{"id":"https://openalex.org/W1967062402","doi":"https://doi.org/10.1001/jama.299.9.1057","title":"Who Really Pays for Health Care?","display_name":"Who Really Pays for Health Care?","publication_year":2008,"publication_date":"2008-03-04","ids":{"openalex":"https://openalex.org/W1967062402","doi":"https://doi.org/10.1001/jama.299.9.1057","mag":"1967062402","pmid":"https://pubmed.ncbi.nlm.nih.gov/18319416"},"language":"en","primary_location":{"id":"doi:10.1001/jama.299.9.1057","doi":"https://doi.org/10.1001/jama.299.9.1057","is_oa":false,"landing_page_url":"https://doi.org/10.1001/jama.299.9.1057","pdf_url":null,"source":{"id":"https://openalex.org/S172573765","display_name":"JAMA","issn_l":"0002-9955","issn":["0002-9955","0098-7484","1538-3598","2376-8118"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320259","host_organization_name":"American Medical Association","host_organization_lineage":["https://openalex.org/P4310320259"],"host_organization_lineage_names":["American Medical Association"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"JAMA","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5108128029","display_name":"Ezekiel J. Emanuel","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1299303238","display_name":"National Institutes of Health","ror":"https://ror.org/01cwqze88","country_code":"US","type":"government","lineage":["https://openalex.org/I1299022934","https://openalex.org/I1299303238"]},{"id":"https://openalex.org/I4210155647","display_name":"National Institutes of Health Clinical Center","ror":"https://ror.org/04vfsmv21","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1299022934","https://openalex.org/I1299303238","https://openalex.org/I4210155647"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Ezekiel J. Emanuel","raw_affiliation_strings":["Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, Maryland 20892, USA. eemanuel@nih.gov"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, Maryland 20892, USA. eemanuel@nih.gov","institution_ids":["https://openalex.org/I1299303238","https://openalex.org/I4210155647"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5006848448","display_name":"Victor R. Fuchs","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Victor R. Fuchs","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":26.0746,"has_fulltext":false,"cited_by_count":63,"citation_normalized_percentile":{"value":0.99415335,"is_in_top_1_percent":true,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":89,"max":99},"biblio":{"volume":"299","issue":"9","first_page":"1057","last_page":"1057"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.9595000147819519,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.9595000147819519,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T11531","display_name":"Healthcare Systems and Reforms","score":0.039400000125169754,"subfield":{"id":"https://openalex.org/subfields/2003","display_name":"Finance"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T12708","display_name":"Economic and Financial Impacts of Cancer","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/health-care-financing","display_name":"health care financing","score":0.9139999747276306},{"id":"https://openalex.org/keywords/health-insurance-premiums","display_name":"health insurance premiums","score":0.7250000238418579},{"id":"https://openalex.org/keywords/employer-sponsored-health-insurance","display_name":"employer-sponsored health insurance","score":0.8159999847412109},{"id":"https://openalex.org/keywords/public-health-expenditure","display_name":"public health expenditure","score":0.5630000233650208},{"id":"https://openalex.org/keywords/medicare","display_name":"Medicare","score":0.7699999809265137},{"id":"https://openalex.org/keywords/medicaid","display_name":"Medicaid","score":1.0},{"id":"https://openalex.org/keywords/children-s-health-insurance-program","display_name":"State Children's Health Insurance Program","score":0.921999990940094},{"id":"https://openalex.org/keywords/health-care-reform","display_name":"health care reform","score":0.7749999761581421},{"id":"https://openalex.org/keywords/health-care-costs","display_name":"health care