{"id":"https://openalex.org/W2479185609","doi":"https://doi.org/10.7551/mitpress/9659.003.0007","title":"Medical Spending Reform and the Fiscal Future of the United States","display_name":"Medical Spending Reform and the Fiscal Future of the United States","publication_year":2014,"publication_date":"2014-12-26","ids":{"openalex":"https://openalex.org/W2479185609","doi":"https://doi.org/10.7551/mitpress/9659.003.0007","mag":"2479185609"},"language":"en","primary_location":{"id":"doi:10.7551/mitpress/9659.003.0007","doi":"https://doi.org/10.7551/mitpress/9659.003.0007","is_oa":false,"landing_page_url":"https://doi.org/10.7551/mitpress/9659.003.0007","pdf_url":null,"source":{"id":"https://openalex.org/S4306463997","display_name":"The MIT Press eBooks","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/P4310315718","host_organization_name":"The MIT Press","host_organization_lineage":["https://openalex.org/P4310315718","https://openalex.org/P4310316440"],"host_organization_lineage_names":["The MIT Press","Massachusetts Institute of Technology"],"type":"ebook platform"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Pathways to Fiscal Reform in the United States","raw_type":"book-chapter"},"volume":{"id":"https://openalex.org/W581171993","display_name":"Pathways to Fiscal Reform in the United States"},"type":"book-chapter","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://repository.upenn.edu/bitstreams/0083b7e9-b398-4365-8913-2d9b004d1079/download","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5072048687","display_name":"Mark V. Pauly","orcid":"https://orcid.org/0000-0003-4957-4825","observed_orcids":["https://orcid.org/0000-0003-4957-4825"]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Mark V. Pauly","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":["https://openalex.org/A5072048687"],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":3,"citation_normalized_percentile":{"value":0.15007765,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":88,"max":94},"biblio":{"volume":null,"issue":null,"first_page":"19","last_page":"53"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.8817999958992004,"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":0.8817999958992004,"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":0.10520000010728836,"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":0.0071000000461936,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/health-care-costs","display_name":"health care costs","score":0.6769999861717224},{"id":"https://openalex.org/keywords/fiscal-sustainability","display_name":"fiscal sustainability","score":0.8560000061988831},{"id":"https://openalex.org/keywords/medicare","display_name":"Medicare","score":0.9039999842643738},{"id":"https://openalex.org/keywords/medicaid","display_name":"Medicaid","score":0.9950000047683716},{"id":"https://openalex.org/keywords/health-care-reform","display_name":"health care reform","score":0.675000011920929},{"id":"https://openalex.org/keywords/federal-budget","display_name":"federal budget","score":0.43299999833106995},{"id":"https://openalex.org/keywords/health-insurance-subsidies","display_name":"health insurance subsidies","score":0.6420000195503235},{"id":"https://openalex.org/keywords/private-health-insurance-market","display_name":"private health insurance market","score":0.652999997138977}],"concepts":[{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.4908519387245178},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.4326939582824707},{"id":"https://openalex.org/C105639569","wikidata":"https://www.wikidata.org/wiki/Q582577","display_name":"Economic policy","level":1,"score":0.4000219702720642}],"mesh":[],"locations_count":4,"locations":[{"id":"doi:10.7551/mitpress/9659.003.0007","doi":"https://doi.org/10.7551/mitpress/9659.003.0007","is_oa":false,"landing_page_url":"https://doi.org/10.7551/mitpress/9659.003.0007","pdf_url":null,"source":{"id":"https://openalex.org/S4306463997","display_name":"The MIT Press eBooks","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/P4310315718","host_organization_name":"The MIT Press","host_organization_lineage":["https://openalex.org/P4310315718","https://openalex.org/P4310316440"],"host_organization_lineage_names":["The MIT Press","Massachusetts Institute of Technology"],"type":"ebook platform"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Pathways to Fiscal Reform in the United States","raw_type":"book-chapter"},{"id":"doi:10.7551/mitpress/9780262028301.003.0002","doi":"https://doi.org/10.7551/mitpress/9780262028301.003.0002","is_oa":false,"landing_page_url":"https://doi.org/10.7551/mitpress/9780262028301.003.0002","pdf_url":null,"source":{"id":"https://openalex.org/S4306463997","display_name":"The MIT Press eBooks","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/P4310315718","host_organization_name":"The MIT Press","host_organization_lineage":["https://openalex.org/P4310315718","https://openalex.org/P4310316440"],"host_organization_lineage_names":["The MIT Press","Massachusetts