Chernew, Michael E., Lindsay M. Sabik, Amitabh Chandra, and Joseph P. Newhouse. "Ensuring the Fiscal Sustainability of Health Care Reform." New England Journal of Medicine 362.1 (January 7, 2010): 1-3.
Much of the recent health care reform debate has focused on achieving budget neutrality over a 10-year period, but this goal is less important than the reform's long-run fiscal sustainability. If the rate of growth of health care spending continues to exceed the rate of income growth by its historical margin of more than 2 percentage points, the consequences for beneficiaries, federal and state budgets, and the entire economy — given the implied increase in tax rates and forgone consumption — will be dire.