Dear Senator Reid:

We write to thank you again for your leadership in the Senate health reform deliberations. We greatly appreciate the important elements of fiscal sustainability that are included in the Manager’s Amendment.

Among the features that we believe to be critical to a fiscally responsible approach to health reform is a more effective independent Medicare advisory body. The Manager’s Amendment has strengthened the role of the body, now called the Independent Payment Advisory Board. The Amendment gives the Board the authority to produce annual reports beginning in 2014 and to report on privately financed medical care as well as care financed by Medicare. In addition, its recommendations will receive fast-track consideration under a broader set of circumstances than under the Senate Leadership Bill. These are important steps toward assuring that health care reform will significantly reduce health care inflation in both the public and private sectors.

Another feature that has been strengthened is the commitment to delivery system change. The Manager’s Amendment contains several provisions that should stimulate the development of innovative approaches to payment for care. These approaches hold the promise of improving quality and lowering the costs of care. Specifically, the Manager’s Amendment includes an expansion of Medicare pilot programs and provisions for bundled payments for a larger set of conditions. These aspects of the proposed legislation make it far more likely that health care providers will have the tools and incentives to deliver better health outcomes.

As a nation, we will need to do more in the coming decade to promote the efficiency and quality of health care. The Manager’s Amendment includes important features that will move our nation’s health care forward while helping to control health expenditure growth. We are grateful for your ongoing efforts and the improvements in the Manager’s amendment. We urge expeditious enactment of your reform legislation.

Sincerely yours,

Dr. Henry Aaron, The Brookings Institution

Dr. Stuart Altman, Brandeis University

Dr. Kenneth Arrow, Stanford University, Nobel Laureate in Economics

Dr. Gary Burtless, The Brookings Institution

Dr. David Cutler, Harvard University

Dr. Patricia Danzon, University of Pennsylvania

Dr. Angus Deaton, Princeton University

Dr. Brad DeLong, University of California, Berkeley

Dr. Peter Diamond, Massachusetts Institute of Technology

Dr. Victor Fuchs, Stanford University

Dr. Alan M. Garber, Stanford University

Dr. Dana Goldman, University of Southern California

Dr. Jonathan Gruber, Massachusetts Institute of Technology

Dr. Daniel McFadden, University of California, Berkeley, Nobel Laureate in Economics

Dr. David Meltzer, University of Chicago

Dr. Joseph Newhouse, Harvard University

Dr. Uwe Reinhardt, Princeton University

Dr. Alice Rivlin, The Brookings Institution

Dr. Meredith Rosenthal, Harvard University

Dr. Isabel Sawhill, The Brookings Institution

Dr. William Sharpe, Stanford University, Nobel Laureate in Economics

Dr. John Shoven, Stanford University

Dr. Robert M. Solow, Massachusetts Institute of Technology, Nobel Laureate in Economics

Dr. Laura D’Andrea Tyson, University of California, Berkeley