Want even more cost of doing nothing data nuggets? Here’s one: If we stick to the status quo, for every extra  $1 of real per capita income increase -- $1.20 will go to health care.

That’s right. Not only will we have to devote every extra dollar to health care – we’ll have to take some of what we’re spending on other things and plunk it into our health budget.

We told you a bit about the recent Health Affairs briefing on bending the cost curve, but never had a chance to come back in more detail. (You really don’t want to know how many hours we’ve spent watching Senate Finance). So here, belatedly, is an overview of the overview.

Harvard's Michael Chernew and colleagues updated their 2003 cost paper and found:

Our estimates now show that at approximately long-run average rates of excess health spending growth, 119 percent of the real increase in per capita income would be devoted to health spending over the 2007–2083 projection period.

We argue that an alternative scenario, under which health spending grew just one percentage point faster than real per capita income, is "affordable," although 53.6 percent of real income growth over the period would go to health care.

Moreover, even with the more favorable assumption, the nation would still face important challenges paying for care and dividing up the burden.

That of course is a projection, not a certainty, and it assumes we stay on the current trajectory. But the paper looks back too -- and what the authors found there is fact about the recent past, not an informed guess about the distant future. Between 1999 and 2007, health care consumed 35.7 percent of the real increase in per capita income, while the share of GDP spent on health care rose from 13.7 percent to 16.2 percent.

Chernew (who writes about this work on the RWJF blog as well) illustrated that it’s worse than being over the barrel economically:

Chernew’s conclusion, naturally, is that we need to do something about this. Pronto, Because of this:

Henry Aaron of Brookings and Joseph Newhouse of Harvard said we have plenty of options. Neither saw a single bullet for curve-bending, but both said there many potential approaches to try. One place to start, Newhouse said, is reducing low-value care and working to increase patient compliance, steps which can buy us some time while we tackle more complex payment problems. Sometimes these (relatively) simple steps are referred to as low-hanging fruit. Newhouse dubbed them “a free snack.” He also noted that convincing patients that a given treatment or procedure is “low-value” can be challenging. Why settle for a free snack when they want a free all-you-can eat buffet?

Harold Miller, president and CEO of the Network for Regional Healthcare Improvement, also has a piece in this edition of Health Affairs and he spoke too at the briefing. I’ve heard him speak before, and his presentation is easy to understand but hard to summarize. He argues of course for more value and greater efficiency -- as well as new and greater collaboration on the provider side. He also points out that we probably don’t want a one-size fits all payment system -- how we pay for a discreet episode like delivering a baby is very different than how we should pay for the multi-year care in and out of the hospital of someone with COPD or congestive heart failure. Medicare needs to lead, but other payers must follow -- and we need to know both what to pay and how to pay. You can read more about his work at PaymentReform.org.