{"id":"https://openalex.org/W2021475007","doi":"https://doi.org/10.1377/hlthaff.13.3.7","title":"Medical Innovation Duels Cost Containment","display_name":"Medical Innovation Duels Cost Containment","publication_year":1994,"publication_date":"1994-01-01","ids":{"openalex":"https://openalex.org/W2021475007","doi":"https://doi.org/10.1377/hlthaff.13.3.7","mag":"2021475007","pmid":"https://pubmed.ncbi.nlm.nih.gov/7927162"},"language":"en","primary_location":{"id":"doi:10.1377/hlthaff.13.3.7","doi":"https://doi.org/10.1377/hlthaff.13.3.7","is_oa":false,"landing_page_url":"https://doi.org/10.1377/hlthaff.13.3.7","pdf_url":null,"source":{"id":"https://openalex.org/S4210185023","display_name":"Health Affairs","issn_l":"0278-2715","issn":["0278-2715","1544-5208","2694-233X"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":["anvur-scientific","dongbi-a","doyens","fnege-2","jufo-2","medline","norway-1","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315983","host_organization_name":"Project HOPE","host_organization_lineage":["https://openalex.org/P4310315983"],"host_organization_lineage_names":["Project HOPE"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health Affairs","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"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/A5089002263","display_name":"Richard A. Rettig","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Richard A. Rettig","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":["https://openalex.org/A5089002263"],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":14.6212,"has_fulltext":false,"cited_by_count":88,"citation_normalized_percentile":{"value":0.98695679,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":88,"max":99},"biblio":{"volume":"13","issue":"3","first_page":"7","last_page":"27"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.49050000309944153,"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":0.49050000309944153,"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/T11792","display_name":"Pharmaceutical Economics and Policy","score":0.38960000872612,"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/T12781","display_name":"Global Health Care Issues","score":0.05290000140666962,"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-innovation","display_name":"healthcare innovation","score":0.8849999904632568},{"id":"https://openalex.org/keywords/health-care-cost-containment","display_name":"health care cost containment","score":0.9419999718666077},{"id":"https://openalex.org/keywords/medical-technology","display_name":"medical technology","score":0.8379999995231628},{"id":"https://openalex.org/keywords/health-care-expenditure","display_name":"health care expenditure","score":0.7229999899864197},{"id":"https://openalex.org/keywords/health-policy","display_name":"health policy","score":0.6420000195503235},{"id":"https://openalex.org/keywords/medical-device-regulation","display_name":"medical device regulation","score":0.3869999945163727},{"id":"https://openalex.org/keywords/drug-regulation","display_name":"drug regulation","score":0.5479999780654907},{"id":"https://openalex.org/keywords/health-care-reform","display_name":"health care reform","score":0.6129999756813049},{"id":"https://openalex.org/keywords/technological-change","display_name":"technological change","score":0.34599998593330383},{"id":"https://openalex.org/keywords/quality-of-care","display_name":"quality of care","score":0.3370000123977661}],"concepts":[{"id":"https://openalex.org/C2776050585","wikidata":"https://www.wikidata.org/wiki/Q7439360","display_name":"Scrutiny","level":2,"score":0.6736117601394653},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.5420130491256714},{"id":"https://openalex.org/C2780627709","wikidata":"https://www.wikidata.org/wiki/Q920285","display_name":"Prologue","level":2,"score":0.5237107872962952},{"id":"https://openalex.org/C21333345","wikidata":"https://www.wikidata.org/wiki/Q1519843","display_name":"Health technology","level":3,"score":0.5214035511016846},{"id":"https://openalex.org/C94625758","wikidata":"https://www.wikidata.org/wiki/Q7163","display_name":"Politics","level":2,"score":0.49685266613960266},{"id":"https://openalex.org/C2780265253","wikidata":"https://www.wikidata.org/wiki/Q1416012","display_name":"Managed care","level":3,"score":0.45598629117012024},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.4468902349472046},{"id":"https://openalex.org/C2780765947","wikidata":"https://www.wikidata.org/wiki/Q12033531","display_name":"Administration (probate law)","level":2,"score":0.44402581453323364},{"id":"https://openalex.org/C2777276634","wikidata":"https://www.wikidata.org/wiki/Q211067","display_name":"Conflict of