TY - JOUR T1 - Marshaling leadership for high-value health care: An institute of medicine discussion paper AU - Gabow P, Halvorson G, Kaplan G Y1 - 2012/07/18 N1 - 10.1001/jama.2012.7081 JO - JAMA SP - 239 EP - 240 VL - 308 IS - 3 N2 - 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. SN - 0098-7484 M3 - doi: 10.1001/jama.2012.7081 UR - http://dx.doi.org/10.1001/jama.2012.7081 ER -