Requested by: Committee on Labor and Human Resources Hon. Edward M. Kennedy, Ranking U.S. House of Representatives Hon. John Dingell, Chairman Hon. Henry Waxman, Chairman GOVERNMENT POLICIES AND PHARMACEUTICAL R&D This project examines current trends in the costs of and returns to pharmaceutical R&D and the profitability of research-intensive pharmaceutical companies. Trends in the regulatory process, the market for new drugs, and tax policy affecting pharmaceutical R&D are also being analyzed. Project Director: Judy Wagner Estimated Publication Date: Spring 1993 Requested by: U.S. House of Representatives Committee on Energy and Commerce Hon. John D. Dingell, Chairman Subcommittee on Health and the Environment Hon. Henry A. Waxman, Chairman TECHNOLOGY, INSURANCE AND THE HEALTH CARE SYSTEM Major issues to be addressed by this assessment include relationships among having health insurance, other factors in access and health, and health outcomes; and how a minimum benefit package for the uninsured might be fashioned from the perspectives of effectiveness and cost-effectiveness. Project Director: Denise Dougherty Estimated Publication Date: Spring 1993 Associated Publications Does Health Insurance Make a Difference? (published 9/92) Competing Approaches to Health Care Reform: Impacts on Health Care Expenditures, Government Budgets. Employment and Individual Households Health Insurance: The Hawaiian Experience Jan. 1993 Medical Testing of Applicants for Individual Health Insurance: Reliability Insurance Status and Health Care Utilization: Analysis of Four Data Bases Lasers in Health Care: Case Study of Information about Effectiveness in FEDERAL RESPONSE TO AIDS: CONGRESSIONAL ISSUES The growing impact of AIDS on the Nation's health continues unabated, despite the optimism generated by the discovery and rapid approval of the first palliative drug against the AIDS virus and preliminary testing of possible vaccines. Preventing the spread of the AIDS virus is the primary strategy that is available, but is dependent on as yet unresolved differences on when testing for infection is appropriate and on how to alter the behavior of high-risk groups. The nation's, and even many other countries', social, economic, legal, and political systems have all been affected to some degree by the appearance of AIDS, and controversies over AIDS have begun to affect international relations and community among nations. Congress has responded with rapid increases in federal funds for scientific and medical research and for research and services in preventive education, and has begun to grapple with the difficult issues involved in financing AIDS-related health care. These diverse issues warrant a different approach from the usual OTA assessment, and this effort is oriented toward a monitoring and advisory capability within OTA to assist the increasing number of congressional committees that have AIDS on their agendas. Project Director: Bob McDonough Requesters: Technology Assessment Board, with encouragement from the House Appropriations Committee DEFENSIVE MEDICINE AND THE USE OF MEDICAL TECHNOLOGY This assessment will examine the degree to which physicians respond to the medical malpractice environment by altering their treatment strategies, and in particular their use of medical technologies. OTA will attempt to analyze defensive medicine's impact on health care delivery costs and the use of medical technology. INTERNATIONAL DIFFERENCES IN HEALTH TECHNOLOGY, SERVICES AND ECONOMICS This assessment will identify how differences in organization, adoption, and use of medical technologies among industrialized countries contribute to differences in costs and health outcomes, and how differences in the structure of health financing, payment, and regulation among industrialized countries contribute to the different patterns of technology use among countries. Project Director: Hellen Gelband Estimated Publication Date: Fall 1993 Requested by: U.S. House of Representatives Committee on Ways and Means Hon. Dan Rostenkowski, Chairman Subcommittee on Health Hon. Pete Stark, Chairman TUBERCULOSIS: RESEARCH, TECHNOLOGICAL AND POLICY ISSUES This study will analyze the clinical science and epidemiology of TB as well as policy issues of particular concern to the Congress: programs and funding for TB prevention and control within Federal, State, and local health agencies; the development of new TB drugs, drug delivery systems, and vaccines; and the effectiveness of policies and programs to achieve compliance with TB treatment regimens. Particular attention will be given to the overlap between the HIV and TB epidemics. Project Director: Michael Gluck Estimated Publication Date: Summer 1993 Requested by U.S. House of Representatives Committee on Energy and Commerce Subcommittee on Health and the Environment Hon. Henry Waxman, Chairman POLICY ISSUES IN THE PREVENTION AND TREATMENT OF OSTEOPOROSIS This report addresses questions about Federal funding for research on osteoporosis, technologies to detect osteoporosis, methods of prevention and treatment, professional education and training, and public education about osteoporosis. PROSPECTS FOR HEALTH TECHNOLOGY ASSESSMENT This study will describe the array of existing