By the end of 2016, almost half of the world’s population will be online as mobile networks grow and prices fall, but their numbers will remain concentrated in the developed world, a United Nations agency said.
In the world’s developed countries about 80 percent of the population use the internet. But only about 40 percent in developing countries and less than 15 percent in less-developed countries are online, according to a report by the U.N.’s International Telecommunications Union.
In several of Africa’s poorer and more fragile countries, only one person in 10 is on the internet. The offline population is female, elderly, less educated, poorer and lives in rural areas, said the union, a specialized agency for information and communication technologies.
Globally, 47 percent of the world’s population is online, still far short of a U.N. target of 60 percent by 2020. Some 3.9 billion people, more than half the world’s population, are not. ITU expects 3.5 billion people to have access by the end of this year.
“In 2016, people no longer go online, they are online. The spread of 3G and 4G networks across the world had brought the internet to more and more people,” the report said.
Telecoms and internet companies are expanding as more affordable smartphones encourage consumers to browse the internet, causing demand to grow for data-heavy services. However, less-developed countries – LDCs – still trail the rest of the world.
“Internet penetration levels in LDCs today have reached the level enjoyed by developed countries in 1998, suggesting that the LDCs are lagging nearly 20 years behind the developed countries,” the report said.
It blamed the cost of services and of extending infrastructure to rural and remote customers and the high price of mobile cellular use.
Edith Stowe, 83, waited patiently on a recent afternoon at the bus stop outside MedStar Washington Hospital Center in the District of Columbia. It’s become routine for her, but that doesn’t make it any easier.
Stowe, who lives about five miles from the hospital, comes into the medical center twice every three months to get checkups for chronic kidney failure. She doesn’t own a car and relies on buses. During rush hour, buses are more frequent, and she can keep the commute to about 30 minutes. But when she has to come in the middle of the day, it takes her at least an hour to get in and another hour to get home.
“It’s pretty good except for waiting during non-rush hours,” she said. “When that happens I don’t plan anything else for the day.”
For people without access to private transportation, getting to medical appointments can be a challenge, especially if they have chronic conditions that require frequent appointments.
Some hospitals and medical providers think that the hot-new technology in town — ride-hailing services such as Uber and Lyft — can address this problem by making the trips easier and, in some cases, it is even covered by Medicaid and other insurance plans.
Partnerships between ride-hailing companies and hospitals are emerging around the country. While the efforts are still small, some hospitals and medical transportation providers think the potential for growth is large.
MedStar Health, a nonprofit health care system with hospitals in Maryland and the district began a partnership with Uber in January that allows its patients who use Uber to access the ride service while on the hospital’s website and set up reminders for appointments. Medicaid patients who may not have access to the Uber app can also arrange the ride by calling the hospital’s patient advocates.
National MedTrans Network, a transportation system that provides non-emergency medical rides for patients and medical providers in a number of states, expanded its services through a partnership with Lyft last year in New York, California and Nevada.
Hackensack UMC, a hospital in New Jersey, the Sarasota Memorial Hospital in Florida, and Relatient, a health care communication company have also announced partnerships with Uber in the past year. Veyo, a San Diego startup, says it is offering a ride-hail-like technology for health care appointments in Idaho, Arizona, Texas, Colorado and California.
“We probably had 50 different systems across the country reach out to us and ask us ‘How did you do it?’” said Michael Ruiz, chief digital officer for MedStar. “I would say that it has been a seismic shift for the people who have used the service and the places we’ve provided it.”
Patients’ costs for the services vary. For Medicaid patients, transportation for non-emergency medical visits are covered, although the extent of reimbursement depends on state rules. Traditional Medicare does not cover non-emergency medical transportation, although some private Medicare Advantage plans may offer some benefits.
Getting To Your Doctor
When going to a medical appointment becomes a hassle, patients are likely to miss the visit, and that can help lead to untreated symptoms or worsening health.
“Transportation can make it difficult for people to see health care providers on a regular basis,” said Ben Gerber, an associate professor of medicine at the University of Illinois at Chicago who has studied patient transportation issues. “It is important to see health care professionals regularly, especially for patients with diabetes or asthma.”
