Technology is often presented for healthcare as an extraneous variable that can be used to explain the continuing rise in health care costs. The general consensus seems to be that most technology raises total expenditure, either through higher unit costs or through raising the volume of procedures. Recent events seem to have borne out Schwartz's forecast in 1994 that health services were on the brink of a period of rapid technological change and the consensus is that the change has cost a great deal. This chapter explores another model of how technology is determined. The changes in...

Technology is often presented for healthcare as an extraneous variable that can be used to explain the continuing rise in health care costs. The general consensus seems to be that most technology raises total expenditure, either through higher unit costs or through raising the volume of procedures. Recent events seem to have borne out Schwartz's forecast in 1994 that health services were on the brink of a period of rapid technological change and the consensus is that the change has cost a great deal. This chapter explores another model of how technology is determined. The changes in technology that have actually happened have been more diverse than was envisaged in 1994. Alongside the ‘big ticket’ technology projected by Schwartz, a ‘small ticket’ technology has grown up, which is much more available outside large hospitals in clinics, doctor's surgeries, or pharmacies. The rise of small ticket technology opens up a range of very different investment opportunities from those available in the past four decades.