This report discusses the biotechnology development, government, research institutes and industry and finance in the following countries: Singapore, Thailand, South Korea, and Taiwan.
This report identifies key technologies and shows how they are being used to communicate clinical information, simplify administration of health care delivery, assess the quality of health care, inform the decision-making of providers and administrators, and support delivery of health care at a distance.
This report focuses on energy use in buildings, which account for over one-third of all energy used in the United States. Significant energy savings in buildings are possible through the use of commercially available, cost-effective, energy efficient technologies; yet adoption rates for these technologies are often low. Interviews with industry, property managers, homeowners, and others were used to explore why technology adoption rates are so low. Past Federal efforts to encourage energy efficiency are reviewed, and policy options for encouraging the adoption of energy efficient technologies are discussed.
This report elaborates on the findings of the earlier OTA publications and examines in greater detail the specific policy choices involved in restructuring the defense technology and industrial base (DTIB) over the next decade.
Listings of publications by subject from the Office of Technology Assessment, with some contextual information about the organization and ongoing work.
This background paper examines the epidemiologic evidence used by the CDC in deciding to revise the AIDS case definition and the impact the proposed definition will have on surveillance. The paper also explores the logistical consequences and other implications of the revised definition, including its impact on Social Security disability determinations.
This report discusses the actions necessary to effect a major reduction of United States. carbon dioxide emissions. The U.S. is the world’s leading industrial society and largest single emitter of carbon dioxide. Climate change therefore presents a unique challenge to this Nation. It is a threat that will require major prudent political actions even before all the scientific certainties are resolved. The analysis, prevention, and remediation of global warming will require unprecedented international cooperation and action—an effort requiring actions sustained over decades, not just a few years.
Background paper exploring the multifaceted challenge of integrating a private, primarily civil industry into the global arms-control regime established by the Chemical Weapons Convention (CWC).
The report discusses the oral health of children eligible for Medicaid, the House Committee on Energy and Commerce and its Subcommittee on Health and the Environment requested OTA to determine whether children eligible for Medicaid are provided at least a minimum level of dental care. This study compares the dental manuals of seven State Medicaid programs with a set of “basic’ dental services (which comprise shared components of various well-accepted dental guidelines) to see if States allow these particular services.
This report analyzes the case for developing a long-term, comprehensive strategic plan for civilian satellite remote sensing, and explores the elements of such a plan, if it were adopted. The report also enumerates many of the congressional decisions needed to ensure that future data needs will be satisfied.
This report reviews technologies available for hazardous waste cleanup at wood-treating sites throughout the United States. OTA found that there are many Superfund wood-treatment sites located in this country that are very similar in terms of the contaminants present and the options selected for cleanup.
This paper seeks to place the issue of climate change within an international context. Specifically, it addresses the feasibility of forging treaty agreements among countries to achieve significant worldwide reductions in emissions of greenhouse gases.
This report discusses how the loss of tropical forests and reduction in the Earth’s biological diversity has grown from development assistance concerns to themes of global debate during the last decade. At the same time that the value of biological resources to local communities and individual nations has become more fully appreciated, the connections between these resources and global environmental stability and economic development potential have been uncovered.
This report examines how the economic environment of the United States can be made more conducive to improving manufacturing performance. It considers how Federal institutions, in cooperation with industry, can develop competitiveness strategies for high-tech, fast growing industries; and how trade, financial, and technology policies could be combined into a strategic competitiveness policy.
This paper contains glossaries of terms and abbreviations compiled from selected reports issued between 1987 and 1992 by the Health Program and the Biological and Behavioral Sciences Program of the Office of Technology Assessment.
This report is a comprehensive look at the problem as we now know it, the public concerns about the problem, and DOE’s plans for addressing it. It focuses especially on the need for additional attention to those areas which DOE has neither the capability nor the credibility to handle.
This background paper examines existing intellectual-property protection for computer software-copyrights, patents, and trade secrets—and provides an overview of the often conflicting views and concerns of various stakeholders. It was prepared in response to a request from the Subcommittee on Courts, Intellectual Property, and the Administration of Justice of the House Committee on the Judiciary.
This OTA report analyzes the problem of locating and arranging services for people with dementia, presents a framework for an effective system to connect them to appropriate services, and discusses congressional policy options for establishing such a system. One of the main policy issues is whether the system should serve people with dementia exclusively or serve people with other diseases and conditions as well.
This report synthesizes current understanding of tuberculosis (TB) in the United States, including the extent of the disease, the state of research of new preventive, diagnostic, and therapeutic technologies to aid in its control, and the delivery of effective TB services. The report also provides an overview of Federal involvement in these activities.
This report examines how NIST and DOE weapons laboratories could contribute to advances in semiconductor technology aimed specifically at civilian applications. Semiconductor technology was chosen as an example of a technology focus for a civilian technology initiative, primarily because the industry had already developed a set of comprehensive technology roadmaps and the federal labs had substantial expertise in the area.
In the aftermath of the Exxon Valdez oil spill in Alaska in March, 1989, a myriad of investigations were initiated to evaluate the causes of that accident and to propose remedies. The Office of Technology Assessment was asked to study the Nation’s oil spill clean-up capabilities and to assess the technologies for responding to such catastrophic spills in the future.
This paper presents an analysis of the cost-effectiveness of colorectal cancer (CRC) screening in average-risk adults beginning at age 50. It examines the relative cost effectiveness of competing CRC screening technologies and schedules.
This paper examines what is known about the course of cervical cancer in elderly women; the effectiveness of the Pap test and its accuracy in this age group; the relative costs and effectiveness of different screening test schedules for elderly women; and the implications of these findings for Medicare.
