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Understanding how capacity constraints interact with service delivery requires a shift in perspective that is sometimes difficult to grasp. The disconnect between individual and group perspective is, however, easily seen by considering what happens when people try to win a gold medal at the Olympics.

2 Thomas E. Getzen, "Health Care is an Individual Necessity and a National luxury: Applying Multilevel Decision Models to the Analysis of Health Care Expenditures," Journal oj Health Economics 19 (2000): 259-270.

3 . David Mayston, "Disadvantaged Populations, Equity, and the Determinants of Health: Lessons from Down Under," in Health, Health Care and Health Economics: Perspectives on Distribution, Morris L. Barer, Thomas E. Getzen and Greg L. Stoddart, eds. (Chichester, U.K.: John Wiley & Sons, 1998).

4 Note that savings may temporarily be negative, as they are for many students who go into debt to support a lifestyle.

5 The economic definitions of "necessity" or "inferior good" and of "superior" or "luxury goods" depend solely on consumer buying behavior, whether income elasticity is less than or greater than 1.0, and not on any judgments regarding the usefulness or importance of the items, or how most people think of them. Thus bottled water, new cars and organic baby food all qualify as luxuries, while hot dogs, cheap costume jewelry and bus tickets are all termed necessities.

6 Milton Friedman and Simon Kuznets, Income from Independent Professional Practice (New York: National Bureau of Economic Research, 1945).

7 Milton Friedman, A Tlieotj of the Consumption Fvnction (Princeton, N.I.: Princeton University Press, 1957).

8 . Franco Modigliani, The Collected Papers of Franco Modigliam: Vol. 2: The life-Cycle Hypothesis of Saving (Cambridge, Mass.: MIT Press, 1980).

9 . Getzen, op. cit., 2000.

10 . Take-home advice: if you want to become rich, get in the habit of saving now, while you are still in school.

11 . Thomas E. Getzen, "Macro Forecasting of National Health Expenditures," Advances in Health Economics and Health Sen-ices Research 11 (1990): 27-48.

12 . William С Goodman, "Employment in Services Industries Affected by Recessions and Expansions" Monthly labor Review (October 2002): 1-15 (www.bls.gov).

13 . Angus Deaton, "Involuntary Savings Through Inflation," American Economic Review 67 (1977): 899-910.

14 The data for all health workers are, unfortunately, not readil, comparable across these years.

15 . Shiela Smith et al., "The Next Ten Years of Health Spending: What Does the Future Hold?" Health Affairs 17, no. 5 (September 1998): 128-141.

16 . Thomas E. Getzen, "Macro Forecasting of National Health Expenditures," Advances in Health Economics and Health Services Research 11 (1990): 27-18.

17 Thomas E. Getzen, "Forecasting Health Expenditures: Short, Medium and Long (Long) Term " Journal of Health Cure Finance 26, no. 3 (Spring 2000): 56-72.

18 . Christopher J. Ruhm, "Are Recessions Good For Your Health?" The Quarterly Journal of Economics CXV (May 2000): 617-650; "Good Times Make You Sick," December 2002, and "Healthy Living in Hard Times," January 2003, working papers for University of North Carolina Greensboro and NBER

19David Dranove and Kenneth Cone, "Do State Rate Regulations Really Lower Hospital Expenses?" Journal of Health tconomics 4, no. 2 (1985: 159-165; С Eby and D. Cohodes, "What Do We Know About Rate400 CHAPTER 18 DYNAMICS OF NATIONAL HEALTH SPENDING

Setting?" Journal of Health Politics, Policy & Law 10 (1985): 299-327; Michael Morrisey, Douglas Conrad, Steven Shortell, and Karen Cook, "Hospital Rate Review: A Theory and Empirical Review," journal of Health Economics 3, no. 1 (1984): 24-47.

20 . Paul Ginsburg, "Impact of the Hospital Stabilization Program on Hospitals," in M. Zubkoff, I. E. Raskin, and R. S. Hanft, eds., Hospital Cost Containment: Selected Notes for Future Policy (New York: PRODIST for Milbank Memorial Fund, 1978), 293-323.

21 . Congressional Budget Office, Rising Health Care Costs: Causes, Implications and Strategies (Washington, D.C.: U.S. Government Printing Office, 1991).

22 . Karen Davis, Gerard Anderson, Diane Rowland, and Earl Steinberg, Health Cart Cost Containment (Baltimore, Md.: Johns Hopkins University Press, 1990).

23 . Michael Kendix and Thomas Getzen, "U.S. Health Services Employment: A Time Series Analysis," Health Economics 3, no. 3 (1994): 169-181.