Technology and medical advances are helping improve the effectiveness of care, but they have also added significantly to the price tag.
That inexorable rise in cost could be stemmed by the use of evidence-based medicine, but shifting toward that approach is controversial and difficult to implement, said a report issued in January by the Congressional Budget Office.
The report, "Technological Change and the Growth of Health Care Spending," suggests that the country will need to use more discretion in determining when to use services, or restrict the use of expensive services to when they're most effective, in order to constrain the rise of healthcare spending.
The report defines a technological advance to include any change in clinical practice that enhances the ability of providers to diagnose, treat or prevent health problems.
Spending on healthcare, primarily as a result of the growth of technology and medical advances, has grown more rapidly than the economy as a whole, the report states, and the share of national income devoted to healthcare has nearly tripled.
Technological improvements increase the capabilities of medicine and, "historically, the nature of technological advances in medicine and the changes in clinical practice that followed them have tended to raise spending," the report's writers said.
The report concludes from reviews of economic literature that about half of all growth in healthcare spending in the past several decades can be linked to changes in medical care resulting from advances in technology. Without intervention, that trend is likely to continue, the report said.
"Technological advances are likely to yield new, desirable medical services in the future, fueling further spending growth and imposing difficult choices between spending on healthcare and spending on other priorities," the report said. "If the healthcare system adopts new services rapidly and applies them broadly in the future - as it has tended to do in the past - then large increases in healthcare spending are likely to continue."
Future debates may include restrictions on the use of medical technologies to cases where evidence suggests they're cost-effective, it said.
"The added clinical benefits of new medical services are not always weighed against the added costs before those services enter common clinical practice," the report noted. "These findings suggest that some medical services could be used more selectively without a substantial loss of clinical value."