techniques, their limitations and potential uses, and the questions to which they are most appropriately and profitably applied. Additionally, an evaluation of the validity of newer techniques and how further refinement of these techniques is likely to enhance their usefulness to Federal and State policymakers will be made. Finally, the study will examine how technology assessment information is disseminated to medical care practitioners and consumers, and assess its ability to affect medical practice and health care utilization. Project Director: Elaine Power Estimated Publication Date: Spring 1994 Requested by: Senate Committee on Labor and Human Resources Hon. Edward M. Kennedy, Chairman Hon. Orrin G. Hatch, Ranking Minority Member Endorser Hon. Charles Grassley SYSTEMS AT RISK FROM CLIMATE CHANGE Most policy decisions made in the next several years about climate change will be made in the face of great uncertainty about the nature and magnitude of potential effects on natural and engineered systems. It will be a decade or more before the General Circulation Models (GCMs) offer the kind of temporal and regional detail desirable or the results of the massive research efforts underway both here and broad are available. In this assessment, OTA will attempt a strategic look at the interplay between the natural and engineered systems potentially at risk from climate change, the timing of information needed for planning for these systems, and how well-coordinated the Federal research program is to provide such answers. MANAGING MATERIALS FROM NUCLEAR WARHEADS The dissolution of the former Soviet Union has accelerated U.S. and international efforts to eliminate thousands of nuclear weapons over the coming years. These efforts raise important issues as to how weapon dismantlement can be accomplished so that the nuclear materials and other hazardous and toxic materials in the warheads will be managed safely and with adequate protection to human health and the environment. This assessment will examine approaches being considered or planned by the U.S. and the nations of the former Soviet Union for removing the nuclear warheads from active stockpiles and for storing, converting or disposing of the plutonium, uranium, and other components. The study will analyze the health and environmental impacts of these approaches. The study will evaluate the role of U.S. and international agencies in carrying out or overseeing the programs, and will assess policy options for future use or disposal of the nuclear materials removed from the warheads. Project Director: Peter Johnson and Emilia Govan Requested by: Senate Committee on Governmental Affairs Hon. John Glenn, Chairman Hon. William V. Roth, Jr., Ranking Minority Member NEW APPROACHES TO ENVIRONMENTAL REGULATION As U.S. environmental compliance costs have risen, Congress has come under increasing pressure to move away from traditional regulatory programs to newer and more economically efficient or effective approaches. These include: market-based mechanisms (such as the marketable permit program used to control acid rain) and information programs (such as the toxic release inventory under Superfund). This assessment would evaluate how well current command-and-control regulations have worked and the appropriateness of alternative policy instruments for the wide variety of pollution problems we face today. The theoretical advantages of alternative policy instruments have been discussed for years. The study would systematically evaluate, using a consistent set of Congressionally relevant criteria, the strengths and weaknesses of the full range of choices available: market-based approaches, information programs, technology-based standards, performance-based standards, enhanced monitoring and enforcement, etc. Unfortunately, little effort has been given to such pragmatic issues as implementation, monitoring, and enforcement. The assessment will examine new programs being tried by State and localities, such as the marketable permit program currently being tried to control ozone in Southern California. Other OECD countries have tried nontraditional approaches as well and no doubt will be a source of useful information. Special attention will be paid to how new advances in monitoring, modeling and control technology development have affected the feasibility and costs of the regulatory choices. Project Director: Robert Friedman Estimated publication date: Summer 1994 Requested by: Senate Committee on Environment and Public Works Hon. Quentin Burdick, then Chairman Hon. John H. Chafee, Ranking Minority Member TECHNOLOGIES FOR ADULT LITERACY How can technology offer new resources and create new opportunities to reach adult learners and improve productivity of learning? This study will identify ways to increase learning access in existing programs and in new ways, crossing the economic, cognitive, social, and institutional barriers that confront so many adults in need of improved literacy. Project Director: Linda Roberts Estimated publication date: Early 1993 Requested by: Senate Committee on Labor and Human Resources Hon. Edward M. Kennedy, Chairman U.S. House of Representatives Hon. Augustus F. Hawkins, then Chairman Hon. William D. Ford, Member |