TECHNOLOGY

Abstract

We must not assume, as we so often have, that any problem can be solved merely by the application of more technology, and more hardware. In the case of medicine, far-reaching cultural and economic changes will have to take place before we can develop an optional health care system—changes which need have nothing whatever to do with machines or automation. A computer, or a "patient's assistant," can improve the quality of care or render it mediocre; it can be a means of freeing medical talent for larger questions, or just larger incomes; it can increase the dignity of healing or it can cheapen and degrade the experience. These are outcomes that are relatively independent of the technology itself; as we have learned so often and so painfully, it is the social uses to which we put these capabilities that are crucial. If we don't allow a blind technological imperative to squeeze all that is human out of the healing process, if we don't let lust for maximized profit margins contaminate even more of medicine, these tools may play a role in ending the crisis of health care delivery we now face. But if we choose to approach these problems as we have approached so many others in this century, even pulling out all the plugs won't help.