The technological revolution has characterized the past fifty years of medical care. Innovations in health services have dramatically improved patients' quality of life and longevity while reducing the rate of hospitalization and enhancing productivity. Nevertheless, it is clear that modern technological advances both represent and claim a large portion of current health expenditures. This article presents an historical review of the advances in health services in the USA and Israel, and the unique contribution of medical technology (MT) in determining the supply and demand in the health systems. It will outline the factors that influence the processes of health technology assessment and decision-making in allocating the appropriate utilization of MT in an era of limited resources.