Hope Springs Eternal

In the long run, neither tech¬nology assessment as it’s currently done nor methods that include cost-effectiveness analysis will check the growth of tech¬nology costs enough to keep health care affordable. The former can weed out only interventions that are ineffective or harmful, and the latter can only inform value judgments that are best made by physicians and patients.

Yet tech¬nology assessment can slow down the introduction of some technologies until more evidence is available on their effectiveness. And when we get to “breakthroughs” that can bankrupt the system, a consumer council’s members might give their fellow Americans pause if they recommended against adopting the tech¬nology, or would approve it only for narrow indications.

We should not be too optimistic about this. Most people want to live at all costs, and most of the population still has enormous faith in the power of medi¬cal advances to improve health and extend life. A 2004 study, for example, found that “the public is enthusiastic about cancer screening. This commitment is not dampened by false-¬positive test results or the possibility that testing could lead to unnecessary treatment.”