Powerful forces encourage the growth of medical technology (health benefits, private equity capital, public funding, pervasive academic research, consumer demand, specialist training, reimbursement mechanisms, and industry competition). Countervailing forces that inhibit growth are the costs of the technology, difficulty in evaluating clinical and cost effectiveness, unequal patient access, and misuse, overuse, and underuse. While technology funding sources continue to expand, so do the methodologies for technology assessment.

They are part of a broad movement to better manage the diffusion of medical technology. Specific proposals include more centralized planning, more discriminating federal funding, drug price controls, curtailing insurance reimbursements, more selective adoption of new technologies, and more rigorous attention to cost effectiveness. Savvy develops of and investors in new medical technology will anticipate these changes and take them into account in their planning.