Victor Fuchs

All Publications

• Stabilizing Health Care's Share of the GDP. The New England journal of medicine Skinner, J., Cahan, E., Fuchs, V. R. 2022

  View details for DOI 10.1056/NEJMp2114227

  View details for PubMedID 35179852

• Health Care Policy After the COVID-19 Pandemic. JAMA Fuchs, V. R. 2020

  View details for DOI 10.1001/jama.2020.10777

  View details for PubMedID 32530458

• To Control Costs Expand Managed Care and Managed Competition. JAMA Enthoven, A., Fuchs, V. R., Shortell, S. M. 2019

  View details for DOI 10.1001/jama.2019.17147

  View details for PubMedID 31697334

• Does Employment-Based Insurance Make the US Medical Care System Unfair and Inefficient? JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Fuchs, V. R. 2019; 321 (21): 2069–70

  View details for DOI 10.1001/jama.2019.4812

  View details for Web of Science ID 000470158700007

• How to Make US Health Care More Equitable and Less Costly: Begin by Replacing Employment-Based Insurance. JAMA Fuchs, V. R. 2018

  View details for PubMedID 30398514

• Is US Medical Care Inefficient? JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Fuchs, V. R. 2018; 320 (10): 971–72

  View details for DOI 10.1001/jama.2018.10779

  View details for Web of Science ID 000444341400006

• Is US Medical Care Inefficient? JAMA Fuchs, V. R. 2018; 320 (10): 971-972

  View details for DOI 10.1001/jama.2018.10779

  View details for PubMedID 30422272

• Is Single Payer the Answer for the US Health Care System? JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Fuchs, V. R. 2018; 319 (1): 15–16

  View details for PubMedID 29255843

• Social Determinants of Health: Caveats and Nuances. JAMA Fuchs, V. R. 2017; 317 (1): 25-26

  View details for DOI 10.1001/jama.2016.17335

  View details for PubMedID 28030707

• Black Gains in Life Expectancy. JAMA Fuchs, V. R. 2016; 316 (18): 1869-1870

  View details for DOI 10.1001/jama.2016.14398

  View details for PubMedID 27656867

• The weaker sex? Vulnerable men and women's resilience to socio-economic disadvantage. SSM - population health Cullen, M. R., Baiocchi, M. n., Eggleston, K. n., Loftus, P. n., Fuchs, V. n. 2016; 2: 512–24

  Abstract

  Sex differences in mortality vary over time and place as a function of social, health, and medical circumstances. The magnitude of these variations, and their response to large socioeconomic changes, suggest that biological differences cannot fully account for sex differences in survival. Drawing on a wide swath of mortality data across countries and over time, we develop a set of empiric observations with which any theory about excess male mortality and its correlates will have to contend. We show that as societies develop, M/F survival first declines and then increases, a "sex difference in mortality transition" embedded within the demographic and epidemiologic transitions. After the onset of this transition, cross-sectional variation in excess male mortality exhibits a consistent pattern of greater female resilience to mortality under socio-economic adversity. The causal mechanisms underlying these associations merit further research.

  View details for PubMedID 29349167

• The transformation of US physicians. JAMA Fuchs, V. R., Cullen, M. R. 2015; 313 (18): 1821-1822

  View details for DOI 10.1001/jama.2015.2915

  View details for PubMedID 25965225

• Major Concepts of Health Care Economics ANNALS OF INTERNAL MEDICINE Fuchs, V. R. 2015; 162 (5): 380-U96

  Abstract

  This article applies major economic concepts, such as supply, demand, monopoly, monopsony, adverse selection, and moral hazard, to central features of U.S. health care. These illustrations help explain some of the principal problems of health policy-high cost and the uninsured-and why solutions are difficult to obtain.

  View details for DOI 10.7326/M14-1183

  View details for Web of Science ID 000350238300007

  View details for PubMedID 25732280

• Critiquing US health care. JAMA Fuchs, V. R. 2014; 312 (20): 2095-6

  View details for DOI 10.1001/jama.2014.14114

  View details for PubMedID 25322201

• Restructuring medical education to meet current and future health care needs. Academic medicine Pershing, S., Fuchs, V. R. 2013; 88 (12): 1798-1801

  Abstract

  U.S. health care is changing, and it will continue to change across multiple dimensions: a different mix of patients; more ambulatory, chronic care and less acute, inpatient care; an older population; expanded insurance coverage; a team approach to care; rapid growth of subspecialty care; growing emphasis on cost-effective care; and rapid technological change. These changes demand a corresponding evolution in physician roles and training. However, despite innovation in content and teaching methods, there has been little alteration to the basic structure of medical education since the Flexner Report sparked widespread reform in 1910. Looking to the future, medical education might evolve to include preparation for a team approach to care via practical training for multispecialty collaborative practice and preparing physicians to be leaders of primary care teams that include nonphysician providers; shorter training for some physicians via flexible pathways and "fast tracks" at each phase of training; cost-effective care in clinical practice; increased training in geriatrics; and "on ramps" and "off ramps" along the physician career path for flexible training over a lifetime. Although the challenges facing the health care system are great, meeting changing health care needs must begin at the foundation, in medical education.

