RT Journal
A1 Floyd JS, Wolfe SM, Angell M
T1 THe role of tax reform in health care reform
JF JAMA
JO JAMA
YR 2009
FD March 25
VO 301
IS 12
SP 1226
OP 1227
DO 10.1001/jama.2009.300
UL http://dx.doi.org/10.1001/jama.2009.300
AB 
First, a VAT would inflict a higher tax rate on the poor than the wealthy because the poor spend more of their income on consumer goods. For many poor Medicaid recipients who currently pay little or no federal taxes, a VAT would likely represent a severe financial hardship. Sessions and Lee state that this effect would be cushioned by adjusting other elements of the tax system, but they do not say how.