Technologic change has proceeded at a rapid pace during the past twent
y years, and advances that are even more remarkable in sight over the
next decade. These changes will be driven largely by advances in molec
ular and cell biology, imaging techniques, and tissue engineering. The
rapies directed toward causes rather than consequences of disease coul
d conceivably produce inexpensive cures and thus slow the rise in medi
cal costs. A more likely scenario envisions a continued rise in costs
as advances in technology produce many expensive interventions that ex
tend life but are not curative.