Author Affiliations: Chief executive officer, Denver Health Foundation, Denver, Colorado (Dr Gabow); chairman and chief executive officer, Kaiser Permanente, Oakland, California (Mr Halvorson); and chairman and chief executive officer, Virginia Mason Health System, Seattle, Washington (Dr Kaplan).
Health care in the United States is at a turning point, and the nation's health and economic security hang in the balance. Federal health care costs—expected to reach $950 billion this year—will become the largest contributor to the national debt.1 Medicaid costs, which now consume roughly a quarter of state budgets (including both federal and state contributions), are forcing state governments to make cuts in funding priorities such as education and infrastructure.2 The situation is dire in the private sector as well. The escalating cost of insuring employees threatens the competitiveness of US businesses,3 and rising health care costs have eliminated any appreciable gains in income for US families.4 Every purchaser of health care is feeling strained.
Gabow P, Halvorson G, Kaplan G. Marshaling Leadership for High-Value Health CareAn Institute of Medicine Discussion Paper. JAMA. 2012;308(3):239-240. doi:10.1001/jama.2012.7081