Coile R C
Health Forecasting Group, Alameda, CA 94501.
QRB Qual Rev Bull. 1990 Jun;16(6):202-8. doi: 10.1016/s0097-5990(16)30366-9.
The 1990s will be a critical decade for medical technology. An irresistible force (an aging population that requires more medical care) will meet an immovable object (limited resources). Technology will be the centerpiece of debates about the efficiency and efficacy of the health system in the United States, which currently has the best medical technology in the world and the highest medical costs, with much of the cost attributable to technology. Faced with the possibilities of maintaining our current health system, or going to other systems (Medical Break-throughs, Reregulation, or a National Health System), the United States needs a national health policy that cost-effectively raises health levels for all people. Technology can be the strong point of such a system. However, we must plan for and manage technology effectively. If managed care is unsuccessful in holding health inflation to below 10%, more radical solutions to the ethical issues involving the cost and availability of technology become increasingly necessary.
20世纪90年代将是医疗技术发展的关键十年。一股不可阻挡的力量（老龄化人口需要更多医疗护理）将遭遇一个不可动摇的物体（资源有限）。技术将成为美国卫生系统效率和效力辩论的核心，美国目前拥有世界上最先进的医疗技术和最高的医疗成本，其中很大一部分成本归因于技术。面对维持现有卫生系统或转向其他系统（医疗突破、重新监管或国家卫生系统）的可能性，美国需要一项具有成本效益的国家卫生政策，以提高所有人的健康水平。技术可以成为这样一个系统的优势所在。然而，我们必须有效地规划和管理技术。如果管理式医疗在将医疗费用通胀控制在10%以下方面不成功，那么就越来越有必要对涉及技术成本和可得性的伦理问题采取更激进的解决方案。