In a 2013 analysis of 25 studies, Gerber and colleagues found that 10 to 51 percent of patients reported that lack of transportation is a barrier to health care access. One of those studies showed that 82 percent of those who kept their appointments had access to cars, while 58 percent of those who did not keep appointments had that access. Another study reported bus users were twice as likely to skip on appointments compared to car users.
A bus arrives at the bus circle at MedStar Washington Hospital Center in the District of Columbia in July 2016. Stowe gets to the medical center by bus, but when her appointments are in the middle of the day, it takes her at least an hour to get in and another hour to get home. (Zhai Yun Tan/KHN)
In addition to concerns about patients’ health, those absences can also be expensive for medical institutions, which lose revenue from the missed appointment.
Hospitals and managed care organizations do offer a variety of options to assist with transportation for non-emergency medical appointments. Health centers often work with volunteer drivers to pick up and drop off patients.
Patients can call them ahead of time to arrange a ride, but these services generally require advance planning, which becomes a problem when the patient needs to go in for an unscheduled appointment or if the patient forgets to book ahead.
Some patients also end up calling 911 for non-emergency situations, potentially diverting resources that could be used for others with more pressing needs.
The National Medtrans Network partnership with Lyft began after an incident in February 2015. One of its clients, an elderly woman, was left waiting for a ride to a hospital in New York in freezing weather for 30 minutes. The contracted provider failed to show up.
“It was almost a dangerous situation,” said CEO Andrew Winakor. When his company was notified of the situation, officials immediately called a ride-hail service. The ride arrived within six minutes. Winakor said Medtrans officials realized they had to find a transportation option that could respond immediately to canceled rides.
But ride-hailing services do have some disadvantages. Wheel-chair friendly rides are still limited to a few cities. They also depend on the availability of drivers, which might be scarce in rural areas and low-income communities.
MedStar in Washington, dealt with the problem in one of its hospitals in rural Maryland, where there was a lack of Uber drivers, when a patient there had to travel to the flagship hospital in D.C. for an outpatient surgery at 6 a.m.
“Our social workers worked with the folks at Uber to be able to coordinate the ride to pick this patient up at 4:30 am, and coordinate the ride back,” Ruiz said.
Buses, vans and local public transportation for people in wheelchairs come and go frequently in MedStar Washington Hospital Center’s bus center. Stowe is satisfied with the transport options available. While she hasn’t used Uber before, she said it is something she wouldn’t mind trying especially when it gets cold outside.
“There are times when you come out and you really don’t feel that well. If Uber is here, it’d be really nice to have it,” said Stowe.
This story by Zhai Yun Tan was made available by Kaiser Health News, a national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.
U.S. Rep. Mark Pocan, D-Madison, has launched the bipartisan Congressional Rural Broadband Caucus with Democratic Rep. Peter Welch of Vermont and Republican Reps. Kevin Cramer of North Dakota and Bob Latta of Ohio.
Their goal is “to facilitate discussion, educate members of Congress and develop policy solutions to close the digital divide in rural America.”
Pocan said, “Access to reliable, high-speed internet service is vital to economic growth in communities across America. Whether, it is for commerce, education or public safety needs, broadband service allows individuals and businesses in rural communities to take advantage of new technologies and stay connected to a 21st century economy. There are many parts of my district where residents experience extremely slow download speeds even as low as one megabit per second.”
Several communities in Wisconsin’s 2nd Congressional District, including the towns of Vermont and Cross Plains, have publicly adopted resolutions voicing concerns over the lack of quality broadband service available to residents.
“Broadband access is not a luxury, rather it is a necessity,” Pocan said. “I want to ensure people in my district, and across the country in rural areas, have updated broadband infrastructure and access to a reliable connection.”
A significant digital divide remains between urban and rural America.
More than half of all rural Americans lack access to this basic standard of service.
In 2015, the FCC updated its broadband benchmark speeds to 25 megabits per second (Mbps) for downloads and 3 Mbps for uploads.