interest","level":2,"score":0.43900856375694275},{"id":"https://openalex.org/C39549134","wikidata":"https://www.wikidata.org/wiki/Q133080","display_name":"Public relations","level":1,"score":0.3970348834991455},{"id":"https://openalex.org/C199539241","wikidata":"https://www.wikidata.org/wiki/Q7748","display_name":"Law","level":1,"score":0.19646024703979492},{"id":"https://openalex.org/C142362112","wikidata":"https://www.wikidata.org/wiki/Q735","display_name":"Art","level":0,"score":0.0},{"id":"https://openalex.org/C124952713","wikidata":"https://www.wikidata.org/wiki/Q8242","display_name":"Literature","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D003363","descriptor_name":"Cost Control","qualifier_ui":"Q000331","qualifier_name":"legislation & jurisprudence","is_major_topic":false},{"descriptor_ui":"D003363","descriptor_name":"Cost Control","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":false},{"descriptor_ui":"D006291","descriptor_name":"Health Policy","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D006291","descriptor_name":"Health Policy","qualifier_ui":"Q000331","qualifier_name":"legislation & jurisprudence","is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011057","descriptor_name":"Politics","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D013673","descriptor_name":"Technology Assessment, Biomedical","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D013673","descriptor_name":"Technology Assessment, Biomedical","qualifier_ui":"Q000331","qualifier_name":"legislation & jurisprudence","is_major_topic":false},{"descriptor_ui":"D013677","descriptor_name":"Medical Laboratory Science","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D013677","descriptor_name":"Medical Laboratory Science","qualifier_ui":"Q000331","qualifier_name":"legislation & jurisprudence","is_major_topic":false},{"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":false}],"locations_count":3,"locations":[{"id":"doi:10.1377/hlthaff.13.3.7","doi":"https://doi.org/10.1377/hlthaff.13.3.7","is_oa":false,"landing_page_url":"https://doi.org/10.1377/hlthaff.13.3.7","pdf_url":null,"source":{"id":"https://openalex.org/S4210185023","display_name":"Health Affairs","issn_l":"0278-2715","issn":["0278-2715","1544-5208","2694-233X"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":["anvur-scientific","dongbi-a","doyens","fnege-2","jufo-2","medline","norway-1","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315983","host_organization_name":"Project HOPE","host_organization_lineage":["https://openalex.org/P4310315983"],"host_organization_lineage_names":["Project HOPE"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health Affairs","raw_type":"journal-article"},{"id":"pmid:7927162","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/7927162","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":"Health affairs (Project Hope)","raw_type":"Journal Article"},{"id":"pmh:oai:repository.library.georgetown.edu:10822/874958","doi":null,"is_oa":false,"landing_page_url":"http://hdl.handle.net/10822/874958","pdf_url":null,"source":{"id":"https://openalex.org/S4306402467","display_name":"DigitalGeorgetown (Georgetown University Library)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I4210145449","host_organization_name":"Center for Security and Emerging Technology","host_organization_lineage":["https://openalex.org/I4210145449"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"eweb:140853","raw_type":null}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.4043000042438507,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":35,"referenced_works":["https://openalex.org/W272932","https://openalex.org/W43857184","https://openalex.org/W1505532753","https://openalex.org/W1970622835","https://openalex.org/W1979016543","https://openalex.org/W1982935664","https://openalex.org/W1991984206","https://openalex.org/W2003709402","https://openalex.org/W2004221764","https://openalex.org/W2013932570","https://openalex.org/W2031937044","https://openalex.org/W2037814741","https://openalex.org/W2042420581","https://openalex.org/W2052649009","https://openalex.org/W2063004127","https://openalex.org/W2088400337","https://openalex.org/W2109028664","https://openalex.org/W2113267861","https://openalex.org/W2148667407","https://openalex.org/W2169942515","https://openalex.org/W2315319592","https://openalex.org/W2318957378","https://openalex.org/W2337912316","https://openalex.org/W2340774344","https://openalex.org/W2401210287","https://openalex.org/W2404469216","https://openalex.org/W2408598031","https://openalex.org/W2410633933","https://openalex.org/W2427007062","https://openalex.org/W2441405180","https://openalex.org/W2474896022","https://openalex.org/W4230578288","https://openalex.org/W4244098701","https://openalex.org/W4301705103","https://openalex.org/W4396738164"],"related