  View details for DOI 10.1097/ACM.0000000000000020

  View details for PubMedID 24128642

• Current challenges to academic health centers. JAMA-the journal of the American Medical Association Fuchs, V. R. 2013; 310 (10): 1021-1022

  View details for DOI 10.1001/jama.2013.227197

  View details for PubMedID 23948811

• The gross domestic product and health care spending. New England journal of medicine Fuchs, V. R. 2013; 369 (2): 107-109

  View details for DOI 10.1056/NEJMp1305298

  View details for PubMedID 23697470

• How and why US health care differs from that in other OECD countries. JAMA-the journal of the American Medical Association Fuchs, V. R. 2013; 309 (1): 33-34

  View details for DOI 10.1001/jama.2012.125458

  View details for PubMedID 23280219

• The New Demographic Transition: Most Gains in Life Expectancy Now Realized Late in Life. The journal of economic perspectives : a journal of the American Economic Association Eggleston, K. N., Fuchs, V. R. 2012; 26 (3): 137-156

  Abstract

  The share of increases in life expectancy realized after age 65 was only about 20 percent at the beginning of the 20th century for the US and 16 other countries at comparable stages of development; but that share was close to 80 percent by the dawn of the 21st century, and is almost certainly approaching 100 percent asymptotically. This new demographic transition portends a diminished survival effect on working life. For high-income countries at the forefront of the longevity transition, expected lifetime labor force participation as a percent of life expectancy is declining. Innovative policies are needed if societies wish to preserve a positive relationship running from increasing longevity to greater prosperity.

  View details for DOI 10.1257/jep.26.3.137

  View details for PubMedID 25076810

  View details for PubMedCentralID PMC4112481

• The New Demographic Transition: Most Gains in Life Expectancy Now Realized Late in Life JOURNAL OF ECONOMIC PERSPECTIVES Eggleston, K. N., Fuchs, V. R. 2012; 26 (3): 137-156

  View details for DOI 10.1257/jep.26.3.137

  View details for Web of Science ID 000307405400007

• If accountable care organizations are the answer, who should create them? JAMA : the journal of the American Medical Association Fuchs, V. R., Schaeffer, L. D. 2012; 307 (21): 2261-2

  View details for DOI 10.1001/jama.2012.5564

  View details for PubMedID 22706830

• Geographic and Racial Variation in Premature Mortality in the US: Analyzing the Disparities PLOS ONE Cullen, M. R., Cummins, C., Fuchs, V. R. 2012; 7 (4)

  Abstract

  Life expectancy at birth, estimated from United States period life tables, has been shown to vary systematically and widely by region and race. We use the same tables to estimate the probability of survival from birth to age 70 (S(70)), a measure of mortality more sensitive to disparities and more reliably calculated for small populations, to describe the variation and identify its sources in greater detail to assess the patterns of this variation. Examination of the unadjusted probability of S(70) for each US county with a sufficient population of whites and blacks reveals large geographic differences for each race-sex group. For example, white males born in the ten percent healthiest counties have a 77 percent probability of survival to age 70, but only a 61 percent chance if born in the ten percent least healthy counties. Similar geographical disparities face white women and blacks of each sex. Moreover, within each county, large differences in S(70) prevail between blacks and whites, on average 17 percentage points for men and 12 percentage points for women. In linear regressions for each race-sex group, nearly all of the geographic variation is accounted for by a common set of 22 socio-economic and environmental variables, selected for previously suspected impact on mortality; R(2) ranges from 0.86 for white males to 0.72 for black females. Analysis of black-white survival chances within each county reveals that the same variables account for most of the race gap in S(70) as well. When actual white male values for each explanatory variable are substituted for black in the black male prediction equation to assess the role explanatory variables play in the black-white survival difference, residual black-white differences at the county level shrink markedly to a mean of -2.4% (+/-2.4); for women the mean difference is -3.7% (+/-2.3).

  View details for DOI 10.1371/journal.pone.0032930

  View details for Web of Science ID 000305347400001

  View details for PubMedID 22529892

  View details for PubMedCentralID PMC3328498

• Major trends in the U.S. health economy since 1950. The New England journal of medicine Fuchs, V. R. 2012; 366 (11): 973-7

  View details for DOI 10.1056/NEJMp1200478

  View details for PubMedID 22417250

• The doctor's dilemma--what is "appropriate" care? The New England journal of medicine Fuchs, V. R. 2011; 365 (7): 585-7

  View details for DOI 10.1056/NEJMp1107283

  View details for PubMedID 21848458

• The $640 Billion Question - Why Does Cost-Effective Care Diffuse So Slowly? NEW ENGLAND JOURNAL OF MEDICINE Fuchs, V. R., Milstein, A. 2011; 364 (21): 1985-1987

  View details for DOI 10.1056/NEJMp1104675

  View details for Web of Science ID 000290952000001

  View details for PubMedID 21591938

• Government payment for health care--causes and consequences. The New England journal of medicine Fuchs, V. R. 2010; 363 (23): 2181-3

  View details for DOI 10.1056/NEJMp1011362

  View details for PubMedID 21121829

• New priorities for future biomedical innovations. The New England journal of medicine Fuchs, V. R. 2010; 363 (8): 704-6

  View details for DOI 10.1056/NEJMp0906597

  View details for PubMedID 20818873

• How to think about future health care spending. The New England journal of medicine Fuchs, V. R. 2010; 362 (11): 965-7

  View details for DOI 10.1056/NEJMp1000200

  View details for PubMedID 20220179

• Four health care reforms for 2009. The New England journal of medicine Fuchs, V. R. 2009; 361 (18): 1720-2

