Bending the Curve: A Comparative Review of the Senate Finance Committee Reform Proposal

Joseph Antos,
Joseph Antos Wilson H. Taylor Scholar in Health Care and Retirement Policy, American Enterprise Institute
John Bertko,
John Bertko Chief Actuary - Covered California
Michael E. Chernew, David M. Cutler,
(Cambridge, MA.--Monday, July 28, 2003)   David M. Cutler is Professor of Economics, Associate Dean of the Faculty of Arts and Sciences and John L. Loeb Professor of Social Sciences.  Staff Photo by Rose Lincoln/Harvard University News Office
David M. Cutler Otto Eckstein Professor of Applied Economics - Harvard University
Dana Goldman, Mark B. McClellan,
Mark B. McClellan Former Brookings Expert, Director, Margolis Center for Health Policy - Duke University
Elizabeth McGlynn, Mark Pauly,
Mark Pauly Bendheim Professor of Health Care Systems, University of Pennsylvania
, and Stephen Shortell

September 29, 2009

In early September, the Engelberg Center for Health Care Reform released a report, Bending the Curve: Effective Steps to Address Long-Term Spending Growth, to help inform the current debate. The report—aimed at identifying a concrete and feasible set of steps to slow long-term growth in health care spending—was developed by a group of leading experts in health care and economics.

This brief provides a high-level review of the legislation introduced by Senate Finance Committee Chairman Max Baucus, including a side-by-side summary of key provisions of the Bending the Curve report and those in the Baucus proposal.

The Baucus health care reform proposal offers many promising ideas to improve the overall performance of the U.S. health care system. In addition to steps that would reduce the number of Americans without insurance coverage, the plan includes ways to slow long-term spending growth while building the high-value health care system our nation urgently needs.

We believe there are important opportunities to modify or augment this proposal to further ensure that payment systems, regulations, and institutions are reformed as part of a comprehensive strategy to increase accountability and support for lowering costs and improving quality. In this review, we briefly summarize: 1) aspects of the Baucus proposal that we believe have the greatest potential to slow long-term spending growth; 2) areas not directly included in the proposal that we believe should be addressed; and 3) other aspects of the plan where modifications could increase the effectiveness of the overall reform package.

As emphasized in Bending the Curve, the individual reforms described below—and in the report itself—should not be viewed as discrete, incremental steps that alone would slow long-term spending growth. Rather, these are interdependent and reinforcing reforms that should be implemented together to improve and modernize the U.S. health care system.