In this paper OTA summarizes the evidence on the effectiveness and costs of colorectal cancer screening in the elderly and explores the implications for Medicare of offering this preventive technology as a Medicare benefit. Nowhere are the hard choices between potential medical benefits and high costs illustrated more clearly than with this cancer screening technology.
The background paper summarizes the evidence on the effectiveness and costs of prostate cancer screening and treatment in elderly men and explores the implications for Medicare of offering this preventive technology as a Medicare benefit.
This paper presents some empirical information on how insurers consider payment for new medical devices. It describes the survey results of medical directors affiliated with private health insurers about their coverage decisions using, as examples, three applications of lasers: laser angioplasty for opening narrowed or blocked coronary arteries; laser discectomy for treating herniated intervertebral discs; and photodynamic therapy (using a light–sensitive dye) for bladder cancer.
This paper first describes prevention and clinical preventive services, and specialties the way in which OTA uses the concept of preventive services in its analysis of current health care reform proposals. Second, the paper provides a “roadmap” to four major approaches to reform. Third, the paper summarizes the preventive services proposed under selected health care reform proposals.
The U.S. communication infrastructure is changing rapidly as a result of technological advances, deregulation, and an economic climate that is increasingly competitive. This change is affecting the way in which information is created, processed, transmitted, and provided to individuals and institutions. The report analyzes the implications of new communication technologies for business, politics, culture, and individuals, and suggests possible strategies and options for congressional consideration.
This report concludes that the value of the cystic fibrosis (CF) carrier test is the information it provides. No one can estimate in common terms what it means to an individual to possess information about his or her genetic status, especially when the value concerns reproductive decision-making. As our knowledge of the human genome increases, what we do with information such as CF carrier status will depend on the perceptions and beliefs of all Americans.
This report discusses the earth data—positional, topographic, climatological, meteorological, man–made features, and changes over time in all of these, which are increasingly important to the military. Data from these systems are bought and extensively used by the military and intelligence communities. The need to integrate data from military-unique systems as well only complicates the situation.
Part one of this report analyzes how R&D institutions currently pursuing defense missions could be more responsive and useful to civilian technology development. The Report focuses particularly on the Department of Energy’s (DOE’s) three nuclear weapons laboratories, Livermore National Laboratory, Los Alamos National Laboratory, and Sandia National Laboratories. The report examines two sectors in Part Two: new kinds of automobiles that pollute less and could reduce dependence on foreign oil, and high speed surface transportation.
This report discusses the medical malpractice system that has frequently been cited as a contributor to increasing health care costs and has been targeted in many health care reform proposals as a potential source of savings. The report first examines the nature of defensive medicine, adopting a working definition of defensive medicine that embraces the complexity of the problem from both the physician and broader public policy perspectives. Finally, it comments on the potential impact of a variety of medical malpractice reforms on the practice of defensive medicine.
This report identifies several immediate steps the Federal Government could take. First, new environmental standards, population shifts, and industrial changes have transformed the nature of many public works problems, and Federal programs must be refocused to fit the new circumstances. Second, if we expect to maintain our economic health, the Nation must increase its investment in public works, despite budget dilemmas.
This paper describes briefly the work on DoD’s Kuwait Oil Fire Health Risk Assessment to date, including the results of a pilot study of health risks, and then answers the questions addressed to OTA in PL 102-585.
This background paper provides an overview of developing country environmental problems and markets for environmental technologies and services. It discusses preliminary estimates on the amount and purposes of environmental aid provided by donor countries in 1991. The paper discusses the commercial implications of other countries’ aid for U.S. environmental firms, and the Helsinki package adopted by the OECD in late 1991 to limit commercial advantage from use of tied aid credits.
This paper reviews various possibilities of using non-reusable injection technologies for reducing HIV transmission among injecting drug users in the United States. It does not put forth the redesign of injection equipment as a policy option for congressional consideration; it merely examines some of the implications of a proposal put forth by some health experts.
This paper presents the status of national efforts to cleanup dioxin-contaminated sites and the technologies that have been used, proposed, and researched. It covers thermal and nonthermal treatment techniques as well as approaches such as stabilization and storage. It discusses the development of these technologies as well as advantages and disadvantages of their use.
This report presents the results of OTA’s investigations and analyses regarding the types of adverse environmental and health impacts that resulted from nuclear weapons production in the past. In this report, OTA suggests various initiatives that Congress could consider to establish a national policy, determine the next steps in warhead dismantlement and nuclear materials management, approach decisions on the ultimate disposition of nuclear materials, enhance the institutional capabilities necessary to ensure success, and encourage sound dismantlement and materials management in Russia.
This background paper briefly describes the Army’s chemical weapons destruction program, discusses the factors that could affect a decision to develop alternatives, discusses the alternatives, and illustrates the difficulty of gaining public acceptance of complex technical systems.
This background paper complements OTA’s background paper, Virtual Reality and Technologies of Combat Simulation, which focuses on the human-computer interface technologies used in simulations.
This background paper also responds to the request of the Congressional Sunbelt Caucus that OTA examine and judge the available evidence on whether Medicaid and Medicare patients, particularly obstetrics patients, are more litigious than other patients.
This background paper reviews and evaluates the available literature linking health insurance coverage with the utilization and process of health care services and with individual health outcomes.
This background paper uses very recent data to address that question for individuals just one year out of high school. The paper also presents data on the types of occupations that these young people engage in, and rough statistical correlations between those occupations and types of high-school-level vocational coursework.
This report discusses the pharmaceutical labeling requirements imposed on U.S.-based companies by the laws of the United States and the barriers to U.S. regulation of their labeling in other countries.
This paper summarizes the workshop discussion and contains the commissioned papers in their entirety. In June 1995, the contractors and a number of other prominent educators were invited to OTA for an all-day workshop to discuss these papers and the issues more broadly.
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