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.

The international competitiveness of American firms in most manufacturing industries has been in decline, in large part because of growing competence in other parts of the world. As this assessment shows, the United States remains highly competitive in many service industries, But trade in services will remain small compared to trade in goods, and many of the benefits from foreign investments by American service firms accrue to the host nations where U.S.-based banks, insurance companies, accounting firms, and other suppliers of services do business, Services cannot right the Nation’s trade balance, even granting the many ways in which a strongly competitive service sector benefits the competitiveness of American manufacturing firms.

A report on OTA has conducted a study of a wide range of topics, some of which have recently been receiving a great deal of scrutiny inside and outside the government. In order to derive information specific enough to guide possible congressional action and to be responsive to the requesting Committees, this examination of the issues is specifically tied to particular life-sustaining technologies and their use with patients who are elderly. At the same time, much of this information is applicable to life-sustaining technology in general and to citizens of all ages.

A report on the Hazardous Materials Transportation Act, passed in 1975, is the primary Federal law governing this transportation. Largely unchanged in the past dozen years, the Act will be scrutinized carefully by Congress in the near future as it comes due for reauthorization.

This special report is the fourth in a series of OTA studies being carried out under an assessment of “New Developments in Biotechnology, ” requested by the House Committee on Energy and Commerce and the House Committee on Science, Space, and Technology. This fourth report in the series describes the levels and types of investment currently being made by the Federal, State, and private sectors. Ten major issues that affect investment were identified.

In 1984, the year after cyclosporine made its debut onto the health care market, OTA reported to Congress on the likely benefits of the drug for Medicare kidney transplant recipients. The present report, requested by the Senate Committee on Finance in the wake of the repeal of the Medicare Catastrophic Coverage Act, examines Medicare’s current immunosuppressive drug coverage dilemma and the policy tradeoffs it entails for the 1990s.

Adult education needs are difficult to define and difficult to meet; what constitutes adequate literacy changes continually as the demands facing individuals grow more complex. This report is an attempt to identify those capabilities, along with limitations, and outline how new information technologies can be marshaled to meet the goal of a fully literate citizenry.

This report identifies opportunities for and constraints to reducing Andean coca production through: 1) improving U.S. alternative development efforts and 2) applying biological control technology (bio-control) to eradicate illegally produced coca.

This report examines emerging U.S. national security requirements, surveys the current conditions and trends in the DTIB, and proposes some desirable characteristics for the future base. The report concludes with a discussion of the broad strategic choices and tactical decisions that must be considered as the Nation moves to this future base.

This report deals with the Federal research and development effort in countering terrorism, and with the state of attempts to use technology to aid in detecting and preventing attempts to introduce explosives aboard aircraft. A review of the relevant R&D programs in many agencies is provided. The second report of this study will be released in late summer 1991.

This report responds to requests from the House Committee on Energy and Commerce and the Senate Committee on Banking, Housing and Urban Affairs for an assessment of the economic and strategic implications of technology transfer to the People’s Republic of China and of Congressional actions that would affect it. In addition, the Senate Select Committee on Intelligence endorsed the study request.

This special report presents the results of OTA’s analyses of a group of factors we believe will strongly influence the future direction of U.S. oil production. These factors include the expected profitability of new investments in drilling, the potential of new oil exploration, development, and production technologies, the nature of the remaining oil resource base, and structural changes in the oil industry. The special report also provides a brief discussion of some policy options for Congress to consider if it decides to moderate the expected accelerated decline in U.S. oil production.

This report on urban ozone was requested by the Senate Committee on Environment and Public Works, the House Committee on Energy and Commerce, and its Subcommittee on Health and the Environment in anticipation of the upcoming reauthorization of the Clean Air Act. Of the air pollutants that the Act covers, ozone has been the most difficult to bring under control; it may well be the most expensive.

This background paper reviews the status of the major sectors of the maritime industry engaged in EEZ activities and notes the significant trends. Basic data on the major sectors were first prepared for OTA by the Maritime Administration. OTA then conducted a survey of industry and other interested parties and prepared the analyses in the paper.

This paper examines dichotomous designations used to define rural and urban areas and discusses how they are applied in certain Federal programs. In addition, several topologies are described that are useful in showing the diversity that exists within rural areas.

This document presents different types of OTA publications by author.

This document presents different types of OTA publications by title.

This report is an unclassified version of OTA’s Special Report, Technologies for NATO’s Followon Forces Attack Concept. It contains primarily the executive summary of the classified report, as well as the chapter on delivery systems and munitions, with classified material removed.

This report includes information on technological products released during FY1994, legislation in the 103rd Congress related to the Office of Technology Assessment (OTA), and background information on OTA itself, among other things.

A case study requested by the Office of Technology Assessment (OTA) that presents "a brief overview of selected respiratory therapy modalities, including an assessment, drawn from the available medical and scientific literature, of what is known about the efficacy or effectiveness of various respiratory therapy procedures" (p. 3).

A technical memorandum by the Office of Technology Assessment that evaluates the results of Diagnosis Related Groups and "their implications for use in the Medicare program" (p. iii).

A case study by the Office of Technology Assessment (OTA) that examines the cost effectiveness of and the evidence behind the technology of therapeutic apheresis.

An assessment by the Office of Technology Assessment (OTA) that "explores the dual relationship between medical technology and the Medicare program: Medicare policies affect the adoption and use of medical technologies, and the patterns and levels of use of medical technologies significantly affect Medicare costs" (p. iii).

An assessment by the Office of Technology Assessment that examines the "energy potential of various sources of plant and animal matter (biomass)," giving an analysis of "prominent biomass issues, summaries of four biomass fuel cycles, a description of biomass' place in two plausible energy futures, and discussions of policy options for promoting energy from biomass" (p. iii).