Report

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

Joseph Antos, John Bertko, Michael E. Chernew, David Cutler, Dana Goldman, Mark B. McClellan, Elizabeth McGlynn, Mark Pauly, Leonard Schaeffer, and Stephen Shortell

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.

Overview
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.

Authors

Joseph Antos

Wilson H. Taylor Scholar in Health Care and Retirement Policy, American Enterprise Institute

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John Bertko

Guest Scholar, Engelberg Center for Health Care Reform

Michael E. Chernew

Leonard D. Schaeffer Professor of Health Care Policy and the director of the Healthcare Markets and Regulation (HMR) Lab - Harvard Medical School

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David Cutler

Otto Eckstein Professor of Applied Economics - Harvard University

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Dana Goldman

Leonard D. Schaeffer Director's Chair and Director - USC Schaeffer Center for Health Policy and Economics

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Mark Pauly

Bendheim Professor of Health Care Systems, University of Pennsylvania

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Leonard Schaeffer

Judge Robert Maclay Widney Chair and Professor - University of Southern California

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