lth care insurance and management - electronically integrating the various management and payment processes with a new health industry structure. The aim is to closely integrate all players into a new medical record and inter-payments structure, SO that savings would come initially on the non-clinical side - in the support systems, medical insurance and payments systems. For the American model, this would amount to perhaps 5% of total costs, near to USD 40 billion for the United States. That country's HMO arrangements and similar systems INFRASTRUCTURE TO 2030: TELECOM, LAND TRANSPORT, WATER AND ELECTRICITY - ISBN 92-64-02398-4 © OECD 2006 2. TELECOMS INFRASTRUCTURE TO 2030 Figure 2.27. Total expenditure on health as percentage of GDP LUX IRL FIN GBR ESP JPN AUT ITA DNK SWE BEL NLD PRT FRA GRC DEU USA Source: OECD, 2003. could be replaced by an electronic market in health care in which individuals and organisations such as employers, insurance companies or pension funds contract directly for services on a long term or spot basis. Telemedicine savings on clinical treatment-increased - health levels expected on the clinical side from advances in telemedicine use - especially as health care crosses borders and poorer countries may obtain distant consultancy services at low cost. The core question is then to assess the effects in national economic terms of increased health levels. Effects are twofold. Savings on national budgets as less needs to be spent to build a viable health system, plus the productivity increases. Less lost working days to the economy and insurance restitution costs. Will telemedicine bring any help in moving to a lower cost model, and if SO in what areas of health care? Telemedicine promises advances in seven distinct areas: The sharing of medical expertise across a country and across national boundaries, with improvements in quality and costs. Accurate assessment of the seriousness of illnesses can be estimated, which non-specialist staff often cannot determine. For instance, a 2-way video lin