OFFICE OF TECHNOLOGY ASSESSMENT 101 Requested by: House Committee in Energy and Commerce Hon. Henry A Waxman, Chairman of Subcommittee on Health and the Environment House Committee on Government Operations Hon. Ted Weiss, then Chairman of Subcommittee on Intergovernmental Relations and Human Resources Harmful Non-Indigenous Species in the United States September 1993 This report examines the economic, environmental, and health impacts of harmful non-indigenous species (NIS) those damaging animals, plants, and microorganisms found outside their natural range. It assesses the species' routes and rates of entry, their numbers, and their costs. The report covers technologies for making decisions about species importation and control as well as the particular methods for implementing these decisions, e.g., chemical and biological control. Additionally, the report provides a survey of Federal legislation and activities, State laws and regulations, and local, regional, and international approaches. The report highlights severe problems in Hawaii and Florida; compares NIS to genetically engineered organisms for mutually helpful lessons; and explores a future when new technology, freer trade, and climate change may propel further species spread. The report finds that the number of damaging new NIS continues to grow and those already in the country are spreading further. Thus, these issues are becoming increasingly important to Congress, to resource managers, and to those who import, sell, and use NIS. Requested by: House Committee on Merchant Marine and Fisheries Hon. Walter B. Jones, then Chairman Hon. Robert W. Davis, then Ranking Minority Member Hon. Gerry E. Studds, then Chairman, Subcommittee on Fisheries and Wildlife Conservation and the Environment Hon. Henry Nowak, then Chairman, Subcommittee on Water Resources Hon. Hertel, then Chairman, Subcommittee on Oceanography and Great Lakes House Committee on Energy and Commerce Hon. John Dingell, Chairman Endorser: Hon. Amo Houghton, member of TAB Protecting Privacy in Computerized Medical Information September 1993 The Clinton administration's health care reform proposal envisions a system for exchange of information to improve patient care, enhance resources for medical research and education and lower health care costs. The proposal relies heavily on telecommunications and information technology. This report examines the implications of computerized medical information and the challenges it brings to individual privacy. The report analyzes: 1) the nature of the privacy interest in health care information and the 102 OFFICE OF TECHNOLOGY ASSESSMENT care information and the technologies available to both computerize and protect privacy in the information; and 3) models for protection of health care information. Requested by: Senate Committee on Governmental Affairs Hon. David Pryor, Chairman, Subcommittee on Federal Services, Post Office and Civil Service House Committee on Governmental Affairs Hon. Bob Wise, Chairman, Subcommittee on Government Information, Justice and Agriculture Making Government Work: Electronic Delivery of Federal Services The report examines the potential of computer and telecommunication technologies for delivering Federal services electronically. It concludes that Congress will need to pay special attention to policy and oversight to assure that these technologies benefit all citizens-not just the affluent and highly educated and result in less costly and more effective delivery. The report provides Congress with alternative strategies for improving the performance of government by using modern information technologies. The report offers new perspectives to Congress as it considers reauthorizing the Paperwork Reduction Act and responds to the administration's "National Performance Review" and "National Information Infrastructure" initiatives. More broadly, the report will contribute to the public debate over the role of information technology in reinventing government. Requested by: Senate Committee on Governmental Affairs Hon. John Glenn, Chairman Contributions of DoE Weapons Labs and NIST to Semiconductor Technology The report assesses the potential contributions the Department of Energy nuclear weapons laborato- Requested by: OFFICE OF TECHNOLOGY ASSESSMENT 103 Energy Efficiency: Challenges and Opportunities for Electric Utilities America's electric utilities increasingly are finding that helping their customers use energy more efficiently can be a cost-effective and reliable alternative for meeting electricity demand growth. This report examines the prospects for tapping the economic and technical resources of electric utilities to increase investment in energy efficient technologies. In particular, the report focuses on the potential contributions from utility integrated resource planning (IRP) and demand-side management (DSM) programs and Federal and state regulatory reforms. The report examines recent state regulatory initiatives to encourage utility energy efficiency programs and related federal programs. The report presents a range of Federal policy initiatives for supporting these utility efforts through expanded IRP and DSM programs, and regulatory reforms, and encouraging the development and availability of energy-efficient technologies for electric utilities and their customers. Requested by: Senate Committee on Governmental Affairs Hon. John Glenn, Chairman Senate Committee on Energy and Natural Resources Hon. J. Bennett Johnston, Chairman Hon. James A. McClure, then Ranking Minority Member Hon. Timothy Wirth, then Chairman, Subcommittee on Energy Regulation and Conservation Hon. Don Nickles, Ranking Minority Member, Subcommittee on Energy Regulation and Conservation House Committee on Energy and Commerce Hon. John Dingell, Chairman Hon. Norman F. Lent, then Ranking Minority Member Hon. Philip R. Sharp, Chairman, Subcommittee on Energy and Power Hon. Carlos J. Moorhead, Ranking Minority Member, Subcommittee on Energy and Power House Committee on Science, Space and Technology Hon. James H. Scheuer, then Chairman, Subcommittee on Natural Resources, Agricultural Research, and Environment House Committee