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Technology and Health Care in an Era of Limits (1992) / Chapter Skim
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PART VII: CONCLUDING OBSERVATIONS
Pages 247-254

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From page 247...
... Part VII Concluding Observations
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From page 249...
... We manage somehow to hold two contradictory views seeing technology as the culprit behind rising medical care costs and as the jewel in the crown of American medicine. This dual characterizationtechnology as both hero and villain-underlies this collection of papers exploring the direction of health care reform and its likely impact on the process of medical innovation.
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From page 250...
... The practicing physician and surgeon shape the use of drugs, devices, and instruments as surely as the research chemist in a pharmaceutical firm or the engineer in an equipment manufacturing company. If we are to comprehend the effects of health care reform on medical innovation, then we must comprehend not only the varieties of potential reform, but the impact of these reforms on a multiplicity of actors, including patients, practitioners, institutional providers, entrepreneurs, drug companies, and device and equipment manufacturers.
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From page 251...
... How will the interests of individual patients and communities be incorporated in medical care decisions? In contemplating health care reform, it is easy and wrong-to confuse what creates a problem with what exposes the problem.
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From page 252...
... Thinking optimistically, what may emerge from health care reform is an enlightened strategy for medical innovation that responds to population health needs, to new system and organizational requirements, and to significant advances in biological and technical knowledge. From the various recommendations posed throughout this volume, I would in closing highlight three: an ethic of evaluation, education of physicians and patients, and public policy to promote innovation.
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From page 253...
... Finally, innovation in medical care can be stimulated by expanded public investment in basic biomedical research, tax and other economic incen tives that favor investment in companies developing new technology, and fresh approaches in such regulatory bodies as the Food and Drug Administration to facilitate experimentation and earlier, controlled dissemination of technology (perhaps coupled with more stringent postmarketing evaluation requirements)
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Key Terms

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  • care costs
  • scientific advances

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  • economic return
  • community context
  • public investment
  • controlled dissemination

  • expanded public
  • product innovation
  • significant opportunities
  • manage care
  • facilitate experimentation

  • organizational requirements
  • leading medical
  • equipment manufacturers
  • contradictory views
  • established companies

  • postmarketing evaluation
  • lifetime learners
  • fields offering
  • papers exploring
  • dangers especially

  • care institutions
  • careful evaluation
  • expected return
  • regulate decisions
  • european companies


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