OTA Archive

Today’s document of the day summarizes the key concepts, background and rationale underlying the creation of the Office of Technology Assessment. The report, by  Walter H. Hahn and Rosemary Chalk of the Congressional Research Service,  also gives a brief  legislative history of the Act (P.L. 92-484).

Technology assessment was first discussed in the House Subcommittee on Science and Astronautics. According to the report,

The committee began serious work on the assessment concept in 1965, and on October 17, 1966, the Subcommittee on Science, Research, and Development published a report which examined the consequences and secondary impacts of technical innovations. This report was the first to use the term “technology assessment,” and the  authors cited technological unemployment, toxic pesticides, pollution, exhaustion of resources, the disposal of radioactive wastes, and invasions of personal liberty by electronic snooping and computer data banks as examples of the potentially dangerous consequences of technology. In view of these unforeseeable impacts, the subcommittee concluded that an “early warning” system for both the good and bad results of technology would be of great use to Congress.

In describing why this office should be a part of Congress the report noted,

The proposition of this Act is that the Congress is the proper national forum for deliberating and deciding upon conflicting goals, values, priorities, resource allocations and the distribution of benefits, risks, and costs, all of which are involved in technology assessment.  To carry out these responsibilities, The Congress should be one of the best informed institutions is this country.  Technology assessment alone will not achieve this desired state, but it does offer significant improvements to the current system.

This report is part of a growing colletion of historic documents found  here in the OTA Library.

A Health Reformer’s Online Diary | Ken Terry | November 17, 2008

A blog post suggests that  the U.S. healthcare system can improved by organizing providers,  improving quality,  reforming reimbursements, and researching cost-effectiveness.

As to cost-effectiveness research, Health Reformer says,  “…. have Medicare look not only at the clinical effectiveness of tests and treatments, but also at their cost-effectiveness–an idea that has been banished from American political discourse since the demise of the U.S. Office of Technology Assessment in the early ‘90s.”

You can check out several excellent reports on the cost-effectiveness of health care from the OTA archive:

A  1994 report, Identifying Health Technologies that Work – Searching for Evidence,  is a comprehensive update about what works.   Chapter 6, a history of the federal role in health technology assessment, may be of current interest.

A 1988 report, The Quality of Medical Care: Information for Consumers,  is a great compendium on how medical care can be evaluated.  It combines a conceptual framework,  dimensions to consider, and an analysis of possible indicators of the quality of care provided by physicians and hospitals.

A 1986 report, Payment for Physician Services: Strategies for Medicare, lays out a relevant process for analyzing how we pay for heathcare (even though the policy context is dated).  It evaluates some innovative payment methods, for example, bundling services into a package that is paid for at a flat rate or paying for a greater scope of services by capitation.