  View details for DOI 10.1056/NEJMp0907979

  View details for PubMedID 19812393

• Cost shifting does not reduce the cost of health care. JAMA : the journal of the American Medical Association Fuchs, V. R. 2009; 302 (9): 999-1000

  View details for DOI 10.1001/jama.2009.1278

  View details for PubMedID 19724049

• The proposed government health insurance company--no substitute for real reform. New England journal of medicine Fuchs, V. R. 2009; 360 (22): 2273-2275

  View details for DOI 10.1056/NEJMp0903655

  View details for PubMedID 19474424

• Toward a 21st-Century Health Care System: Recommendations for Health Care Reform ANNALS OF INTERNAL MEDICINE Arrow, K., Auerbach, A., Bertko, J., Brownlee, S., Casalino, L. P., Cooper, J., Crosson, F. J., Enthoven, A., Falcone, E., Feldman, R. C., Fuchs, V. R., Garber, A. M., Gold, M. R., Goldman, D., Hadfield, G. K., Hall, M. A., Horwitz, R. I., Hooven, M., Jacobson, P. D., Jost, T. S., Kotlikoff, L. J., Levin, J., Levine, S., Levy, R., Linscott, K., Luft, H. S., Mashal, R., McFadden, D., Mechanic, D., Meltzer, D., Newhouse, J. P., Noll, R. G., Pietzsch, J. B., Pizzo, P., Reischauer, R. D., Rosenbaum, S., Sage, W., Schaeffer, L. D., Sheen, E., Silber, M., Skinner, J., Shortell, S. M., Thier, S. O., Tunis, S., Wulsin, L., Yock, P., Bin Nun, G., Bryan, S., Luxenburg, O., van de Ven, W. P. 2009; 150 (7): 493-?

  Abstract

  The coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a series of workshops during which physicians, health policy experts, health insurance executives, business leaders, hospital administrators, economists, and others who represent diverse perspectives came together. This group agreed that the following 8 recommendations are fundamental to successful reform: 1. Replace the current fee-for-service payment system with a payment system that encourages and rewards innovation in the efficient delivery of quality care. The new payment system should invest in the development of outcome measures to guide payment. 2. Establish a securely funded, independent agency to sponsor and evaluate research on the comparative effectiveness of drugs, devices, and other medical interventions. 3. Simplify and rationalize federal and state laws and regulations to facilitate organizational innovation, support care coordination, and streamline financial and administrative functions. 4. Develop a health information technology infrastructure with national standards of interoperability to promote data exchange. 5. Create a national health database with the participation of all payers, delivery systems, and others who own health care data. Agree on methods to make de-identified information from this database on clinical interventions, patient outcomes, and costs available to researchers. 6. Identify revenue sources, including a cap on the tax exclusion of employer-based health insurance, to subsidize health care coverage with the goal of insuring all Americans. 7. Create state or regional insurance exchanges to pool risk, so that Americans without access to employer-based or other group insurance could obtain a standard benefits package through these exchanges. Employers should also be allowed to participate in these exchanges for their employees' coverage. 8. Create a health coverage board with broad stakeholder representation to determine and periodically update the affordable standard benefit package available through state or regional insurance exchanges.

  View details for Web of Science ID 000265117600008

  View details for PubMedID 19258550

• Reforming US health care: key considerations for the new administration. JAMA : the journal of the American Medical Association Fuchs, V. R. 2009; 301 (9): 963-4

  View details for DOI 10.1001/jama.2009.248

  View details for PubMedID 19258585

• Health Reform: Getting The Essentials Right HEALTH AFFAIRS Fuchs, V. R. 2009; 28 (2): W180-W183

  Abstract

  As the ninety-year history and failure of health care reform illustrates, it is easy for policymakers to disagree about the details of any new plan. In this Perspective, the author suggests trying a new approach this time: enacting a plan that encompasses four essential principles and then making midcourse adjustments later to get the details right. He defines the essentials as the Four Cs: coverage, cost control, coordinated care, and choice.

  View details for DOI 10.1377/hlthaff.28.2.w180

  View details for PubMedID 19151005

• Health care reform--why so much talk and so little action? The New England journal of medicine Fuchs, V. R. 2009; 360 (3): 208-9

  View details for DOI 10.1056/NEJMp0809733

  View details for PubMedID 19144935

• Three "inconvenient truths" about health care. The New England journal of medicine Fuchs, V. R. 2008; 359 (17): 1749-51

  View details for DOI 10.1056/NEJMp0807432

  View details for PubMedID 18946059

• What are the prospects for enduring comprehensive health care reform? HEALTH AFFAIRS Fuchs, V. R. 2007; 26 (6): 1542-1544

  Abstract

  Enduring reform must cover the uninsured, reduce inefficiency in funding and delivery of care, improve quality, and tame but not destroy the development of new medical technologies. Obstacles to reform include "special interests," especially as they exploit the U.S. political system; Machiavelli's Law of Reform, which favors the status quo; and the inability of reformers to agree on a common approach. Short-term prospects for enduring comprehensive reform are virtually nil. Over five to ten years, prospects are fifty-fifty unless there were a major economic, political, social, or public health crisis. In the long run, major reform is inevitable.

