Chernew, Michael, R.A. Hirth, and D.M. Cutler. 2003. "Increased Spending on Health Care: How Much Can the United States Afford?" Health Affairs, 22(4): 15-25.
Perceptions of whether health care cost growth is affordable contribute greatly to pressures for health system reform. In this paper we develop a framework for thinking about affordability, concluding that a one-percentage-point gap between real per capita growth in health care costs and growth in GDP would be affordable through 2075. A two-percentage-point gap would only be affordable through 2039. In either case, the share of income growth devoted to health care would exceed historical norms. The value of care, which determines willingness to pay, and distributional issues are more important than our ability as a society to pay for care.