm. "Health care has not traditionally been about empowering the patient." For their part, online health care companies seem reluctant to encourage the government to play a larger role.

"It's not appropriate for government to lead the revolution, but to support it with appropriate policy," said Healtheon/WebMD Chief Medical Officer Charles Saunders. California Healthcare Institute CEO David Gollaher suggested that Internet health care companies could find a huge market in providing medical care to low-income people.

"Uninsured people purchase 63 percent as many health care products and services as the fully insured," he said, citing a 1996 Rand study. "The ability to streamline supply and demand to serve underserved populations would seem to be substantial." Yet as Saunders acknowledged, poor and uninsured people don't necessarily fit the demographic sought by the online health care industry.

"We're not targeting groups that are underserved," he said. "And I'd be the first to admit the flaw in that process. There are enormous, enormous holes in the approach we're taking, but it's a pragmatic one."

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