Medical technology in the United States and Canada: Where are we going?

U.S. and Canadian policies concerning medical technology acquisition and diffusion are compared. Healthcare resources are allocated primarily through insurance incentives in the U.S. and through budget controls in Canada. Technological acquisitions, a small component of healthcare expenditures, are influenced by industry competition in the U.S., and by U.S. marketing in Canada. Healthcare utilization, a large component of expenditures, has caused similar resource allocation issues in both countries. Both countries are becoming more similar in their healthcare policies. Canada is becoming more privatized in financing healthcare services, and the U.S. is moving toward more conservative medicine. Both countries face similar challenges in technological acquisition and diffusion. Care must be taken that administrative hurdles do not alter the stream of returns to technology so that the R&D of beneficial technologies will be encouraged. Also, evaluation methods must objectively measure the economic costs and benefits of technological services so that technologies that yield net benefits to society will be promoted.