costs","score":0.3930000066757202}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9697617292404175},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.4581318497657776},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.41255903244018555},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.11216941475868225},{"id":"https://openalex.org/C199539241","wikidata":"https://www.wikidata.org/wiki/Q7748","display_name":"Law","level":1,"score":0.10466578602790833},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.0},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.0}],"mesh":[{"descriptor_ui":"D004651","descriptor_name":"Employment","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005102","descriptor_name":"Health Expenditures","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006076","descriptor_name":"Government","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007182","descriptor_name":"Income","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007348","descriptor_name":"Insurance, Health","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D012941","descriptor_name":"Social Responsibility","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D017048","descriptor_name":"Health Care Costs","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D018166","descriptor_name":"Health Care Reform","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true}],"locations_count":2,"locations":[{"id":"doi:10.1001/jama.299.9.1057","doi":"https://doi.org/10.1001/jama.299.9.1057","is_oa":false,"landing_page_url":"https://doi.org/10.1001/jama.299.9.1057","pdf_url":null,"source":{"id":"https://openalex.org/S172573765","display_name":"JAMA","issn_l":"0002-9955","issn":["0002-9955","0098-7484","1538-3598","2376-8118"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320259","host_organization_name":"American Medical Association","host_organization_lineage":["https://openalex.org/P4310320259"],"host_organization_lineage_names":["American Medical Association"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"JAMA","raw_type":"journal-article"},{"id":"pmid:18319416","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/18319416","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"JAMA","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":9,"referenced_works":["https://openalex.org/W1528109329","https://openalex.org/W1966318755","https://openalex.org/W1978678131","https://openalex.org/W1986911293","https://openalex.org/W2010263772","https://openalex.org/W2032158612","https://openalex.org/W2153058052","https://openalex.org/W2209409107","https://openalex.org/W2252432685"],"related_works":["https://openalex.org/W7096027633","https://openalex.org/W3009217482","https://openalex.org/W2303267931","https://openalex.org/W2058384332","https://openalex.org/W2040886894","https://openalex.org/W2953642873","https://openalex.org/W2016128581","https://openalex.org/W4290391073","https://openalex.org/W2095716022","https://openalex.org/W657993823"],"abstract_inverted_index":{"HEN":[0],"ASKED":[1],"WHO":[2],"PAYS":[3],"FOR":[4],"HEALTH":[5],"CARE":[6],"IN":[7],"THE":[8],"United":[9],"States,":[10],"the":[11,25,37,83,89],"usual":[12],"answer":[13],"is":[14],"\u201cemployers,":[15],"government,":[16],"and":[17,30,44,52,61,107],"individuals.\u201d":[18],"Most":[19],"Americans":[20],"believe":[21],"that":[22,31,91],"employers":[23],"pay":[24,33,54,77],"bulk":[26],"of":[27,48,69],"workers\u2019":[28],"premiums":[29],"governments":[32],"for":[34,55,78,99],"Medicare,":[35],"Medicaid,":[36],"State":[38],"Children\u2019s":[39],"Health":[40],"Insurance":[41],"Program":[42],"(SCHIP),":[43],"other":[45,71],"programs.":[46],"However,thisisincorrect.Employersdonotbearthecost":[47],"employment-based":[49],"insurance;":[50],"workers":[51],"households":[53],"health":[56,79,85,96,111],"insurance":[57],"through":[58],"lower":[59],"wages":[60],"higher":[62],"prices.":[63],"Moreover,":[64],"government":[65],"has":[66],"no":[67],"source":[68],"funds":[70],"than":[72],"taxes":[73],"or":[74],"borrowing":[75],"to":[76,105],"care.":[80],"Failuretounderstandthatindividualsandhouseholdsactually":[81],"foot":[82],"entire":[84],"care":[86,112],"bill":[87],"perpetuates":[88],"idea":[90],"people":[92],"can":[93],"get":[94],"great":[95],"benefits":[97],"paid":[98],"by":[100],"someone":[101],"else.":[102],"It":[103],"leads":[104],"perverse":[106],"counterproductive":[108],"ideas":[109],"regarding":[110],"reform.":[113]},"counts_by_year":[{"year":2025,"cited_by_count":2},{"year":2021,"cited_by_count":2},{"year":2020,"cited_by_count":2},{"year":2019,"cited_by_count":1},{"year":2018,"cited_by_count":3},{"year":2017,"cited_by_count":1},{"year":2016,"cited_by_count":1},{"year":2015,"cited_by_count":6},{"year":2014,"cited_by_count":1},{"year":2013,"cited_by_count":8},{"year":2012,"cited_by_count":2}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2016-06-24T00:00:00"}