  View details for DOI 10.1377/hlthaff.26.6.1542

  View details for Web of Science ID 000251146300009

  View details for PubMedID 17978369

• Vouchsafe - A new health care plan. NEW REPUBLIC Emanuel, E. J., Fuchs, V. R. 2007; 236 (8-9): 14-15

  View details for Web of Science ID 000244409800009

• Employment-based health insurance: Past, present, and future HEALTH AFFAIRS Enthoven, A. C., Fuchs, V. R. 2006; 25 (6): 1538-1547

  Abstract

  We review the rise, stabilization, and decline of employment-based insurance; discuss its transformation from quasi-social insurance to a system based on actuarial principles; and suggest that the presence of Medicare and Medicaid has weakened political pressure for universal coverage. We highlight employment-based insurance's flaws: high administrative costs, inequitable sharing of costs, inability to cover large segments of the population, contribution to labor-management strife, and the inability of employers to act collectively to make health care more cost-effective. We conclude with scenarios for possible trajectories: employment-based insurance flourishes, continues to erode, or is replaced by a more comprehensive system.

  View details for DOI 10.1377/hlthaff.25.6.1538

  View details for Web of Science ID 000242033300013

  View details for PubMedID 17102178

• Health care reform: Why? What? When? HEALTH AFFAIRS Fuchs, V. R., Emanuel, E. J. 2005; 24 (6): 1399-1414

  Abstract

  Dissatisfaction with the U.S. health care system is widespread, but no consensus has emerged as to how to reform it. The principal methods of finance-employer-based insurance, means-tested insurance, and Medicare-are deeply and irreparably flawed. Policymakers confront two fundamental questions: Should reform be incremental or comprehensive? And should priority be given to reforming the financing system or to improving organization and delivery? We consider here several proposals for incremental reform and three for comprehensive reform: individual mandates with subsidies, single payer, and universal vouchers. Over the long term, reform is likely to come in response to a major war, depression, or large-scale civil unrest.

  View details for DOI 10.1377/hlthaff.24.6.1399

  View details for Web of Science ID 000235033500003

  View details for PubMedID 16284011

• Health, government, and Irving Fisher AMERICAN JOURNAL OF ECONOMICS AND SOCIOLOGY Fuchs, V. R. 2005; 64 (1): 407-426

  View details for Web of Science ID 000228108100026

• More variation in use of care, more flat-of-the-curve medicine HEALTH AFFAIRS Fuchs, V. R. 2004; 23 (6): VAR104-VAR107

  Abstract

  Variation in use of health care is ubiquitous in the United States. It is attributable to exogenous differences in supply of medical resources; to identified and unidentified economic, social, and cultural factors; and to the idiosyncratic beliefs of physicians. It is perpetuated by the parochial character of much clinical practice. Patients in high-intensity areas do not appear to have better health outcomes: Much care is "flat of the curve." A more robust scientific foundation for clinical decisions could help to reduce variations, but major reform of health care financing is probably necessary to achieve substantial improvement in the organization and delivery of care.

  View details for DOI 10.1377/hlthaff.var.104

  View details for Web of Science ID 000227835800072

  View details for PubMedID 15471787

• Reflections on the socio-economic. correlates of health 3rd International Meeting of the Global Organization Against Leukemia (GOAL) Fuchs, V. R. ELSEVIER SCIENCE BV. 2004: 653–61

  Abstract

  Income, education, occupation, age, sex, marital status, and ethnicity are all correlated with health in one context or another. This paper reflects on the difficulties encountered in deriving robust scientific conclusions from these correlations or drawing reliable policy applications. Interactions among the variables, nonlinearities, casual inference, and possible mechanisms of action are discussed. Strategies for future work are suggested, and researchers are urged to pay special attention to possible interactions among health, genes, and socio-economic variables.

  View details for DOI 10.1016/j.jhealeco.2004.04.004

  View details for Web of Science ID 000223878600005

  View details for PubMedID 15587692

• Area differences in utilization of medical care and mortality among US elderly Conference on Perspective on the Economics of Aging Fuchs, V. R., McClellan, M., Skinner, J. UNIV CHICAGO PRESS. 2004: 367–413

  View details for Web of Science ID 000230722600011

• Area differences in utilization of medical care and mortality among US elderly Conference on Perspective on the Economics of Aging Fuchs, V. R., McClellan, M., Skinner, J. UNIV CHICAGO PRESS. 2004: 367–413

  View details for Web of Science ID 000223283400010

• Floridian exceptionalism HEALTH AFFAIRS Fuchs, V. R. 2003; 22 (5): W357-W362

  View details for DOI 10.1377/hlthaff.W3.357

  View details for Web of Science ID 000185352500040

• Floridian exceptionalism. Health affairs Fuchs, V. R. 2003: W3-357 62

  Abstract

  Elderly Floridians use much more medical care and have much lower mortality rates than do their peers in other regions of the country. After demographic and other variables are controlled for, the differential between Florida and the rest of the United States is 25 percent for utilization and 10 percent for mortality among whites ages 65-84. This paper summarizes the facts about Floridian exceptionalism and reviews various possible explanations: physician inducement of utilization, differences in preferences, selective migration into and out of the state, climate, and social interactions, among others. Readers are invited to suggest their own explanations and their policy recommendations, if any.

  View details for PubMedID 15506138

• Air pollution and medical care use by older Americans: A cross-area analysis HEALTH AFFAIRS Fuchs, V. R., Frank, S. R. 2002; 21 (6): 207-214

  Abstract

  The case for reduction of air pollution has been predicated primarily on the frequently observed relationship between pollution and mortality and morbidity. Because pollution control usually involves costs, a rational public policy will weigh the benefits against the costs. This study investigates another potential benefit from pollution reduction: namely, decreased use of medical care. We find a strong relationship between particulate matter and inpatient and outpatient care at ages 65-84 across 183 metropolitan statistical areas (MSAs). The relationship is statistically significant at a very high level of confidence even after the region and population size of the areas, education, real income, racial composition, use of cigarettes, and obesity are controlled for.