According to the FCC, using this updated benchmark, the 2015 report finds that 55 million Americans — 17 percent of the population — lack access to advanced broadband.
Fans of Lifetime’s melodramatic movies can now see them for $4 a month — without subscribing to cable.
Lifetime’s online video service is the latest move by an entertainment company to bypass the traditional cable bundle, which easily tops $70 a month. For example, HBO has made its shows and movies available online for $15 a month to people who don’t pay for cable, while Showtime has an $11-a-month service debuting this month. CBS and Nickelodeon also have Internet offerings that don’t require a cable subscription.
Subscribers to Lifetime’s service won’t get the regular cable channel, which has ads and is available on many cable and satellite lineups. Rather, the Lifetime Movie Club service will let viewers watch a rotating pool of movies, about 30 at a time, from Lifetime’s library of more than 300 films. They will be shown without commercials. The channel’s reality shows and scripted TV series won’t be available.
Lifetime has long been known for its movies about stalkers, affairs gone bad and thrillers based on juicy headlines. It has been trying to appeal to younger audiences with such movies as “Aaliyah: The Princess of R&B.” It also has reality shows like “Little Women: LA” and the dance show “Bring It.”
“Lifetime movies definitely have a long history but they’ve changed over the years. Some of our biggest events on Lifetime are the movies,” said Dan Suratt, executive vice president for digital at A+E Networks, which owns Lifetime as well as the History channel and A+E.
While other online video services such as Dish Network’s Sling TV are aimed at people who don’t subscribe to cable, Suratt said he expects the movie app to be “entirely complementary” to Lifetime’s TV channel.
Like many channels, Lifetime’s primetime viewership has declined this year, according to Nielsen.
The new Lifetime Movie Club service will work on iPhones and iPads, with other devices coming this fall.
Sprint is introducing an “all-in” pricing plan, meaning a single, $80-a-month price that includes both a smartphone and a service plan for voice, text and unlimited data.
The new plan, though billed as simpler, won’t have many benefits for consumers. Prices for a Samsung Galaxy S6 and HTC One M9 won’t change, as it had been $20 for the phone and $60 for the service plan. An iPhone 6 plan will cost $10 a month more as Sprint gets rid of a promotion. These three phones are the only ones eligible, as they are among the most popular.
With the new pricing, Sprint is going back to how all wireless plans used to be sold. Until recently, phone companies routinely offered subsidies on phones in exchange for two-year contracts and made up for that in higher monthly fees. In the name of transparency, T-Mobile lowered the monthly service fees two years ago and started charging for the phone separately. AT&T, Verizon and Sprint followed on some of its plans.
Now, Sprint is returning to the old ways in combining the two charges.
There’s one big difference: Sprint is leasing the phone. Customers have to turn it in when upgrading or pay extra to keep it. With subsidies, customers own the phones outright and have no obligations beyond the two-year contract. That means a customer can resell the phone when upgrading or cancelling service.
In a statement, T-Mobile described the move as a “pushback against a trend that wireless users have overwhelmingly supported.” T-Mobile says separating the charges gives consumers more information to make better choices.
Sprint will still sell phones outright, though at higher monthly prices. Those options aren’t as prominent on Sprint’s website.
Sprint’s $80-a-month price doesn’t include taxes and surcharges, including a one-time $36 activation fee.
Internet activists declared victory over the nation’s big cable companies Thursday, after the Federal Communications Commission voted to impose the toughest rules yet on broadband service to prevent companies like Comcast, Verizon and AT&T from creating paid fast lanes and slowing or blocking web traffic.
The 3-2 vote ushered in a new era of government oversight for an industry that has seen relatively little. It represents the biggest regulatory shake-up to telecommunications providers in almost two decades.
The new rules require that any company providing a broadband connection to your home or phone must act in the “public interest” and refrain from using “unjust or unreasonable” business practices. The goal is to prevent providers from striking deals with content providers like Google, Netflix or Twitter to move their data faster.
