Public Administration

Technological innovation is deeply woven into the fabric of American culture, and is no less a basic feature of American health care. Medical technology saves lives and relieves suffering, and is enormously popular with the public, profitable for doctors, and a source of great wealth for industry. Yet its costs are rising at a dangerously unsustainable rate. The control of technology costs poses a terrible ethical and policy dilemma. How can we deny people what they may need to live and flourish?

Our health care system is crippled by desperate efforts to prevent the inevitable. A third of the national Medicare budget - nearly $175 billion - is spent on the final year of life, and a third of that amount on the final month, often on expensive (and futile) treatments. Such efforts betray a fundamental flaw in how we think about healthcare: we squander resources on hopeless situations, instead of using them to actually improve health.