Imagine a world in which millions of senior citizens and disabled Americans, among others, can have, if they want, their medical conditions monitored continuously by devices that communicate over high speed, broadband networks that can automatically alert them if they require immediate medical attention. Such "remote disease management" systems not only would be highly convenient for patients, but based on evidence from the Veterans Administration's use of systems that do not yet make extensive use of broadband, could lead to huge savings in health care costs. I have calculated in a recent report that the health care cost savings and the reduced need for institutionalizing seniors and the disabled could top $1 trillion over the next 25 years.

But there is a hitch. Remote disease monitoring — and telemedicine more broadly — cannot use broadband networks unless they are reliable. Even more important than not having your streamed movie interrupted by heavy traffic from other Internet users is not having your vital signs transmitted without interruption to the individual or computer that is remotely monitoring your health.

Yet perhaps without realizing it, those who are now advocating "net neutrality" — the notion that those who shell out the big bucks to build new much higher speed networks can't ask the websites that will use the networks intensively to help pay for them — could keep this new world from becoming a reality. Further, they could deprive the websites themselves of the benefits of being able to use the networks to deliver their data-heavy content.