“Today is a red-letter day for Internet freedom,” said FCC Chairman Tom Wheeler, whose remarks at Thursday’s meeting frequently prompted applause by Internet activists in the audience.
President Barack Obama, who had come out in favor of net neutrality in the fall, portrayed the decision as a victory for democracy in the digital age. In an online letter, he thanked the millions who wrote to the FCC and spoke out on social media in support of the change.
“Today’s FCC decision will protect innovation and create a level playing field for the next generation of entrepreneurs – and it wouldn’t have happened without Americans like you,” he wrote.
Verizon saw it differently, using the Twitter hashtag (hash)ThrowbackThursday to draw attention to the FCC’s reliance on 1934 legislation to regulate the Internet. Likewise, AT&T suggested the FCC had damaged its reputation as an independent federal regulator by embracing such a liberal policy.
“Does anyone really think Washington needs yet another partisan fight? Particularly a fight around the Internet, one of the greatest engines of economic growth, investment and innovation in history?” said Jim Cicconi, AT&T’s senior executive vice president for external and legislative affairs.
Net neutrality is the idea that websites or videos load at about the same speed. That means you won’t be more inclined to watch a particular show on Amazon Prime instead of on Netflix because Amazon has struck a deal with your service provider to load its data faster.
For years, providers mostly agreed not to pick winners and losers among Web traffic because they didn’t want to encourage regulators to step in and because they said consumers demanded it. But that started to change around 2005, when YouTube came online and Netflix became increasingly popular. On-demand video began hogging bandwidth, and evidence surfaced that some providers were manipulating traffic without telling consumers.
By 2010, the FCC enacted open Internet rules, but the agency’s legal approach was eventually struck down in the courts. The vote Thursday was intended by Wheeler to erase any legal ambiguity by no longer classifying the Internet as an “information service” but a “telecommunications service” subject to Title II of the 1934 Communications Act.
That would dramatically expand regulators’ power over the industry and hold broadband providers to the higher standard of operating in the public interest.
The FCC says it won’t apply some sections of Title II, including price controls. That means rates charged to customers for Internet access won’t be subject to preapproval. But the law allows the government to investigate if consumers complain that costs are unfair.
Industry officials and congressional Republicans fought bitterly to stave off the new regulations, which they said constitutes dangerous overreach and would eventually raise costs for consumers. The broadband industry was expected to sue.
“With years of uncertainty and unintended consequences ahead of us, it falls to Congress to step in,” said Michael Powell, head of the National Cable and Telecommunications Association.
GOP lawmakers said they would push for legislation, although it was unlikely Obama would sign such a bill.
“Only action by Congress can fix the damage and uncertainty this FCC order has inflicted on the Internet,” Sen. John Thune, R-S.D., chairman of the Senate Commerce Committee, said in a statement.
Also at stake Thursday was Obama’s goal of helping local governments build their own fast, cheap broadband. The FCC approved petitions by Chattanooga, Tennessee, and Wilson, North Carolina, to override state laws that restrict them from expanding their broadband service to neighboring towns.
A gay couple is pursuing a discrimination complaint against a Colorado bakery, saying the business refused them a wedding cake to honor their Massachusetts ceremony, and alleging that the owners have a history of turning away same-sex couples.
As more states move to legalize same-sex marriage and civil unions, the case highlights a growing tension between gay rights advocates and supporters of religious freedom.
“Religious freedom is a fundamental right in America and it’s something that we champion at the ACLU,” said Mark Silverstein, the legal director of the group in Colorado, which filed the complaint on behalf of the couple. “We are all entitled to our religious beliefs and we fight for that. But someone’s personal religious beliefs don’t justify breaking the law by discriminating against others in the public sphere.”
The attorney for Jack Phillips, one of the owners of Masterpiece Cakeshop, sees it differently.
“We don’t believe that this is a case about commerce. At its heart, this is a case about conscience,” said Nicolle Martin. She said the matter is important because it will serve as an example for future cases across the country as more gay couples gain legal recognitions for their relationships.
“It brings it to the forefront. I just don’t think that we should heighten one person’s beliefs over and above another person’s beliefs,” she said.
