QUESTIONS AND FULL SOLUTION UPDATED
◉ ISSUES WITH TECH/E-HEALTH.
Answer: -licensure across state lines
-who is legally liable
-lack of reimbursement
-unsubstantiated cost effectiveness
◉ UTILIZATION OF MEDICAL TECHNOLOGY.
Answer: -high-tech procedures are more readily-available in the US:
little is done to limit the expansion of new medical technology
-other countries use "supply-side rationing" to control cost
-the US spends more on medical R&D
◉ REASON FOR HIGH RATES OF DIFFUSION AND UTILIZATION IN
THE US.
,Answer: -utilization beliefs and values
-medical training and practice
-insurance coverage
-competition among providers
◉ CULTURAL BELIEFS AND VALUES.
Answer: -capitalism and lack of government intervention
-high expectations of finding cures through science and technology
-demand advanced technology
-technological imperative: the desire to have state-of-the-art
technology available and to use it despite its cost
◉ MEDICAL TRAINING AND PRACTICE.
Answer: -specialists use more technology than primary care
physicians
,-American medical graduates increasingly choose specialization over
primary care
◉ INSURANCE COVERAGE.
Answer: -insurance insulates both patients and providers from the
utilization and cost of health care
-lack of checks and balances in the US to determine the
appropriateness of high-cost services
-evidence from other countries to curtail the use of high-tech
procedures: fixed payments to providers, limited payments to
hospitals
◉ COMPETITION.
Answer: -specialization has been used as an enticement to attract
insured patients and to recruit specialists: such practices have
resulted in duplication of services
-competitions between hospitals
◉ MECHANISMS TO CONTROL THE GROWTH OF TECHNOLOGY.
Answer: -implement central planning to determine how much
technology will be made available and where
, -withdraw federal funding for R&D
-change the patterns of medical training, placing greater emphasis
on primary care practice
-reduce the number of specialty residency slots for medical
graduates
-curtail insurance payments for expensive medical treatments
-impose controls on pharmaceutical prices, which in turn will make
less money available for R&D and development of new drugs
◉ ROLE OF GOVERNMENT IN TECHNOLOGY DIFFUSION.
Answer: -mainly focus on issues related to safety, benefits, and risks
associated with medical technology
-funding R&D
◉ REGULATION OF DRUGS AND DEVICES.
Answer: -the food and drug administration (FDA): under US
Department of Health and Human Services (DHHS)