medical devices will attract many levels of scrutiny because of the great social costs and benefits associated with health care.

This diversity and complexity of policies can be frustrating to innovators, particularly if they do not appreciate the intricate history of health policy in the United States. It must not be forgotten that multiple sources of public policy may be beneficial as well. The system permits experimentation and flexibility and prevents the likelihood that one institution or individual could unilaterally ban or promote a technology. Nevertheless, polyintervention is particularly acute for the medical device industry and can have an adverse impact on innovation. While innovation is important, other values, including safety, universal access, and cost controls, cannot be overlooked. Some of these values may compete with innovation. Our ultimate goal should be to reconcile the competing societal values wherever possible. When it is not possible, we must be explicit about the conflicts and make the hard policy choices fairly and rationally. Innovators and patients deserve no less.

NOTE

1. The medical device industry is not the only one subject to polyinterventionary effects. Others include the oil industry, the automobile industry, and the nuclear power industry. For each, the configuration of public policies varies according to the history of the industry, the values of the public, and the perceived importance of the issues at stake.

REFERENCES

1. Jewkes J , Sawers D , Sillerman R. The Sources of Innovation . London : Macmillan , 1969 .

2. Pollard MR , Persinger GS. Investment in health care innovation . Health Affairs 1987 ; 6 :93-106 .

3. Rettig R. The politics of organ transplantation: a parable of our time . Journal of Health Politics, Policy and Law 1989 ; 14 : 191-227 .

4. Rettig R. Lessons learned from end stage renal disease experience . In Egdahl RH , Gertman P (eds). Technology and the Quality of Health Care . Germantown, MD : Aspen Systems 1978 : 153-174 .

5. Plough A. Borrowed Time: Artificial Organs and the Politics of Extending Lives . Philadelphia : Temple University Press , 1986.

6. Foote SB. From crutches to CT scans: business-government relations and medical product innovation . In Post JE (ed). Research in Corporate Social Performance and Policy . Greenwich, Conn. : JAI Press , 1986 .

7. Foote SB. Coexistence, conflict, cooperation: public policies toward medical devices . Journal of Health Politics, Policy and Law 1986 ; 11 : 501-523 .

8. Shannon JA. Advancement of medical research—a twenty year view of the role of the National Institutes of Health . Journal of Medical Education, 1967 .



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