OFFICE OF TECHNOLOGY ASSESSMENT 73 Prescription Drugs and Health Care Reform The prices of prescriptions drugs have risen at a faster rate than other medical expenditures (10 percent between 1989 and 1990). Currently, consumers pay the majority (72.4 percent) of prescription drug expenditures out of pocket. For some consumers, the price of some "high-tech" or other prescription drugs may be so high as to prevent their use of the drugs. This study will address questions related to the coverage, costs, and quality of prescription drugs in national health insurance reform. Should some or all prescription drugs be offered as a benefit under national health insurance reform? What restrictions should be imposed on their use? How would their inclusion/ exclusion affect patients' access to prescription drugs? How would it affect their health status? What mechanisms should be adopted to help control costs? What effect would coverage of prescription drugs have on innovation and drug R&D? Oceans and Environment Water Quality in the U.S. The quality of U. S. water is a continuing and growing concern. As Congress considers reauthorization of the Clean Water Act and the Safe Drinking Water Act, a comprehensive look at such key issues as, watershed planning, funding for municipal sewage treatment, regulation of toxic substances and wetlands protection could provide analytic support to the debate. Transnational Pollution Increased recognition of international pollution problems, prompted to a great extent by the end of the Cold War and increasing globalization of the economy, raises important questions about U. S. capabilities to assist other countries in assessing and in dealing with their pollution problems. Also unclear is the extent of the U. S. role in monitoring and enforcing international treaties that set limits on pollution. The purpose of this assessment would be to provide a context for considering international pollution problems and for setting domestic funding priorities. The Science of Ecotoxicology At least one committee of the Congress has expressed interest in better understanding research findings on Great Lakes fish and wildlife problems associated with contamination. The relationship between estrogen-related chemical contaminants in the environment and cancer revealed by recent research, indicates there may be significance for humans. The purpose of this study would be to illuminate this problem in the context of the rapidly developing science of ecotoxicology and identify appropriate areas for federal research and monitoring. Flood Control and Flood Plain Management In the aftermath of major flooding in the Upper Mississippi Valley in 1993, both Federal and state agencies have extensive studies underway to determine the extent of environmental impacts to evaluate the performance of flood control structures. This assessment would be targeted to helping Have recycling programs achieved expected positive impacts on the environment like energy and resource conservation? Have markets developed for recycled products that make the efforts self sufficient? Is there reason to believe that future trends will create new technologies and new markets for recycling and recycled products. These and related questions will be addressed in an assessment designed to see how well the national effort to recycle is progressing. If undertaken, this project would be coordinated with the potential project on Materials Flow in a Sustainable Society. |