I’ve been following the current US healthcare reform debate – or what passes for it – with a modicum of interest. I don’t pretend to understand how the current system works, or whether President Obama’s reform proposal would make things better or worse, but even his opponents would be hard-pressed to make a rational argument that the current US healthcare system is reasonably priced and affordable.

 

What does that have to do with telecoms technology? Potentially quite a bit.

 

The New York Times recently told the one about Kara Lynn, a woman whose mouth and throat muscles have been atrophied by amyotrophic lateral sclerosis (ALS), thus removing her ability to speak. Two years ago, she bought a specially designed PC, approved by Medicare (the US’s current public health insurance option), with a specialized text-to-speech function.

 

However, that’s all it did, as Medicare requirements dictate (as do private insurers) that such a PC be limited to speech enablement. That means no email, no Web surfing or any of the other things people usually do on PCs. Supposedly, companies that make such PCs can enable them to do all of that for a fee (and after the insurance company agrees to cover the purchase). But as speech-enabling technology went, it was hardly mobile. All of which sounds somewhat absurd considering the PC’s $8,000 price tag.

 

So this year, Ms Lynn bought a device that does everything her expensive speech-generating computer does and a lot more: a $300 iPhone 3G running $150 text-to-speech software.

 

Medicare won’t cover it, even though it’s a far less expensive solution. Neither will private insurance companies. Why? Because the iPhone is not a dedicated medical device.

 

See what just happened there?

 

To be fair, one reason Ms Lynn’s speech-enabling PC costs so much is because it’s customized and highly specialized, and as we’ve seen even in the mobile sector, devices designed to do one thing well tend to do that one thing better than devices designed to do lots of other things (which is why your phone’s camera is still not as good as a high-end standalone digital camera, no matter how many megapixels it supports).

 

Also, dedicated speech-enabling devices is getting a lot more portable than it was two years ago when Ms Lynn bought her big clunky PC. In August this year, speech equipment specialist DynaVox released a handheld device in a touch-screen PND form factor with Wi-Fi/Bluetooth connectivity and 8GB of flash memory. It also sports a contact list, MP3/video players and a Web browser (though the latter is optional, otherwise, insurance companies won’t cover it). 

 

On the downside, at 1.5 pounds, it’s a brick compared to the iPhone, and Wi-Fi connectivity is geographically limiting. And while DynaVox hasn’t released pricing information just yet, odds are you’ll be able to buy at least several iPhone 3Gs for the same price. Also, while DynaVox’s software is undoubtedly sophisticated and flexible, Ms Lynn seems happy with the iPhone’s capabilities for the price.

 

In any case, I can’t help looking at this anecdote in the context of mobile’s increasing role in healthcare, from doctors and nurses using smartphones and netbooks to remote patient monitoring and Bluetooth-enabled body-area networks monitoring your heart rate and blood pressure. All of this can be done mostly with standard and comparatively low-cost wireless technology. It’s even possible now to build an ultrasound device that fits in your pocket with $150 in spare parts.

 

Which is why the case of Kara Lynn fascinates me. It shows how mobile phones, services and apps could provide an alternative (albeit not necessarily a comprehensive one) to more expensive solutions. And as these solutions become more widespread – with a mobile-tech-savvy generation waiting in the wings to use them – it will be interesting to see the impact, if any, on healthcare costs and insurance coverage requirements.