on Government Operations Hon. Mike Synar, Chairman, Subcommittee on Environment, Energy, and Natural Resources Benefit Design in Health Care Reform: Clinical Preventive Services The report examines the perception that clinical preventive services are "good investments" and, as such, are potentially good candidates for health insurance coverage. The report finds that many clinical preventive services have not been evaluated; therefore their value is unknown. Other clinical preventive services have been found to be effective in protecting health, but they would not reduce health expenditures on a large scale. A very few services have been found to be both effective and cost-saving to society. Requested by: Senate Committee on Labor and Human Resources Hon. Edward M. Kennedy, Chairman Endorsed by: House Committee on Energy and Commerce Hon. John D. Dingell, Chairman House Committee on Ways and Means, Subcommittee on Health The Ranking Minority Member Willis D. Gradison 104 OFFICE OF TECHNOLOGY ASSESSMENT Background Papers Genetic Tests and Health Insurance: Results of a Survey As we increase our knowledge of human genetic diseases and improve our ability to diagnose and predict them, concern about denial or restriction of health care insurance is often raised. Yet little is known about either health insurers' attitudes toward reimbursement for genetic tests or policies for using test results in underwriting. To assess these views and practices, OTA surveyed commercial insurers, Blue Cross and Blue Shield plans, and health maintenance organizations that offer individual or medically underwritten group policies. This background paper (part of the assessment Cystic Fibrosis and DNA Tests: Implications of Carrier Screening) summarizes information about cystic fibrosis and presents additional results that pertain to the broader topic of health insurers' practices and attitudes toward genetic information and genetic tests for diseases other than cystic fibrosis. It presents survey findings related to: how health insurers view information from various sources-e.g., genetic tests, other medical tests, or family histories—in underwriting decisions; current and future policies toward reimbursing consumers for the costs of genetic tests; and expectations about the impact and use of genetic tests and genetic information on health insurance. Genetic Counseling and Cystic Fibrosis Carrier Screening: Results of a Survey October 1992 This background paper presents results for 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 CF carrier screening, and to evaluate their attitudes regarding CF carrier screening. Federal and Private Roles in the Development and Provision of Alglucerase Therapy for Gaucher Disease October 1992 Gaucher disease is a rare inherited disorder in which the body lacks an enzyme necessary to break down fats. 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. Science and Technology Issues in Coastal Ecotourism Nature-based tourism, increasingly called "ecotourism"-one of the fastest growing sectors of tourism worldwide—is fast gaining the attention of developed and developing countries as a potential means to conserve natural resources and support sustainable economic progress. Particularly in areas with stagnant or recessionary economies, ecotourism is being looked to as a promising means to protect wildlife and ecosystems, to maintain rural aesthetic character, to provide OFFICE OF TECHNOLOGY ASSESSMENT 105 This background paper summarizes information relevant to ecotourism development and coastal resource management and, where possible, identifies issues of special concern to U.S. Atlantic and Caribbean coastal and island areas. It presents information on the ecotourism trends; identifies issues related to resource conservation, ecotourism development and management, and planning; and presents questions for further consideration. U.S. Banks and International Telecommunications U.S. banks competing in the European market for financial services are among the largest users of international telecommunications networks. Their ability to create innovative financial services and deliver them through public, private, and shared networks provides a competitive edge and allows financial services to contribute strongly to our positive trade-in-services balance. At the same time, however, reliance on electronic systems means increased risk to our national payment system, probably the most serious of the public policy issues related to U.S. banks and international telecommunications. Part of the assessment, U.S. Telecommunications Services in European Markets, this background paper focuses on exporters of trade in services as users of global networks. Coverage of Preventive Services: Provision of Selected Current October 1992 This background paper describes prevention and clinical preventive services, and specifies the way in which OTA uses the concept of preventive services in its analysis of current health care reform proposals. It provides a "roadmap" to four major approaches to reform and it summarizes the preventive services proposed under selected health care reform proposals. Hazards Ahead: Managing Cleanup Worker Health and February 1993 Cold War nuclear weapons production has left a legacy of environmental contamination that is unprecedented in scope and complexity. The Department of Energy has begun cleaning up pollution at the Nuclear Weapons Complex (NWC) an expensive, decades-long task that will require a workforce numbering tens of thousands of scientists, technicians, and laborers. Protecting their health and safety must be a major goal of this cleanup effort. Achieving this goal will require DoE to successfully confront significant technical and managerial challenges, but it also poses a unique opportunity to advance state-of-the-art occupational health and safety technologies and practices. As part of an evaluation of environmental restoration and waste management at the DoE Nuclear Weapons Complex, this background paper examines risks workers might face in cleaning up contamination at the Complex and evaluates the effectiveness of DoE's occupational safety and |
