Web-Based Consumer Health Information: Public Access, Digital Division, and Remainders

Daniel Lorence, PhD, JD; Heeyoung Park, MHA, MS

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In This Article

Eliminating the Divide

1999 proved to be a watershed year for efforts aimed at reducing the digital divide. The Universal Service program, for example, was funded in an effort to make basic telecommunications services accessible to the public at reasonable and affordable costs. Congress had previously expanded the goal of this program to cover advances in telecommunications and information technology, and required "reasonable comparability" of services and rates between rural and urban areas. The Federal Communications Commission's (FCC's) Universal Service Fund, a key component of the program and funded at $1.7 billion for 1999, was promoted as helping telecommunications carriers mitigate the high costs of providing service to consumers in rural and insular parts of the country. Totaling $500 million, the FCC's low-income support program was implemented through 2 basic forms: the Lifeline Assistance program, designed to help low-income households pay monthly service bills, and the Link-Up America program, designed to help low-income subscribers pay the installation costs required to initiate service. Almost every state participated in at least 1 of the 2 programs. These efforts were designed to achieve higher telephone penetration rates among all US households. The Clinton Administration also sought to enact legislation that extended universal service to schools, libraries, and rural healthcare providers, enabling them to access the Internet more easily. This was accomplished, in part, through the eRate program, which required telecommunications carriers to provide, upon request by an eligible school or library, commercially available telecommunications services at a discounted rate. Discounts ranged from 20% to 90%, with the highest discounts accruing to the most economically or geographically disadvantaged schools and libraries. Total expenditures for the program were capped at $2.25 billion. The FCC supported full funding of the program beginning July 1, 1999, with the stated goal of helping connect more than 80,000 schools and libraries, and assisting numerous children and adults in learning how to use new technologies through new points of access to the Internet. In addition, during the same time period the US Agriculture Department's Rural Utilities Service initiated a targeted lending strategy and technical advice to help establish advanced telecommunications infrastructures in rural communities. The Administration also launched a coordinated public/private sector initiative to provide Internet functionality at community access centers, such as schools, libraries, and other public access facilities. The US Commerce Department's National Telecommunications and Information Administration (NTIA) was likewise one of the first programs to fund Community Access Centers (CAC) through its Telecommunications Information Infrastructure Assistance Program (TIIAP). A parallel program at the US Department of Education, the Community Technology Centers (CTC) program was initiated to enable the funding of CACs in economically distressed communities on a broader scale. Private corporations were also solicited to donate computers and software to neighborhood centers in support of these access efforts.[10]

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