Sisk J E, Glied S A
Health Aff (Millwood). 1994 Summer;13(3):82-97. doi: 10.1377/hlthaff.13.3.82.
Health care reform, which seeks to expand coverage and control spending, contains mixed messages for innovators. Policies that advance reform goals are likely to shift resources away from hospitals, specialists, and expensive procedures and toward areas such as prevention and primary care where innovation may yield greater health improvements per dollar spent. The size of these effects depends critically on the extent of cost containment achieved. Constraining spending will be politically difficult because it requires that consumers forego some possible health benefits in return for lower costs. In a climate of cost containment, systematic evaluation of new technology is vital to identify and expand coverage to worthwhile innovations and to assure a fair hearing for innovators.
旨在扩大医保覆盖范围并控制支出的医疗保健改革，向创新者传递了复杂的信息。推进改革目标的政策可能会将资源从医院、专科医生和昂贵的医疗程序转移到预防和初级保健等领域，在这些领域，创新可能会在每花费一美元时带来更大的健康改善。这些影响的大小关键取决于成本控制的程度。限制支出在政治上会很困难，因为这要求消费者放弃一些可能的健康益处以换取更低的成本。在成本控制的环境下，对新技术进行系统评估对于识别有价值的创新并扩大其覆盖范围、以及确保创新者得到公平听证至关重要。
