An Open Letter to Congressman Jason Chaffetz

Dear Congressman Chaffetz,

You don’t know me but I am social worker in upstate New York. I am not in your constituency but I am concerned about your remarks on CNN today…

 

I appreciate that you then attempted to correct yourself but even that fell a little short in my book.

I have spent the last 14 years as a social worker, mostly serving youth and their families. I did work briefly with adults but I have served mostly people who relay on Medicaid, Medicare, and other safety nets like the ACA. People with multiple chronic conditions struggle with many questions about their finances, but I assure you what Iphone they choose is not one of them. That “self-reliance” as you call it is dependent on many factors.

Young people and their families struggle with choices every day…

Do they pay their copay or buy groceries?

Do they not hospitalize their child in an inpatient psychiatric unit because the nearest         one is 45 minutes away?

What do we need to cut so that we don’t become homeless?

I made $5 too many at my job so I lost my Medicaid benefits, what do I do?

How do I report my landlord who is doing shady things but also keep housing?

Not once; not one single time in my 14 years of serving the most vulnerable has someone had to choose between an IPhone and their healthcare. Your statement and even the “correction” is endemic of the GOP view on this population. That poverty comes with this fantastic menu of options. That those with multiple health conditions can just “pick and choose” where their money goes. By continuing to endorse idea’s like “High Risk Pools”, “Health Savings Accounts”, and Tax Breaks; you continue to ignore a huge segment of the population.

Healthcare costs that are often so astronomical, the price of their cell phone is the least of their worries. That basic needs like food, clothing, and shelter are a daily struggle. That finding transportation and childcare come with multiple barriers. That people have access to mental health care that helps them get out of bed to begin with.

I understand Obamacare is not perfect. My fear is what any GOP replacement means to those on the borders of the poverty level; too those with multiple and/or chronic health conditions. My hope is that you and others in the GOP listen to this segment of the population. Also understand that their choices are much more complex than how they are going to pay for their IPhone.

 

Net Neutrality and The Under-Served?

The election of Donald Trump as President has increased an understanding in issues that I did not really care about nor grasp before. Net Neutrality is one of them. The Wikipedia definition of “Net Neutrality” is as follows…

Net neutrality is the principle that Internet service providers and governments regulating the Internet should treat all data on the Internet the same, not discriminating or charging differentially by user, content, website, platform, application, type of attached equipment, or mode of communication. The term was coined by Columbia University media law professor Tim Wu in 2003, as an extension of the longstanding concept of a common carrier, which was used to describe the role of telephone systems.

What prompted this post was reading this article on Medium about how the FCC Chairman is spoken openly about how he is against internet neutrality (an argument we will get to in a bit). The below article argued how decreasing internet neutrality will actually decrease job creation…

Both the definition and the above criticism forced me to think about the implications for both social work and healthcare. This is complex argument that started several years ago when the FCC and then President Obama increased regulation on the Internet to ensure more equal access and pricing. The opposition made several arguments. That this was the government over-stepping and not leaving it up the free market. By making the internet a public service that is regulated it may stifle innovation. That by decreasing competition it will decrease innovation. A fairly balanced of the argument against net neutrality is laid out here…

Conversely, people who are for Neutrality are concerned by reducing regulation. That making it a free market, and making bandwidth/ISP’s costly; it will limit access. This seems like why this issue matters right now. I find the implications of this disturbing. That decreasing regulation will decrease internet access. That it would create high priced “internet fast lanes” that would exclude companies and ultimately consumers that can’t afford them.

Both sides seem to go against competing interests. Innovation versus access. The question I am left with is how can you increase innovation without access? Innovation is the act of “introducing something new; a new device or product”. In terms of health information technology, innovation is only as good as the people who can access it.

It is alarming for me to think about those with limited access to technology being further hampered by cost. As healthcare and mental health services become more digitized, there are potential implications for services. That companies attempting to innovate in this area might be hampered by cost of ISP services. There is already issues with mental health parity in general. Driving up costs to digital services may have a negative impact on access.

This seems like a complex issue that those interested in health and social service innovation should stay tuned to. Digital space has the potential to reach people but there is already a digital divide. Net Neutrality seems to be the key to not potentially further a digital divide. The kind of innovation I am interested in is less about worrying about price gauging of ISP’s and more about insuring access for the most frail and vulnerable.

I tried my best to understand this complex issue but I am very concerned about the loss of net neutrality. I would love to hear varying opinions on this. However, if you are as concerned as I am, stay informed is “Save The Internet” presented by Free Press Inc.