  View details for Web of Science ID 000179338700031

  View details for PubMedID 12442858

• What's ahead for health insurance in the United States? The New England journal of medicine Fuchs, V. R. 2002; 346 (23): 1822-4

  View details for DOI 10.1056/NEJM200206063462314

  View details for PubMedID 12050346

• The financial problems of the elderly - A holistic view Conference on Policies for an Aging Society Fuchs, V. R. JOHNS HOPKINS UNIV PRESS. 2002: 378–389

  View details for Web of Science ID 000185027800017

• Physicians' views of the relative importance of thirty medical innovations HEALTH AFFAIRS Fuchs, V. R., Sox, H. C. 2001; 20 (5): 30-42

  Abstract

  In response to a mail survey, 225 leading general internists provided their opinions of the relative importance to patients of thirty medical innovations. They also provided information about themselves and their practices. Their responses yielded a mean score and a variability score for each innovation. Mean scores were significantly higher for innovations in procedures than in medications and for innovations to treat cardiovascular disease than for those to treat other diseases. The rankings were similar across subgroups of respondents, but the evaluations of a few innovations were significantly related to physicians' age. The greatest variability in response was usually related to the physician's patient mix.

  View details for Web of Science ID 000170862800004

  View details for PubMedID 11558715

• Medicare reform: The larger picture JOURNAL OF ECONOMIC PERSPECTIVES Fuchs, V. R. 2000; 14 (2): 57-70

  View details for Web of Science ID 000087560700004

  View details for PubMedID 15179970

• The future of health economics JOURNAL OF HEALTH ECONOMICS Fuchs, V. R. 2000; 19 (2): 141-157

  Abstract

  This paper discusses health economics as a behavioral science and as input into health policy and health services research. I illustrate the dual role with data on publications and citations of two leading health economics journals and three leading American health economists. Five important and relatively new topics in economics are commended to health economists who focus on economics as a behavioral science. This is followed by suggestions for health economists in their role of providing input to health policy and health services research. I discuss the strengths and weaknesses of economics, the role of values, and the potential for interdisciplinary and multidisciplinary research. The fourth section presents reasons why I believe the strong demand for health economics will continue, and the paper concludes with a sermon addressed primarily to recent entrants to the field.

  View details for Web of Science ID 000086327700001

  View details for PubMedID 10947574

• Health care for the elderly: How much? Who will pay for it? HEALTH AFFAIRS Fuchs, V. R. 1999; 18 (1): 11-21

  Abstract

  Health care expenditures on the elderly tend to grow about 4 percent per year more rapidly than the gross domestic product (GDP). This could plunge the nation into a severe economic and social crisis within two decades. This paper describes recent growth in age/sex-specific health care utilization by the elderly and discusses the important role of technology in that growth. It also explores the potential for the elderly to pay for additional care through increases in work and savings. Efforts to "save Medicare" will prove to be "too little, too late" unless they are embedded in broader policy initiatives that slow the rate of growth of health care spending and/or increase the income of the elderly.

  View details for Web of Science ID 000078060600003

  View details for PubMedID 9926642

• "Provide, provide": The economics of aging 1998 Conference on Medicare Reform Fuchs, V. R. UNIV CHICAGO PRESS. 1999: 15–36

  View details for Web of Science ID 000089281700002

• Economists' views about parameters, values, and policies: Survey results in labor and public economics JOURNAL OF ECONOMIC LITERATURE Fuchs, V. R., Krueger, A. B., Poterba, J. M. 1998; 36 (3): 1387-1425

  View details for Web of Science ID 000076056600003

• Ethics and economics. Antagonists or allies in making health policy? Western journal of medicine Fuchs, V. R. 1998; 168 (3): 213-216

  View details for PubMedID 9549430

  View details for PubMedCentralID PMC1304872

• WHAT EVERY PHILOSOPHER SHOULD KNOW ABOUT HEALTH ECONOMICS PROCEEDINGS OF THE AMERICAN PHILOSOPHICAL SOCIETY Fuchs, V. R. 1996; 140 (2): 186-196

  View details for Web of Science ID A1996UV16900006

• Individual and social responsibility - Child care, education, medical care, and long-term care in America - Introduction National-Bureau-of-Economic-Research Conference on Individual and Social Responsibility - Child Care, Education, Medical Care, and Long-Term Care in America Fuchs, V. R. UNIV CHICAGO PRESS. 1996: 3–12

  View details for Web of Science ID A1996BF20F00001

• A CONVERSATION ABOUT HEALTH-CARE REFORM WESTERN JOURNAL OF MEDICINE Fuchs, V. R. 1994; 161 (1): 83-86

  Abstract

  Professor Victor R. Fuchs is the Henry J. Kaiser Jr Professor at Stanford (California) University, where he applies economic analysis to social problems of national concern, with special emphasis on health and medical care. He holds joint appointments in the Economics Department and the School of Medicine's Department of Health Research and Policy. Professor Fuchs is a Distinguished Fellow of the American Economic Association and a member of the American Philosophical Society, the American Academy of Arts and Sciences, and the Institute of Medicine of the National Academy of Sciences. He was the first economist to receive the Distinguished Investigator Award of the Association for Health Services Research and has also received the Baxter Foundation Health Services Research Prize. Professor Fuchs is president-elect of the American Economic Association. His latest book, The Future of Health Policy, was published by Harvard University Press in 1993. The following edited conversation between Professor Fuchs and Linda Hawes Clever, MD, Editor of the journal, took place on April 8, 1994.

