Title: A sub rosa world: Medicare and the cost of new technology

Authors: Jacqueline R. Fox

Addresses: University of South Carolina School of Law, 701 Main Street, Columbia, SC 29208, USA

Abstract: The cost of medical care, particularly new medical technologies, continues to rise. This article examines how Medicare struggles to confront the challenge of shaping coverage decisions for expensive new technologies in light of political pressure to restrain cost, imperfect information about the effectiveness of new technologies, and a limited scope of power for how these decisions can be made. This article argues that, while these coverage decisions must be made with express reference to evidence of effectiveness, the interpretation of this evidence is distorted by hidden cost concerns by both Medicare and those who seek coverage.

Keywords: healthcare technology; rationing; Medicare; healthcare reform; implantable defibrillators; technology effectiveness; cost effectiveness; evidence-based medicine; medical care; political pressure; technology costs; technology investment.

DOI: 10.1504/IJHTM.2011.040482

International Journal of Healthcare Technology and Management, 2011 Vol.12 No.3/4, pp.321 - 332

Published online: 28 Mar 2015 *

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