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 complements OTA’s background paper, Virtual Reality and Technologies of Combat Simulation, which focuses on the human-computer interface technologies used in simulations.

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 paper assesses the medical benefits and costs of both screening and hormone replacement therapy. It is divided into two volumes. This volume presents the results of a model that estimates the cost per year of life gained from osteoporosis screening and hormone replacement therapy in postmenopausal women.

This paper assesses the medical benefits and costs of both screening and hormone replacement therapy. It is divided into two volumes. This volume provides the basis for the assumptions about the costs and effects of screening and hormonal replacement therapy used in the cost-effectiveness model.

This background paper discusses the technological options available for use in an electronic system to deliver public assistance benefits, the privacy and security implications of such a system, and the programmatic effects of changing to an electronic delivery system. It was requested by the Subcommittee on the Handicapped of the Senate Committee on Labor and Human Resources.

This background paper reviews the progress of the industry and the law enforcement agencies in implementing the Act since its approval in October 1994.

The background paper extends the analysis of energy use into new areas by explicitly looking at how energy use has changed with the expansion of the service sector, the explosion of international trade, and greater complexity of the U.S. economy as the structure of businesses changed in response to new technologies and competitive challenges. The increasing sophistication of the U.S. economy means that the role of energy is less likely to be directly identified and is instead more likely to be an indirect factor that was added many steps before in the complex network that connects producer to consumer. This report explicitly separates direct from indirect energy use.

This report focuses on key assumptions that will affect the sizing and procurement of the new FBI system, and on other related steps that appear necessary to ensure complete and up-to-date record systems. These include full implementation of a Federal/State/local partnership for maintaining and exchanging fingerprint and criminal history records; enactment of an interstate compact or Federal legislation setting out uniform rules for the exchange of such records; standards and funding for improving criminal history record completeness and disposition reporting; and privacy and security protections for electronic fingerprint and record information.

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 report analyzes universities’, companies’, and researchers’ experiences and perspectives since enactment of federal laws to enhance technology transfer—especially as it pertains to research funded by the National Institutes of Health and the Department of Energy, the agencies funding U.S. efforts in the Human Genome Project.

This report focuses on the following two questions for the U.S. fusion energy program. First, what is the role of the Tokamak Physics Experiment (TPX), an approximately $700 million fusion reactor currently awaiting a congressional decision to begin construction? Second, what is the role of alternatives to the tokamak concept in a broad-based fusion energy program?

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 report examines the question of how telecommunication related aid policies might be designed to support both United States trade and foreign aid goals.

This paper concludes that, thus far, Department of Energy has (DOE) and its contractors have devoted little attention to cleanup worker health and safety. They have not convinced workers and managers that a “new culture” of accountability in environment, safety, and health is truly ascendent.

This background paper explores key issues concerning the Federal role in supporting national high performance computing facilities and in developing a national research and education network.

This background paper is one of four documents resulting from OTA’s study of policy issues in the prevention and treatment of osteoporosis.

The focus of this paper is the history of Department of Defense (DoD) Federally Funded Research and Development Centers (FFRDCs) over the past 50 years, which forms part of the Office of Technology Assessment (OTA) study of defense modeling and simulation.

This background paper, which describes the state-of the- art of identifying substances that can harm the immune system, represents one response to the committee’s request. Chapter 2 provides basic information about the principal components of the immune system and the general consequences that stem from perturbations to it. Chapter 3 describes methods for evaluating chemical immunotoxicity and reports on some known or suspected immunotoxicants. Chapter 4 summarizes Federal research and regulatory activities related to immunotoxicity.

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 report discusses the indirect cost of medical malpractice, commonly referred to as “defensive medicine,” that may add to overall health care costs. The cost of defensive medicine remains unknown and is subject to much speculation because there are no sound empirical data.

In June 1995, OTA convened a workshop that brought together some of the world’s leading practitioners, academic experts, experienced diplomats, and leading technologists in order to study and discuss this issue. This report contains a summary of the results of the workshop, along with the original papers presented.

This paper examines what is known about administrative costs in the health care systems of the United States and several other countries. In addition to exploring the types of activities that constitute health care administration, it reviews studies that measure and compare these activities in different countries, and it explores the potential usefulness of such comparisons.