  View details for Web of Science ID A1994NY52600022

  View details for PubMedID 7941523

  View details for PubMedCentralID PMC1011385

• THE CLINTON PLAN - A RESEARCHER EXAMINES REFORM HEALTH AFFAIRS Fuchs, V. R. 1994; 13 (1): 102-114

  Abstract

  The Clintons are commended for bringing health care reform to the top of the domestic policy agenda. Their plan's basic elements are summarized and critiqued, with emphasis on the problems posed by its complexity. Five false assumptions that underlie most reform proposals are examined. They concern the burden of health care costs, the significance of firm size, the effect of health care costs on global competitiveness, the relation between insurance coverage and expenditures, and the implications of health care reform for the health of the population. Three critical issues for the future of health policy are discussed: the disengagement of health insurance from employment, the taming of technologic change, and coping with an aging society.

  View details for Web of Science ID A1994MX78800013

  View details for PubMedID 8188130

• AMERICA CHILDREN - ECONOMIC PERSPECTIVES AND POLICY OPTIONS SCIENCE Fuchs, V. R., REKLIS, D. M. 1992; 255 (5040): 41-46

  Abstract

  American children are worse off than those in the previous generation in several important dimensions of mental, physical, and emotional well-being. During the 1960s cultural changes adversely affected children while their material condition improved substantially. By contrast, material conditions deteriorated in the 1980s, especially among children at the lower end of the income distribution. Public policies to improve the material condition of children require a transfer of resources from households that do not have children to those that do. Government programs such as tax credits and child allowances are more efficient and equitable than employer-mandated programs.

  View details for Web of Science ID A1992GX79100032

  View details for PubMedID 1553531

• EMPLOYEE RESPONSE TO COMPULSORY SHORT-TIME WORK INDUSTRIAL RELATIONS Fuchs, V. R., Jacobsen, J. P. 1991; 30 (3): 501-513

  View details for Web of Science ID A1991GM65100011

• ARE AMERICANS UNDERINVESTING IN THEIR CHILDREN SOCIETY Fuchs, V. R. 1991; 28 (6): 14-22

  View details for Web of Science ID A1991GD16400005

• NATIONAL-HEALTH INSURANCE REVISITED HEALTH AFFAIRS Fuchs, V. R. 1991; 10 (4): 7-17

  View details for Web of Science ID A1991GZ66200001

  View details for PubMedID 1778569

• HOW DOES CANADA DO IT - A COMPARISON OF EXPENDITURES FOR PHYSICIANS SERVICES IN THE UNITED-STATES AND CANADA NEW ENGLAND JOURNAL OF MEDICINE Fuchs, V. R., Hahn, J. S. 1990; 323 (13): 884-890

  Abstract

  As a percentage of the gross national product, expenditures for health care in the United States are considerably larger than in Canada, even though one in seven Americans is uninsured whereas all Canadians have comprehensive health insurance. Among the sectors of health care, the difference in spending is especially large for physicians' services. In 1985, per capita expenditure was $347 in the United States and only $202 (in U.S. dollars) in Canada, a ratio of 1.72. We undertook a quantitative analysis of this ratio. We found that the higher expenditures per capita in the United States are explained entirely by higher fees; the quantity of physicians' services per capita is actually lower in the United States than in Canada. U.S. fees for procedures are more than three times as high as Canadian fees; the difference in fees for evaluation and management services is about 80 percent. Despite the large difference in fees, physicians' net incomes in the United States are only about one-third higher than in Canada. A parallel analysis of Iowa and Manitoba yielded results similar to those for the United States and Canada, except that physicians' net incomes in Iowa are about 60 percent higher than in Manitoba. Updating the analysis to 1987 on the basis of changes in each country between 1985 and 1987 yielded results similar to those obtained for 1985. We suggest that increased use of physicians' services in Canada may result from universal insurance coverage and from encouragement of use by the larger number of physicians who are paid lower fees per service. U.S. physicians' net income is not increased as much as the higher U.S. fees would predict, probably because of greater overhead expenses and the lower workloads of America's procedure-oriented physicians.

  View details for Web of Science ID A1990EA11300006

  View details for PubMedID 2118594

• THE HEALTH SECTORS SHARE OF THE GROSS NATIONAL PRODUCT SCIENCE Fuchs, V. R. 1990; 247 (4942): 534-538

  Abstract

  Between 1947 and 1987 expenditures for health care in the United States grew 2.5 percent per annum faster than expenditures for other goods and services. The health sector's share of the gross national product rose from well under 5 percent in the late 1940s to more than 11 percent in the late 1980s. The expenditures gap has two components: health care prices rose 1.6 percent per annum more rapidly than other prices, while the quantity of health care grew 0.9 percent per annum faster than other quantities. Many factors, including wages, productivity, technology, and insurance contributed to these trends. No single explanation suffices, and no simple solution is apparent.

