Innovations and Inequities in Access to Medical Services
Improving the return on health spending requires balancing tradeoffs between promoting novel treatments and ensuring equitable access to care. In addition to being costly, medical innovations may reduce availability of older services, an understudied source of inequity. I propose a framework to study this tradeoff, where innovations reduce other treatments’ availability due to patient selection and reduced returns from specialization. Innovations lead some patients to lose access to care altogether, particularly those from high-risk groups. I apply the model to minimally-invasive valve replacement surgeries in the U.S., showing that innovation reduced local surgical volumes, particularly for patients of marginalized groups.