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The which-hunt: assembling health technologies for assessment and rationing
Journal of Health Politics, Policy and Law
|September 30, 1999
Summary
Health care policy decisions on funding cuts often overlook how technologies are grouped. Defining these technology assemblies is socially constructed and impacts trade-off decisions.
Area of Science:
- Health Policy
- Health Economics
- Technology Assessment
Background:
- Health care spending constraints necessitate decisions on technology funding.
- Existing frameworks focus on selecting services to cut, not defining the choices.
- The process of framing technological trade-offs (technology assembly) is under-examined.
Purpose of the Study:
- To examine the concept of 'technology assembly' in health care rationing.
- To identify conventions and problems in defining technological trade-offs for policy decisions.
Main Methods:
- Analysis of theoretical and applied rationing exercises.
- Review of Oregon's Medicaid rationing, economic evaluations, citizen surveys, and Canadian deinsurance policies.
Main Results:
- Technology boundaries are fluid, interlocked, and socially constructed.
- Trade-offs are negotiated and reflect broader political, administrative, and ethical issues.
- Examples include equity, concepts of need, and legitimacy of therapeutic goals.
Conclusions:
- Understanding technology assembly is crucial before deciding which health technologies to fund or deinsure.
- Policy makers should critically assess how technologies are framed to ensure informed decision-making.