  View details for Web of Science ID A1990CM41900023

  View details for PubMedID 2300814

• WOMENS QUEST FOR ECONOMIC EQUALITY JOURNAL OF ECONOMIC PERSPECTIVES Fuchs, V. R. 1989; 3 (1): 25-41

  View details for Web of Science ID A1989T148400003

• THE COMPETITION REVOLUTION IN HEALTH-CARE HEALTH AFFAIRS Fuchs, V. R. 1988; 7 (3): 5-24

  View details for Web of Science ID A1988P320800001

  View details for PubMedID 3145916

• CITATION CLASSIC - WHO SHALL LIVE - HEALTH, ECONOMICS, AND SOCIAL CHOICE CURRENT CONTENTS/CLINICAL MEDICINE Fuchs, V. R. 1988: 16-16

  View details for Web of Science ID A1988M686700001

• CITATION CLASSIC - WHO SHALL LIVE - HEALTH, ECONOMICS, AND SOCIAL CHOICE CURRENT CONTENTS/SOCIAL & BEHAVIORAL SCIENCES Fuchs, V. R. 1988: 16-16

  View details for Web of Science ID A1988M606200001

• CITATION CLASSIC - WHO SHALL LIVE - HEALTH, ECONOMICS, AND SOCIAL CHOICE CURRENT CONTENTS/ARTS & HUMANITIES Fuchs, V. R. 1988: 16-16

  View details for Web of Science ID A1988M605600001

• VALUING HEALTH - A PRICELESS COMMODITY AMERICAN ECONOMIC REVIEW Fuchs, V. R., Zeckhauser, R. 1987; 77 (2): 263-268

  View details for Web of Science ID A1987H238400042

  View details for PubMedID 10282032

• HIS AND HERS - GENDER DIFFERENCES IN WORK AND INCOME, 1959-1979 JOURNAL OF LABOR ECONOMICS Fuchs, V. R. 1986; 4 (3): S245-S272

  View details for Web of Science ID A1986D237400015

• SEX-DIFFERENCES IN ECONOMIC WELL-BEING SCIENCE Fuchs, V. R. 1986; 232 (4749): 459-464

  Abstract

  Despite large structural changes in the economy and major antidiscrimination legislation, the economic well-being of women in comparison with that of men did not improve between 1959 and 1983. The women to men ratio of money income almost doubled, but women had less leisure while men had more, an increase in the proportion of adults not married made more women dependent on their own income, and women's share of financial responsibility for children rose. The net result for women's access to goods, services, and leisure in comparison with that of men ranged from a decrease of 15 percent to an increase of 4 percent, depending on assumptions about income sharing within households.

  View details for Web of Science ID A1986A932700020

  View details for PubMedID 17743570

• EXPENDITURES FOR REPRODUCTION-RELATED HEALTH-CARE JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Fuchs, V. R., Perreault, L. 1986; 255 (1): 76-81

  View details for Web of Science ID A1986AWP4500025

  View details for PubMedID 3079616

• HAS COST CONTAINMENT GONE TOO FAR MILBANK QUARTERLY Fuchs, V. R. 1986; 64 (3): 479-488

  Abstract

  Current cost-containment strategies will undoubtedly result in fewer health services for patients. The effects of reductions in services on health and social welfare depend upon the amount and distribution of services (relative to potential benefit) prior to cost containment, and on the size and selectivity of the reductions. Disagreement over whether cost containment has gone too far arises from disagreements about the criterion (health or social welfare), the prior distribution, and how selective the reductions will be. In the long run, selectivity will be the key to successful cost containment.

  View details for Web of Science ID A1986E188400006

  View details for PubMedID 3762506

• CASE MIX, COSTS, AND OUTCOMES - DIFFERENCES BETWEEN FACULTY AND COMMUNITY-SERVICES IN A UNIVERSITY HOSPITAL NEW ENGLAND JOURNAL OF MEDICINE Garber, A. M., Fuchs, V. R., Silverman, J. F. 1984; 310 (19): 1231-1237

  Abstract

  To gain insight into the possible consequences of prospective payment for university hospitals, we studied 2025 admissions to the faculty and community services of a university hospital, measuring differences in case mix, costs, and mortality in the hospital. The faculty service had more of the patients with costly diagnoses, but even after adjustment for diagnosis-related groups (DRGs), costs were 11 per cent higher on the faculty service (95 per cent confidence limits, 4 to 18 per cent). The percentage differential was greatest for diagnostic costs. The differential was particularly large--70 per cent (95 per cent confidence limits, 33 to 107 per cent)--for patients with a predicted probability of death of 0.25 or greater. The in-hospital mortality rate was significantly lower on the faculty service after adjustment for case mix and patient characteristics (P less than 0.05); the difference was particularly large for patients in the high-death-risk category. Comparison of a matched sample of 51 pairs of admissions from the high-death-risk category confirmed the above results with respect to costs and in-hospital mortality, but follow-up revealed that the survival rates were equal for the two services at nine months after discharge. The effect of prospective payment on the cost of care will be closely watched; we conclude that is will also be important to monitor the effect on outcomes, including hospital mortality rates.

  View details for Web of Science ID A1984SQ22900006

  View details for PubMedID 6424018

• THOUGH MUCH IS TAKEN - REFLECTIONS ON AGING, HEALTH, AND MEDICAL-CARE MILBANK MEMORIAL FUND QUARTERLY-HEALTH AND SOCIETY Fuchs, V. R. 1984; 62 (2): 143-166

  Abstract

  Public policies regarding health care for the elderly--including the Medicare program--are reconsidered with respect to six critical areas: the number of elderly, their health status, use of medical care, labor force participation, income, and their living arrangements.