The Colorado Attorney General’s office filed a formal complaint last week after the ACLU initiated the process last year on behalf of David Mullins and Charlie Craig. The case is scheduled for a hearing in September before Colorado’s Civil Rights Commission.
Nationwide, 12 states now allow gay marriage, with Rhode Island, Delaware and Minnesota doing so this year. And in a year that Colorado lawmakers approved civil unions, they also elected the first gay Speaker of the House.
But Colorado’s civil union law does not provide religious protections for businesses despite the urging of Republican lawmakers. Democrats argued that such a provision would give businesses cover to discriminate.
Mullins, 28, and Craig, 33, filed the discrimination complaint against Phillips after visiting his business in suburban Denver last summer. After a few minutes looking at pictures of different cakes, the couple said Phillips told them he wouldn’t make one for them when he found out it was to celebrate their wedding in Colorado after they got married in Massachusetts. Phillips has said making a wedding cake for gay couples would violate his Christian religious beliefs, according to the complaint.
“We were all very upset, but I was angry and I felt dehumanized and mortified,” Mullins said. He said he vented his frustration on Facebook and was surprised at how “the story ended up catching fire,” with responses from local media and bloggers in other countries posting about it.
“We felt that the best way to honor the support that they had given us was to follow this complaint through,” he said. In the process, the ACLU said they found out about two other gay couples who had been refused a wedding cake from the same shop. Both have written affidavits in support of the discrimination claim.
Recent advances on gay rights only underscore Colorado’s difficult past on the issue. In 2006, voters banned gay marriage. More notably, in 1992, voters approved a ban on municipal anti-discrimination laws to protect gays, leading some to brand Colorado a “hate state.” Four years later, the U.S. Supreme Court said the law, known as Amendment 2, was unconstitutional.
The complaint seeks to force Masterpiece Cakeshop to “cease and desist” the practice of refusing wedding cakes for gay couples, and to tell the public that their business is open to everyone.
If Phillips loses the case and refuses to comply with the order, he would face fines of $500 per case and up to a year in jail, his attorney said.
“It would force him to choose between his conscience and a paycheck. I just think that’s an intolerable choice,” Martin said.
The Peace Corps will begin accepting applications from same-sex domestic partners who want to serve together as volunteers overseas.
Deputy director Carrie Hessler-Radelet said Same-sex couples may begin the application process starting on June 3.
“Service in the Peace Corps is a life-defining leadership experience for Americans who want to make a difference around the world,” Hessler-Radelet said in a news release. “I am proud that the agency is taking this important step forward to allow same-sex domestic partners to serve overseas together.”
Married heterosexual couples have been serving together in the Peace Corps since its inception in 1961. Currently, 7 percent of Peace Corps assignments are filled by married volunteers serving together.
Expanding service opportunities to same-sex domestic partners who want to volunteer together further diversifies the pool of Peace Corps applicants and the skills of those invited to serve overseas in the fields of education, health, community economic development, environment, youth in development and agriculture, according to the announcement.
The Peace Corps requires formal documentation for all couples who want to serve, and same-sex domestic partners will be required to sign an affidavit before leaving for service that will act as verification of their relationship.
The PC said “couples who serve together gain a unique perspective of host country customs and culture, but opportunities for couples are limited, as both applicants must apply at the same time and qualify for assignments at the same post. Many factors affect placements, including an applicant’s overall competitiveness, program availability, departure dates, and safety and medical accommodations. For any applicant, the number one factor in determining an assignment is the demand from host countries for skilled volunteers.
The second inaugural of President Barack Obama and Vice President Joe Biden begins on Jan. 19 and continues through Jan. 22.
“This Inauguration is about bringing Americans together to celebrate our shared purpose,” said David Cusack, executive director of the Presidential Inaugural Committee. “The schedule of official public events will allow Americans across the country to participate in the celebration.”
The schedule includes:
9:30 a.m. EST.: National Day of Service Summit on the National Mall, where the first and second families will gather to issue a call to action for all Americans to join in service and honor the legacy of slain civil rights leader Martin Luther King Jr.
