Medical Efficacy versus Economic Efficiency: A Conflict in Values

Disquiet over rising costs has come to dominate discussions of the health-care system. A major cause of the cost spiral, in the view of many policy makers, is the excessive and inefficient use of innovations such as CAT scanners and coronary-artery surgery. Consequently, Congress has recently voted to establish a Center for National Health Care Technology with a mandate to define the safety, efficacy, efficiency and cost-effectiveness of medical procedures.1 , 2 This center, by formulating and disseminating standards for such procedures, is expected to influence decisions made by both physicians and government and thus to affect favorably both the quality and . . .