ITY - ISBN 92-64-02398-4 © OECD 2006 2. TELECOMS INFRASTRUCTURE TO 2030 There are also plans in some electricity supply companies to re-examine the use of power line signalling for communications, for urban, suburban and rural communities. Thus where there is a power line there could be a broadband connection. Experiments in transmissions to the home or office have been under way for many years, some with backhaul from the local electricity substation via alternative wireless technologies, or via embedded fibre in the high voltage cabling. Gas and other fuels for heating - an enhanced storage and distribution network for gas would be required in response to the effects of telework, wherever it is economically viable to supply via the piped network. For more dispersed communities, this may never be the case, SO that alternative heating energy supplies (heating oil, electricity) would be turned to, increasing their infrastructure demands proportionately. Water, sanitation and sewage - We would also expect some impact on water and sanitation/sewage infrastructures to require denser network coverage for remote environments. Telecommunications for infrastructure services Telecommunications has been promoted over the past decade as a potential advance for infrastructure services - medical care, eldercare for an ageing population, education and justice. Health systems and telemedicine Over the past four decades, total expenditure on health as percentage of GDP as been rising significantly towards a median of 8% for OECD countries, as shown below, but with the United States exceeding 12% of GDP.86 Today's systems face problems of high inflation in treatment costs, scarcity of trained personnel leading to deteriorating standards of care and challenges from particular medical trends - cardiovascular disorders and an ageing population. Moreover the management bureaucracy surrounding health care is a significant portion of total cost. Telecommunications could provide relief in two principle areas: Telemedicine savings on hea