6 p.m.: Kids’ Inaugural Concert at the Washington Convention Center with first lady Michelle Obama and Dr. Jill Biden hosting.
11:55 a.m.: An official swearing-In for Biden and Obama at the White House, in the Blue Room. Inauguration Day is traditionally on Jan. 20, but inaugural ceremonies are not usually held on Sundays because courts and other government officers are not open. So the official swearing-in will take place Jan. 20 but the celebratory swearing-in is Jan. 21.
11:30 a.m. — Ceremonial swearing-in ceremony on Capitol Hill.
2:30 p.m. — The inaugural parade from the Capitol to the White House along Pennsylvania Avenue, with the first and second families and 58 groups.
7 p.m. — The Inaugural Ball at the Walter E. Washington Convention Center.
10:30 a.m. — National Prayer Service at the Washington National Cathedral.
Four female servicemembers filed a lawsuit on Nov. 27 challenging the Pentagon’s ban on women serving in combat, hoping the move will add pressure to drop the policy just as officials are gauging the effect that lifting the prohibition will have on morale.
The lawsuit, filed in federal court in San Francisco, is the second one this year over the 1994 rule that bars women from being assigned to ground combat units, which are smaller and considered more dangerous since they are often in battle for longer periods.
The legal effort comes less than a year after the ban on gays serving openly was lifted and as officials are surveying Marines about whether women would be a distraction in ground combat units.
“I’m trying to get rid of the ban with a sharp poke,” said U.S. Army Staff Sgt. Jennifer Hunt, who was among the plaintiffs in the latest lawsuit and was injured in 2007 when her Humvee ran over an improvised explosive device in Iraq.
Hunt and the other three women said the policy unfairly blocks them from promotions and other advancements open to men in combat. Three of the women are in the reserves. A fourth, Marine Corp Lt. Colleen Farrell, leaves active duty this week.
Women comprise 14 percent of the 1.4 million active military personnel. The lawsuit alleges that women are barred from 238,000 positions across the Armed Forces.
At a Washington, D.C., news conference, Pentagon press secretary George Little said the Defense Department was making strides in allowing more women into combat. He said Defense Secretary Leon Panetta has opened about 14,500 combat positions to women.
“And he has directed the services to explore the possibility of opening additional roles for women in the military,” Little said. “His record is very strong on this issue.”
American Civil Liberties Union Ariela Migdal, who represents the four women, said Panetta’s actions weren’t enough. She called for an end to the combat ban. “These tweaks and minor changes on the margins do a disservice to all the women who serve,” she said.
“It falls short,” she said. “It is not enough.”
Marine Corps Capt. Zoe Bedell said she left active duty, in large part, because of the combat exclusion policy. Bedell said she was frustrated that her advancement in the Marines was blocked by her inability to serve directly in combat units.
“The military is the last place where you are allowed to be discriminated against because of you gender,” she said.
Bedell said the blurred front lines of modern warfare, with suicide bombs and sniper attacks, have put more and more women in combat situations.
More than 144 female troops have been killed and more than 860 have been wounded in Iraq and Afghanistan since the wars began, according to Pentagon statistics.
Military leaders say they want to make sure lifting gender-based barriers would not disrupt the cohesion of the smaller combat ground units and military operations.
The Marine Corps’ top leader, Gen. James Amos, ordered a survey of 53,000 troops to get their views, including whether they believe women in those units would distract male Marines from doing their jobs. The results have not been released yet.
The lawsuit alleges the ban violates constitutional female service members’ equal rights. “As a direct result of this policy,” the lawsuit states, “women – as a class and solely because of their gender – are barred from entire career fields.
The lawsuit also alleges that women are already serving unofficially in combat units.
Air National Guard Major Mary Jennings Hegar sustained shrapnel wounds in 2009 when she exchanged fire on the ground in Afghanistan after her Medevac helicopter was shot down. Both she and Hunt received Purple Heart medals for their injuries.
The lawsuit was assigned to U.S. District Judge Edward Chen, an appointee of President Barack Obama.