Double-Edged Sword of Technology Assignment

Double-Edged Sword of Technology Assignment

Double-Edged Sword of Technology Assignment

Learning Objectives

By the end of this chapter, you should be able to:

1. Describe how medical technologies contribute to high healthcare costs.

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2. Describe connections between technological advances in care and patients’ expectations.

3. Explain how medical technologies are becoming increasingly patient-facing.

4. Discuss how medical technologies can be used to reform the U.S. healthcare system in the areas of accountability, efficiency, and effectiveness.

10

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The Double-Edged Sword of Technology: Need Versus Cost Chapter 10

Imagine entering a doctor’s office and the doctors and nurses have access to all of your previous medical records. Your waiting time is shortened, you don’t need to fill out forms, and you don’t have to explain prior hospitalizations. And should you move to a new city, your medical files will follow you there. Now imagine being able to review your lab results on your iPad at home and send electronic messages to your doctor’s office at any hour of the day. These types of interactions may be less common right now, but with the growth of new technologies in healthcare, they could become part of the typical healthcare experience in the United States.

Medical technologies can include a broad array of devices, instruments, or systems related to how medical knowledge is applied. Such technologies are not limited to the way we transmit health information, but can include innovative devices, such as an artificial pancreas for diabetics and brain implants for epileptics, and treatment procedures. Medical technology extends even to video games designed to hone the decision-making skills of medical students. Though varied, all of these technological innovations share the same goals: To help people stay healthy, diagnose disease, treat illness, and provide a better quality of life for patients.

Table 10.1 shows some examples of recent developments in medical technology.

Table 10.1: Examples of medical technology

Pharmaceuticals

Medical procedures

Medical devices

Diagnostic equipment

Information technology

Chicken pox vaccine Open-heart surgery Pacemaker MRI (magnetic resonance imaging)

Electronic health record

Viagra Arthroscopic knee surgery

Insulin infusion pump

CT (computed tomography)

Telemedicine

Some have argued that medical technology is the most significant catalyst for change in the healthcare sector. This chapter introduces the leading medical technologies and discusses the role they play in sustaining particular aspects of the U.S. healthcare system, such as high costs, healthcare disparities, and the culture of healthcare. The chapter also describes the complexity of the advantages and disadvantages of these technologies in the ever-changing healthcare land- scape of the United States.

10.1 The Double-Edged Sword of Technology: Need Versus Cost

It is hard to deny two aspects of medical technologies: their benefits and their costs. Tied to the notion of efficiency (see Chapter 1), a healthcare system is challenged to balance the health needs of its population and the costs of providing the best healthcare services available.

The medical technology industry is one of the most profitable industries in the United States. In fact, the United States is both the largest producer of medical technologies and the biggest consumer. The U.S. market value share exceeded $110 billion in 2012, equivalent to almost 40% of the global medical technologies industry (Select USA, n.d.). According to the Department of Commerce, U.S. exports of medical technologies were valued at approximately $44.2 billion in 2012, a 7.2% increase from the previous year (Los Angeles County Medical Association, 2013).

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The Double-Edged Sword of Technology: Need Versus Cost Chapter 10

One subset of this industry includes companies producing medical devices. Several of these com- panies have international reputations for their innovations and high quality standards. This can be attributed in part to the large investment in research and development (R&D), which more than doubled during the 1990s. In fact, research and development in this industry is more than double what is invested in other domestic industries.

The outcomes of these significant investments in medical technology have been credited with increasing life expectancy in the United States. Although life expectancy more than doubled between the years 1900 to 1965 due to improved sanitation, nutrition, and overall living condi- tions, increases in longevity beyond this have largely been attributed to medical technologies (Burger, Baudisch, & Vaupel, 2012).

However, the increase in longevity has come with other costs. Some have argued that one rea- son the United States has not been able to fund medical care for the entire population is the high costs associated with operating a healthcare system that is reliant on medical technologies (Chaudhry et al., 2006). In contrast, other countries with a universal healthcare system (e.g., the United Kingdom [UK] and Canada) have much tighter regulations on the use of technology in basic healthcare. These health systems use medical rationing, a process which restricts health- care goods and services based on the value they add to an additional year of an individual’s life (i.e., quality-adjusted life year). For example, in the UK, the healthcare system generally does not recommend paying for therapies that exceed more than $31,000 to $47,000 for each year of life gained (Porter, 2012). As a result, a patient might not have access to the latest (i.e., most expen- sive) therapy available. This type of rationing has been strongly criticized for “putting a price on life” and has been widely rejected by the majority of Americans. The tradeoff is that medical rationing enables the UK to offer free healthcare to all its legal residents, not simply to those who can afford it. Assignment: Double-Edged Sword of Technology.