Managing medical technology: Lessons for tee united states from Quebec andFrance

Important modifications to technology assessment, diffusion, adoption, and utilization must take place if the United States is to better employ medica l technology and save resources so as to assure access for the uninsured an d underinsured. The United States can learn from other health systems that are more successful in achieving these goals. The author selects for compar ison the health systems of France and Quebec. The discussion focuses on the differences between the three systems in the management of medical technol ogy on a range of policy-relevant dimensions, including health system struc ture, attitudes about planning versus market competition, government regula tion, the balance between decentralization and centralization, the needs of the individual and those of the society, linkages between technology asses sment and policy-making, and the importance of medical technology assessmen t for medical practice. Seven specific recommendations are made for better managing medical technology in the United States, drawing on what can be ob served from the experiences of Quebec and France.