  View details for Web of Science ID A1984SR82700001

  View details for PubMedID 6425716

• Who will control health care? Hospital management quarterly : HMQ Fuchs, V. R. 1983: 16-19

  Abstract

  American medicine could be consumed by conflict in the years to come, says a Stanford University professor. The "battle" for control of health care pits teaching hospitals against community hospitals, and physicians against hospital management.

  View details for PubMedID 10260893

• SELF-EMPLOYMENT AND LABOR-FORCE PARTICIPATION OF OLDER MALES JOURNAL OF HUMAN RESOURCES Fuchs, V. R. 1982; 17 (3): 339-357

  View details for Web of Science ID A1982PA14900002

• LOW-LEVEL RADIATION AND INFANT-MORTALITY HEALTH PHYSICS Fuchs, V. R. 1981; 40 (6): 847-854

  View details for Web of Science ID A1981LU63800007

  View details for PubMedID 7251360

• CHANGES IN THE PROPENSITY TO LIVE ALONE - 1950-1976 DEMOGRAPHY Michael, R. T., Fuchs, V. R., Scott, S. R. 1980; 17 (1): 39-56

  Abstract

  The growth in single-person households is a pervasive behavioral phenomenon in the United States in the post-war period. In this paper we investigate determination of the propensity to live alone, using 1970 data across states for single men and women ages 25 to 34 and for elderly widows. Income level appears to be a major determinant of the propensity to live alone. The estimated cross-state equations track about three-quarters of the increase in the propensity to live alone between 1950-1976 and suggest that income growth has been the principal identified influence. Other variables found to affect (positively) the propensity to live alone include mobility, schooling level, and for young people a measure of social climate; non-whites appear to have a somewhat lower propensity to live alone.

  View details for Web of Science ID A1980JG02400004

  View details for PubMedID 7353707

• PUBLIC-POLICY AND THE MEDICAL ESTABLISHMENT - WHOS ON 1ST JOURNAL OF MEDICAL EDUCATION Fuchs, V. R. 1979; 54 (1): 8-11

  View details for Web of Science ID A1979GD85200002

  View details for PubMedID 105134

• ECONOMICS OF HEALTH IN A POST-INDUSTRIAL SOCIETY PUBLIC INTEREST Fuchs, V. R. 1979: 3-20

  View details for Web of Science ID A1979HB96000001

  View details for PubMedID 10308941

• SUPPLY OF SURGEONS AND DEMAND FOR OPERATIONS JOURNAL OF HUMAN RESOURCES Fuchs, V. R. 1978; 13: 35-56

  Abstract

  This paper presents a multiequation, multivariate analysis of differences in the supply of surgeons and the demand for operations across geographical areas of the United States in 1963 and 1970. The results provide considerable support for the hypothesis that surgeons shift the demand for operations. Other things equal, a 10 percent increase in the surgeon/population ratio results in about a 3 percent increase in per capita utilization. Moreover, differences in supply seem to have a perverse effect on fees, raising them when the surgeon/population ratio increases. Surgeon supply is in part determined by factors unrelated to demand, especially by the attractiveness of the area as a place to live.

  View details for Web of Science ID A1978FW07600003

  View details for PubMedID 722069

• SOCIOECONOMIC-FACTORS AFFECTING UTILIZATION OF SURGICAL OPERATIONS NEW ENGLAND JOURNAL OF MEDICINE Bombardier, C., Fuchs, V. R., Lillard, L. A., Warner, K. E. 1977; 297 (13): 699-705

  Abstract

  Between 1963 and 1970 public programs were introduced to reduce inequalities in access to medical care. We examined differentials in surgical utilization among socioeconomic groups in 1970 as well as changes between 1963 and 1970. Multivariate analysis of National Health Interview Survey data indicated that large increases in surgical utilization occurred among disadvantaged groups: the aged, lower educated and nonwhites in urban areas. Some differential by race and residence remains, but is strongly related to income. Income had a large positive effect on surgical utilization, but this effect was less strong in 1970 than in 1963. Education had a negative effect on surgical utilization. Eleven surgical procedures were selected and scaled on indexes of "complexity," "urgency" and "necessity." These indexes do not vary among demographic groups that have significant differences in surgical utilization. However, lower-income groups utilized to a lesser extent procedures rated lowest on the necessity scale.

  View details for Web of Science ID A1977DV80400005

  View details for PubMedID 895790

• BISMARCK TO WOODCOCK - IRRATIONAL PURSUIT OF NATIONAL-HEALTH-INSURANCE JOURNAL OF LAW & ECONOMICS Fuchs, V. R. 1976; 19 (2): 347-359

  View details for Web of Science ID A1976CX98600009

• CONCEPTS OF HEALTH - ECONOMISTS PERSPECTIVE JOURNAL OF MEDICINE AND PHILOSOPHY Fuchs, V. R. 1976; 1 (3): 229-237

  View details for Web of Science ID A1976CE84500005

• MORE EFFECTIVE, EFFICIENT AND EQUITABLE SYSTEM WESTERN JOURNAL OF MEDICINE Fuchs, V. R. 1976; 125 (1): 3-5

  View details for Web of Science ID A1976BZ11500003

  View details for PubMedID 941449

  View details for PubMedCentralID PMC1237169

• WHY HEALTH ECONOMICS MOUNT SINAI JOURNAL OF MEDICINE Fuchs, V. R. 1973; 40 (4): 569-575

  View details for Web of Science ID A1973Q240300006

  View details for PubMedID 4541798