Institute of Technology"],"type":"ebook platform"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Pathways to Fiscal Reform in the United States","raw_type":"book-chapter"},{"id":"pmh:oai:repository.upenn.edu:hcmg_papers-1144","doi":null,"is_oa":true,"landing_page_url":"https://repository.upenn.edu/hcmg_papers/7","pdf_url":"https://repository.upenn.edu/bitstreams/0083b7e9-b398-4365-8913-2d9b004d1079/download","source":{"id":"https://openalex.org/S4306402083","display_name":"ScholarlyCommons (University of Pennsylvania)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I79576946","host_organization_name":"University of Pennsylvania","host_organization_lineage":["https://openalex.org/I79576946"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Health Care Management Papers","raw_type":"text"},{"id":"pmh:oai:repository.upenn.edu:20.500.14332/2690","doi":null,"is_oa":false,"landing_page_url":"https://repository.upenn.edu/handle/20.500.14332/2690","pdf_url":null,"source":{"id":"https://openalex.org/S4306402083","display_name":"ScholarlyCommons (University of Pennsylvania)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I79576946","host_organization_name":"University of Pennsylvania","host_organization_lineage":["https://openalex.org/I79576946"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"published","raw_type":"Presentation"}],"best_oa_location":{"id":"pmh:oai:repository.upenn.edu:hcmg_papers-1144","doi":null,"is_oa":true,"landing_page_url":"https://repository.upenn.edu/hcmg_papers/7","pdf_url":"https://repository.upenn.edu/bitstreams/0083b7e9-b398-4365-8913-2d9b004d1079/download","source":{"id":"https://openalex.org/S4306402083","display_name":"ScholarlyCommons (University of Pennsylvania)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I79576946","host_organization_name":"University of Pennsylvania","host_organization_lineage":["https://openalex.org/I79576946"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Health Care Management Papers","raw_type":"text"},"sustainable_development_goals":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W2479185609.pdf","grobid_xml":"https://content.openalex.org/works/W2479185609.grobid-xml"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W560554225","https://openalex.org/W1939020695","https://openalex.org/W1587891049","https://openalex.org/W7222931438","https://openalex.org/W7051991109","https://openalex.org/W1969663710","https://openalex.org/W1491705173","https://openalex.org/W2051101198","https://openalex.org/W2070513446","https://openalex.org/W2407954252"],"abstract_inverted_index":{"The":[0],"rate":[1,32],"of":[2,19,33,39,56,78,85,151,183,186,196,211],"growth":[3,34,52,74,113,147],"in":[4,7,35,53,75,93,103,131],"medical":[5,40,202],"spending":[6,41,48,73,112,146],"the":[8,20,27,31,51,79,82,86,94,98,127,184,187,219],"United":[9],"States":[10],"and":[11,22,43,49,66,91,97,106,121,139,161,189,192,208,221],"most":[12,18],"other":[13,76],"developed":[14,115],"countries":[15],"is":[16,23,44,59,148,158],"high":[17],"time,":[21],"commonly":[24],"higher":[25],"(over":[26],"long":[28],"term)":[29],"than":[30,71,176],"GDP.":[36],"Because":[37],"much":[38],"affects":[42],"affected":[45],"by":[46,135],"government":[47],"taxation,":[50],"this":[54,214],"share":[55],"consumption":[57],"expenditures":[58],"both":[60,179],"more":[61,68,174],"important":[62],"for":[63,109],"fiscal":[64,123,152],"policy":[65,141,153],"raises":[67],"potential":[69],"problems":[70],"consumer":[72],"sectors":[77],"economy.":[80],"Given":[81],"growing":[83],"importance":[84],"major":[87,117],"federal":[88,136],"programs":[89],"Medicare":[90],"Medicaid":[92,104],"US":[95],"budget,":[96],"impending":[99],"health":[100,205,209],"reform":[101],"expansion":[102],"eligibility":[105],"insurance":[107,133,206],"subsidies":[108],"Exchanges,":[110],"federally-financed":[111],"has":[114],"a":[116,149,159,180,190],"challenge":[118],"to":[119],"present":[120],"future":[122],"stability.":[124],"In":[125,213],"addition,":[126],"strong":[128],"role":[129],"played":[130],"private":[132,145],"markets":[134],"tax,":[137],"spending,":[138],"regulatory":[140],"means":[142],"that":[143,162,171],"even":[144],"matter":[150],"concern.":[154],"We":[155],"know":[156],"there":[157],"problem,":[160],"current":[163],"policies":[164],"are":[165],"not":[166],"sustainable.":[167],"But":[168],"designing":[169],"solutions":[170],"will":[172,217],"do":[173],"good":[175],"harm":[177],"requires":[178],"clear":[181],"idea":[182],"causes":[185],"problem":[188,220],"precise":[191],"politically":[193],"feasible":[194],"articulation":[195],"our":[197],"social":[198],"goals":[199],"concerned":[200],"with":[201],"care":[203],"use,":[204],"protection,":[207],"outcomes":[210],"Americans.":[212],"paper":[215],"I":[216],"describe":[218],"talk":[222],"about":[223],"solutions.":[224]},"counts_by_year":[{"year":2025,"cited_by_count":1},{"year":2023,"cited_by_count":1},{"year":2020,"cited_by_count":1}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2016-08-23T00:00:00"}