_works":["https://openalex.org/W597284304","https://openalex.org/W2180710599","https://openalex.org/W7100394484","https://openalex.org/W600351894","https://openalex.org/W2001073456","https://openalex.org/W1604049451","https://openalex.org/W2344294059","https://openalex.org/W2145879393","https://openalex.org/W2059100244","https://openalex.org/W192926413"],"abstract_inverted_index":{"Prologue:":[0],"However":[1],"the":[2,12,34,57,69,86,92,122,156,162,189,195,217,229,255,310,321,325],"tortuous":[3],"debate":[4],"over":[5],"health":[6,108,178,270,300],"care":[7,17,301],"reform":[8],"concludes":[9],"this":[10,52,148],"year,":[11],"pressure":[13],"on":[14,188,304],"providers":[15],"of":[16,33,43,71,124,155,158,161,165,172,191,208,232,249,254,259,312],"to":[18,38,79,90,97,113,269,280,323,338],"change":[19],"their":[20],"traditional":[21],"practices":[22],"will":[23,273],"only":[24],"escalate.":[25],"The":[26,252,266],"reason":[27],"seems":[28],"quite":[29],"obvious:":[30],"No":[31],"sector":[32],"economy":[35],"can":[36,101],"continue":[37],"consume":[39],"an":[40,185,203],"increasing":[41,299],"share":[42],"society's":[44],"resources":[45],"without":[46],"facing":[47],"more":[48],"intense":[49],"scrutiny.":[50],"Within":[51],"framework":[53],"Richard":[54],"Rettig":[55,83,142,167,183,201,221],"discusses":[56],"inevitably":[58],"sharper":[59],"conflict":[60,94,275],"that":[61,85,174],"looms":[62],"ahead":[63],"between":[64],"two":[65],"societal":[66],"goals:":[67],"moderating":[68],"growth":[70],"medical":[72,283,285],"expenditures":[73],"and":[74,197,242,288,291,317,333],"maintaining":[75],"a":[76,151,170,223,305],"world-class":[77],"capacity":[78],"innovate":[80],"in":[81,225,282,298],"medicine.":[82,313],"asserts":[84],"challenge":[87],"is":[88,143,246,296],"not":[89,117],"deny":[91],"coming":[93],"but":[95,116,126],"rather":[96],"determine":[98],"how":[99],"it":[100,128,308],"best":[102],"be":[103,331],"managed.":[104],"He":[105,245],"invokes":[106],"noted":[107],"economist":[109],"Victor":[110],"Fuchs's":[111],"imperative":[112],"\u201ctame":[114],"technology":[115,295],"destroy":[118],"it,\u201d":[119],"by":[120,194,216],"\u201cmaintaining":[121],"rate":[123],"innovation":[125,281],"redirecting":[127,140],"toward":[129],"cost-reducing,":[130],"quality-enhancing":[131],"technical":[132],"change,":[133],"or":[134],"possibly":[135],"slowing":[136],"as":[137,139],"well":[138],"it.\u201d":[141],"ideally":[144],"suited":[145],"for":[146],"illuminating":[147],"conflict.":[149],"As":[150],"senior":[152],"staff":[153],"member":[154],"Institute":[157,231],"Medicine":[159],"(IOM)":[160],"National":[163,218,256],"Academy":[164,219],"Sciences,":[166],"has":[168],"directed":[169,184,202],"number":[171],"studies":[173],"have":[175],"examined":[176],"vexing":[177],"policy":[179,341],"issues.":[180],"Most":[181],"recently":[182],"IOM":[186],"study":[187,207],"use":[190],"advisory":[192],"committees":[193],"Food":[196],"Drug":[198],"Administration.":[199],"Earlier":[200],"exhaustive,":[204],"congressionally":[205],"requested":[206],"Medicare":[209],"s":[210],"End-Stage":[211],"Renal":[212],"Disease":[213],"Program,":[214],"published":[215],"Press.":[220],"holds":[222],"doctorate":[224],"political":[226,318],"science":[227],"from":[228],"Massachusetts":[230],"Technology.":[233],"Previously":[234],"he":[235],"held":[236],"appointments":[237],"at":[238,243],"three":[239],"academic":[240],"institutions":[241],"RAND.":[244],"also":[247],"author":[248],"Cancer":[250,257],"Crusade:":[251],"Story":[253],"Act":[258],"1971":[260],"(Princeton":[261],"University":[262],"Press,":[263],"1977).":[264],"Abstract:":[265],"nation's":[267],"commitment":[268,279],"cost":[271],"control":[272],"potentially":[274],"with":[276],"its":[277],"deeper":[278],"technology\u2014drugs,":[284],"devices,":[286],"diagnostic":[287],"therapeutic":[289],"procedures,":[290],"administrative":[292],"infrastructure.":[293],"Medical":[294],"implicated":[297],"costs":[302],"because,":[303],"net":[306],"basis,":[307],"increases":[309],"capabilities":[311],"Conceptual,":[314],"methodological,":[315],"institutional,":[316],"factors":[319],"limit":[320],"ability":[322],"address":[324],"potential":[326],"conflict;":[327],"these":[328],"limits":[329],"must":[330],"confronted":[332],"addressed":[334],"if":[335],"we":[336],"are":[337],"formulate":[339],"sound":[340],"responses.":[342]},"counts_by_year":[{"year":2026,"cited_by_count":2},{"year":2021,"cited_by_count":2},{"year":2020,"cited_by_count":1},{"year":2019,"cited_by_count":3},{"year":2016,"cited_by_count":3},{"year":2015,"cited_by_count":3},{"year":2014,"cited_by_count":4},{"year":2013,"cited_by_count":6},{"year":2012,"cited_by_count":7}],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2016-06-24T00:00:00"}