This background paper describes the development of alglucerase, illustrates the role that both the Federal Government and private sector can have in making new therapies available for orphan diseases, and lays out some of the tradeoffs that can exist between developing new medical technologies and controlling health care costs.

This short background paper summarizes the discussion concerning data pricing and distribution from a one-day workshop convened by OTA on May 20, 1992.

This paper presents information on the ecotourism trends; identifies issues related to resource conservation, ecotourism development and management, and planning; and presents questions for possible further consideration.

This paper presents results from a 1991 OTA survey of 431 genetic counselors and nurse geneticists. It was conducted to better understand the environment in which the average genetic counselor or nurse in genetics works, to describe the infrastructure and tools available to these professionals, to assess the state of practice in the provision of cystic fibrosis (CF) carrier screening, and to evaluate their attitudes regarding CF carrier screening.

This background paper describes results from a 1991 OTA survey of U.S. health insurers’ attitudes toward genetic tests and genetic information— both how they currently view information from various sources (e.g., genetic tests, other medical tests, or family histories) in underwriting decisions and how they might reimburse consumers for genetic tests. It also reports data on the role health insurers expect genetic tests and genetic information will play in their business practices over the coming decade.

This Background Paper examines whether the agencies responsible for administering Federal environmental and health and safety laws have taken this concern for respiratory health to heart. This paper provides a partial response to the committees’ request for an assessment of noncancer health risks in the environment and follows OTA’s previous work on carcinogenic, neurotoxic, and immunotoxic substances.

This background paper first describes the structure and management of the French defense-industrial base and then reviews a variety of strategies the French Government and industry are pursuing to rationalize the base, while preserving key technological assets and strengthening the competitive position of French defense contractors in world markets.

This background paper examines wastes generated by industrial activities that play a dominant role in our national economy-oil and gas production, mining and mineral processing, coal combustion, and manufacturing. In previous reports on municipal solid waste and medical waste, OTA examined other solid wastes not classified as hazardous.

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 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 describes what is known about the natural progression of the menopause and its effect on women’s health, hormone treatment and prescribing practices, alternative approaches, and research needs.

This background paper describes what appears to be an enlarging potential for conflict between the two, as reflected in disputes about the trade impacts of environmental laws and about the environmental impacts arising from efforts to liberalize trade and investment. The paper explores some trade and environment questions, especially from the context of the General Agreement on Tariffs and Trade, which provides a framework of rules governing most of the world’s trade.

This background paper on U.S. banks is one of several case studies prepared as part of a huger assessment of International Telecommunications Networks and U.S.-European Trade in Services.